The most complete breastfeeding guide

This is an automatically translated article.

The article was professionally consulted with Master, Doctor Doan Ngoc Quynh Tram - Department of Pediatrics - Neonatology - Vinmec Nha Trang International General Hospital.
Breast milk is the ultimate source of nutrition for all infants, promoting immune system development and meeting the needs of infants under 6 months of age. Here's a guide to breastfeeding, including position, latch, frequency and duration of feedings, and vitamin supplement needs.

1. When to start breastfeeding?

Breastfeeding should begin within the first few hours after birth, with the baby resting skin-to-skin on the mother's breast. During this time, most babies are alert and enjoy breastfeeding. However, if your baby can't suckle during this time, it's not a cause for concern.
In some situations, babies or mothers have to be separated for several hours or even days after birth. During this time, the mother should still pump and store milk for the baby. It should be started as soon as possible, preferably within the first 6 hours after birth.
The first few days after giving birth, the mother secretes a small amount of condensed, light yellow milk called colostrum. Colostrum is rich in nutrients and provides all the calories a baby needs in the first few days.
Many women worry that their baby won't get enough milk right after giving birth because the mother only produces a small amount of colostrum. In fact, newborn babies already have a stockpile of enough fluids and sugars to use until the mother has more milk.
After a few days, if breastfeeding is continued, a larger amount of milk will be produced within 2-3 days. Newborns typically lose weight in the first days of life and gradually regain weight over the next 2 weeks.

2. Breastfeeding position when breastfeeding

There are many breastfeeding positions when breastfeeding. However, the best position is when the mother feels comfortable and the infant can latch on, suckle, and swallow easily. Either way, make sure the baby doesn't have to turn his or her head to feed and that the nose is in line with the mother's nipple.
Today, there are many types of breastfeeding support pillows that can help both mother and infant feel comfortable. In addition, mothers can choose to sit in a chair to both help support the baby's weight and prevent fatigue in the mother's arms, shoulders and neck.
After feeding, the baby should be placed back in its own crib. This is the safest sleeping environment and reduces the risk of sudden infant death syndrome (SIDS).
Forehand Holding Mom can do this breastfeeding position while sitting in a chair. For example, to feed on the left breast, the mother's left forearm supports the infant's head and body. The mother's left hand usually supports the baby's bottom or thigh. Some women use extra pillows to support this arm. The baby's belly should lie face down on the mother's chest and the head should be in line with the body. The mother's free hand supports and directs the breast to the baby's open mouth. The mother's thumb rests on the areola and supports the breast with the remaining fingers. Care should be taken to place the hand away from the nipple so that the thumb and fingers do not prevent the baby from latching on to the breast.
Reverse arm Same as above, but to feed on the left breast, the mother's right hand and right forearm need to support the infant's head and body. The other left hand supports the chest as above.
Carrying across the armpit (baby lying on the pillow) This position helps the mother easily see the nursing baby, suitable for women with incisions in the abdomen, large breasts, small babies or premature births. The baby is supported by a pillow when the mother is sitting, the pillow is placed so that the baby's head is level with the mother's breast.
For example to feed from the left breast, the baby's body and legs are under the mother's left arm, while the mother's left hand supports the baby's head. The other hand supports and directs the breast to the baby's open mouth.
Lying on your side Mom can do this position while lying down. However, do not lie on a waterbed, bench or recliner to avoid suffocation for the infant. For example, when breastfeeding from the left breast, the mother lies on the left side. The baby's head and body are parallel to the mother's body, and the baby's mouth is close to and facing the mother's left breast. You can put a pillow under your head, put your left hand between your head and the pillow. The other hand supports and directs the breast to the baby's open mouth. The thumb rests on the areola and the other fingers support the breast. Care should be taken to place the hand away from the nipple so as not to hinder the baby from latching on to the breast.
Lie on your back In this position, the mother lies on her side and the baby lies on her stomach between her breasts. Newborns are able to latch on to the breast more easily because they are safely on the mother's body, and the baby's reflexes also aid in latching. Mothers also find this way of breastfeeding less tiring.

3. How the baby latches on the pacifier

An infant's mouth needs to be closed around the nipple and most of the mother's areola. Proper latching will help your baby get the right amount of milk, and at the same time prevent injury and sore nipples.
Proper nipple latching must meet the following requirements:
Upper and lower lips must open at least 120°; The lower lip should be turned outward; The chin should touch the breast, the nose should be close to the breast; The cheeks must be full; The tongue should extend past the lower lip and hold below the areola during feeding (the tongue can be seen if the lower lip is pulled away). When an infant latches on properly, you may feel some discomfort for the first 30 - 60 seconds, which will subside after that. Constant discomfort can be a sign that your baby is latching on the wrong way. To avoid hurting or injuring the nipple, you should insert your clean finger into the infant's mouth to remove it. After that, you can put the baby's mouth back properly.
Signs that your baby is latching on the wrong way include:
Upper and lower lips touching at the corner of the mouth; sunken cheeks; Sounds like a click (click); The tongue is not visible below the nipple (if the lower lip is pulled down); Nipples are wrinkled after breastfeeding. In addition to latching properly, infants must be able to suck and swallow properly in order to consume adequate amounts of milk. The mother can hear the baby swallowing. An infant's jaw must move rapidly to begin receiving milk, with swallowing sounds occurring every 1-3 jaw movements.

4. Frequency and duration of breastfeeding

Women are encouraged to try to breastfeed as soon as the baby begins to show signs of hunger. Early signs of hunger include: Waking up, looking for the breast, or sucking on hands, lips, and tongue. Most babies don't cry until they're really hungry, so you shouldn't wait until your baby is crying to feed.
During the first 1-2 weeks, most babies will feed 8-12 times per day. Some babies will demand frequent feeds (about every 30-60 minutes), while others must be awakened and urged by the mother to breastfeed. You can wake your baby up by changing diapers or gently touching his feet. During the first week after birth, most doctors encourage parents to wake a sleeping baby to feed every 4 hours. Some babies will feed very often in one session and then sleep for longer periods of time.
How long each feeding lasts varies, especially during the first few weeks postpartum. Some babies only need 5 minutes, while others need 20 minutes or more. Most experts recommend that mothers breastfeed for as long as they want, depending on the initiative of the baby.
It is not necessary to switch sides between feedings. If you express milk from one breast, your baby will consume milk with a higher fat content.
When the feed is over, most babies release the nipple, relaxing the muscles of the face and hands. Newborns under 2 - 3 months often fall asleep while feeding, even falling asleep before the feeding is finished. In this case, the mother should wake the baby and encourage the baby to finish feeding. Once you've finished feeding on one breast, offer the other, even though your baby may no longer be interested.
Every baby is different, even your baby's cravings change at different times. Parents should breastfeed their babies more often when the baby shows interest.

5. How much breast feeding is enough?

Many parents worry that their children are not getting enough milk because they cannot know how much breast milk their babies have consumed. Here are a few ways parents can use to estimate if a baby is getting enough breast milk:
Diaper Tracking Record the number of wet and soiled diapers each day, especially for the first 1-2 weeks. Normally, on the 4th - 5th day after birth, newborns should have at least 6 wet diapers/day with clear or pale yellow urine. Less than 6 wet diapers, or dark yellow or orange urine is a sign that the baby is not getting enough milk, and should be reported to the doctor.
Meconium is the dark sticky stool that babies produce in the first few days after birth. A newborn's poop will be mustard yellow to light brown, usually a visible curd by days 4-5. Most babies have 4 stools a day by day 4.
Weight monitoring It's normal for babies to lose weight after birth, averaging 4 - 5 ounces (113 - 140 grams) over a few days. first day after birth. Usually, babies stop losing weight after 5 days of age and usually regain their birth weight by 2 weeks of age.
Infants who lose more weight than above are at risk of becoming dehydrated and/or developing jaundice. The doctor will try to determine the cause of the infant's weight loss and whether additional breast milk or infant formula is needed.
The American Academy of Pediatrics recommends that all breastfed babies be weighed and checked 3 to 5 days after birth and again 2 to 3 weeks after birth. The doctor will monitor for signs of jaundice, dehydration, weight loss or other complications, as well as answer questions from parents, such as when to wean off breast milk.
Maintain milk supply Breast milk will continue to be produced in the breast based on how much milk is pumped out. In other words, frequent breastfeeding triggers the release of two hormones: prolactin and oxytocin. Milk production will be reduced if milk is not pumped out regularly or if the breasts are not fully expressed. In addition, the breasts are also prone to discomfort and engorgement if you delay or skip breastfeeding.
For this reason, breastfeeding women are encouraged to breastfeed as often as the baby shows signs of hunger. Most experts recommend letting your baby empty one breast, then switch to the other.

6. Does breast milk meet the baby's needs?

There are many reasons why women choose not to breastfeed, including shame, lack of understanding of the benefits of breast milk, belief that formula is equal to breast milk, and myths about the "easiness" of breast milk. ease" of formula-feeding than breast-feeding.
Taking care of a newborn can be tiring. However, the truth is that breastfeeding doesn't take as long as formula feeding. You don't have to buy and mix formula and wash and sterilize bottles.
A full-term, normal-weight infant with a sufficient number of diapers will not need additional formula or water. Providing formula can reduce breast milk supply, especially if formula is given at bedtime or in the middle of the night instead of breastfeeding.
Even in hot climates, parents do not need to give breastfed babies under 6 months of age extra water or juice.
Nutritional supplements Some full-term breastfed babies may be offered a vitamin or mineral supplement as a liquid with a dropper or mixed into breast milk.
Vitamin D All breastfed infants should be supplemented with 400 international units (10 micrograms) of vitamin D per day, starting in the days following birth. Breast milk contains vitamin D, but it is often not enough to meet the needs of an infant. The only source of vitamin D for exclusively breastfed babies is sunlight. However, exposure to the sun carries a risk of sunburn.
The body needs vitamin D to absorb calcium and phosphorus, which are essential in bone formation. Insufficient vitamin D intake in children can lead to rickets, which makes bones fragile and fragile.
Vitamin B12 If the mother follows a vegetarian diet and does not take vitamin B12 supplements, the infant should be given a multivitamin supplement including vitamin B12. Most infant vitamin pills are full of vitamin B12.
The body needs a source of vitamin B12 to maintain blood cells. Low levels of vitamin B12 can lead to anemia, growth retardation, and other problems.
Iron Breast milk contains easily absorbed iron and usually provides enough iron for a healthy infant up to 6 months of age. Premature or low birth weight babies who are exclusively breastfed may need an iron multivitamin supplement. The specific iron needs of infants should be discussed with the physician. Iron is an essential nutrient that the body needs to produce and maintain red blood cells. Infants with low iron levels are at risk for several problems, including low red blood cell counts (anemia). Iron deficiency is also associated with weakened immune systems and growth retardation.
Regarding pacifiers, parents can use to soothe a fussy infant. However, pacifiers should not be used to delay breastfeeding. If the infant shows signs of hunger, the infant should be breastfed.
To protect children's health, parents should do well to exclusively breastfeed their babies for the first 6 months (if possible) and vaccinate on schedule. As soon as the child shows symptoms such as anorexia, fatigue, crying, it is necessary to take the child to the hospital to be consulted by a specialist for monitoring and treatment. Currently, the Pediatrics Department at Vinmec International General Hospital is trusted by many parents to examine the diseases that infants and young children are susceptible to. Vinmec brings satisfaction to customers and is highly appreciated by industry experts by::
Gathering a team of leading pediatricians: Including leading experts with high professional qualifications (professor, associate professor, doctorate, master), experienced, worked at major hospitals such as Bach Mai, 108.. The doctors are well-trained, professional, conscientious - understanding and understanding young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. Advanced techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in pediatrics more effective: neurosurgery - skull, stem cell transplant blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to play comfortably and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment.

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Reference source: update.com