Breastfeeding feels like it should be a natural harmony between baby and parent—with bodies perfectly designed for this very thing. Anyone who’s been through it, though, can tell you otherwise, likely while rocking a crying newborn and massaging sore breasts and chapped nipples.
Why is breastfeeding often so hard? Because it is a learned skill, not natural intuition. You and your baby may even be doing it for the first time. As with anything learned, it takes knowledge and practice to turn novelty into a capability.
Rest assured: breastfeeding is hard for many people, and there are some common, shared challenges (and questions) during the first weeks of breastfeeding.
How do I know if my baby is latching correctly?
Breastfeeding struggles change based on where you’re at in the process. In the beginning days and weeks, helping your baby get a good breastfeeding latch can feel like a synchronized dance you don’t know the steps to.
The newborn latch is based on how the baby opens its mouth and attaches to the nipple. Their mouth should cover the nipple and areola with their lips totally flared out (top lip is curved up and bottom lip is curved down). For you, it should feel relatively pain-free and more like a tugging sensation.
If there is a breastfeeding latch issue, you’ll likely see your infant having trouble bringing the nipple to their mouth and keeping it there. You may even notice your nipple looks flat like a pancake after your baby lets go. The primary symptom for you is pain throughout the nursing session. While a little discomfort can be expected at the beginning of the latch, it should go away after a few seconds. When we normalize pain with nursing, we teach parents that they should struggle through it. Not only is this untrue, but you can end up with damage to the nipple tissue and your emotional health.
Breastfeeding support: 5 tips to get a good latch
- Massage the nipples before feeding to elongate them.
- Hold your baby skin to skin.
- Bring your baby to you, supporting their neck, shoulders and hips; do not hunch toward your baby.
- Aim your nipple just above their top lip and tickle their mouth until it opens. Once their mouth is open, keep aiming the nipple toward the roof of their mouth until they latch on.
- Some people will use a nipple shield, which can function like a longer, firmer nipple. Nipple shields aren’t always the best answer for everyone, though. So, make sure you are getting support from a lactation specialist if you decide to try a nipple shield.
How do I know if I am producing enough breast milk?
One of the more common reasons parents supplement with formula or wean their babies early is the worry that they are not making enough milk for their baby. Sometimes, these parents have fussy babies who seem to want to nurse all the time. So it’s easy to conclude that their babies are hungry, especially if, after giving them a couple of ounces of formula, the babies settle down and sleep soundly.
While formula is absolutely an acceptable way to feed babies, for those who want to breastfeed and are worried about milk production, it’s hard to accept babies are getting enough milk when you can’t measure the intake.
Here’s the thing: newborns don’t need a large quantity of milk, especially not in their first few days of life. It takes 3-5 days for the body to make milk after birth, with babies drinking colostrum in the meantime. And milk supply will regulate within the first weeks, typically peaking by the first month. In short: it takes time.
Though not being able to see how much milk a baby gets can be frustrating—our boobs are not transparent, and we don’t have millimeter markings!—there are other ways to know if your baby is underfed or not.
Breastfeeding support: how to know baby is getting enough milk while nursing (and changes to expect in my baby’s stools during the first weeks of breastfeeding)
- By the end of the first week postpartum, a breastfed baby should have five to 10 yellow stools and at least six to eight wet diapers per day.
- By two weeks postpartum, a newborn should be back up to their birth weight.
- During the first four months, your baby should gain an average of five to eight ounces per week.
It’s interesting to note that breast tissue doesn’t fully mature until it starts the process of lactation and that’s because, as an organ, its primary function is breastfeeding. So while it’s normal for milk production to take some time, for those babies who do not produce enough wet and dirty diapers, or who have not gained sufficient weight, milk supply may be the problem.
Milk supply can sometimes be improved by pumping between feedings and nursing on demand, when possible.
Thankfully, true inadequate milk supply is rare, but it is not unusual to see it in those who have moderate to severe anemia, had a postpartum hemorrhage, have had breast reduction surgery or have insufficient milk-producing breast tissue.
If this is the case, you will usually need several visits with the lactation consultant and close follow-up. In addition to evaluating the latch and correcting any other issues, the lactation consultant can weigh the baby both before and after a feeding to determine how much milk the baby is getting from each breast.
Why is my baby having trouble breastfeeding?
Breastfeeding can go smoothly…until it doesn’t. And when it all of a sudden stops working, especially if it did before, it can feel like a major loss. In reality, it’s normal newborn breastfeeding behavior.
Maybe it’s a change in the baby’s developmental stage, an illness, a new sensitivity to what the parent is eating or trouble with teething. Perhaps it’s the milk supply. Maybe the breast pump isn’t doing a good job. There are many times when challenges can show up throughout the breastfeeding process. This is when a lactation consultant can be super helpful.
Breastfeeding support: how to spot comfort nursing
Comfort nursing is another normal part of breastfeeding when babies nurse to soothe rather than to feed. While some parents may enjoy this sense of bonding, for others, it can make the breastfeeding experience that much longer and uncomfortable. To spot when baby is suckling rather than feeding, look out for these signs:
- Frequent sessions: Baby is nursing very often for a very long time. Most breastfeeding sessions last initially up to 20 minutes per breast.
- Sucking pattern: Baby’s pattern is more rhythmic with longer pauses between sucks.
- Relaxed jaw: Baby’s jaw is relaxed without the pulling sensation or consistent swallowing that happens during nursing.
- Fussy behavior: If baby is still fussy during or right after a feeding session, they likely want comfort. Offer them something else, like a pacifier or your finger on the roof of their mouth. If they suck on your finger and fall asleep, that’s a sign they’re seeking comfort. If they suck and are still fussy, it’s a sign they’re hungry so try nursing again.
How do you combine breastfeeding and pumping?
Pumping is often part of the breastfeeding process, and doing both can, let’s face it, be daunting. To determine how to incorporate pumping, first look at why you’re doing it.
- Pumping to increase supply: latch the baby to try feeding first, and then when they’re done, pump.
- Pumping to return to work: pump between feeds to increase bottle supply. Tip: try pumping in the morning between 5 a.m.-9 a.m. because there can be more milk production at that time.
- Pumping instead of breastfeeding: pump at regular intervals throughout the day to make bottles you’ll use for feeding.
- Pumping because you’ll miss a feeding session: pump ahead of that missed session.
Breastfeeding support: how to keep pumping when you return to work
You are legally protected to pump at work in a provided private space as often as you need to. Typically, this will look like 20-minute sessions every three hours, or until your breasts feel drained. If you’re still actively breastfeeding, refrigerate the pumped milk and bring it home.
Remember that one year of breastfeeding works out to an estimated 1,800 hours, or close to five hours per day (even longer in the beginning). So, if you’re struggling with breastfeeding, contact your provider. We want to help you be successful and make sure you never feel alone in this journey!
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