Ellen Steinberg's Most Important Things To Know Before Your Baby Is Born

Here's what baby expert Ellen Steinberg says are The Most Important Things to Know Before the Baby Arrives:

Although breastfeeding is natural, it is very helpful to take a good breastfeeding class before the baby is born so that you can understand the physiology and mechanics. When I teach a breastfeeding class, I focus in on what I consider to be the 2 most important topics to help you get started on the right track. The first is latching and positioning techniques; the second is developing and maintaining a good milk supply.

Latching and positioning - Although I could write a whole book on this subject, here are the most important basics. You want to hold your baby in such a way that you are comfortable, you have some control of your baby's head movement, and your baby attains a deep latch. I like to recommend the football hold position to get started. My second choice is the cross cradlehold. In both of these positions you place one hand at the base of the baby's head (to help direct his head movement toward the breast), and the other hand on your breast (to offer it to the baby). Use lots of pillows for good support. Wait until the baby's mouth is wide open before bringing him onto the breast. Make sure you latch him with an asymmetrical latch - place his bottom lip way down away from the nipple first, then bring him up and over to make contact with the top lip. Once he is on the breast, his lips should be flanged wide open, and he should create a pulling, drawing motion with his suction. You know that your baby is attached correctly if he "is stuck" to your breast and cannot come off without first breaking the suction. Many babies just pacify at the breast without actually getting a good latch. This baby is not getting milk and is not stimulating your milk supply sufficiently well. You may need assistance from a lactation consultant in order to learn good latch techniques once your baby is born.

Milk supply - During the first 3-4 days after your delivery, your body is producing a substance called colostrum. This early breastmilk is the perfect food for your baby in the perfect quantity. Your baby's stomach capacity at birth is about the size of a teaspoon. As he begins to eat, his stomach gradually stretches to accommodate the increase in milk supply.

These are the important rules for establishing a good milk supply:

• Nurse as soon as possible after the delivery.
• Nurse as frequently as your baby desires, especially in the first 3-4 days. The more the baby suckles, the sooner your full milk supply will come in.
• Nurse exclusively - no water, glucose water, formula, or pacifiers. When the baby wants to suck - give him your breast.
• Nurse without time limits - don't watch the clock. Feed your baby for as long as he is interested. Make sure you have a deep latch. Get some help from a qualified lactation professional just to be sure you and your baby are doing it right. (Many postpartum nurses have not been trained in lactation management. Ask for help from someone who has had this training.)

Once your mature milk comes in, you will notice a heavy feeling in your breasts. Your baby will be doing a lot more active suckling with audible swallowing. He will be having many more wet and dirty diapers. He may sleep longer between feedings because his stomach is feeling very full. If you produce more milk than your baby can take, you may become engorged. A good breast pump will help you to empty some of the extra milk and make you more comfortable.

If you have established a good milk supply in the first 3-5 days, keeping the supply going is the next important step. Remember the rule of supply and demand. The more milk that you give to your baby, the more milk your body knows it must produce. Make sure that you breastfeed exclusively around the clock. Skipping feedings will lead to breast discomfort, and possibly engorgement and plugged ducts. Your husband or mother may think that they are doing you a favor by letting you sleep through the night, but they are actually doing more harm than good. Your breasts need to be emptied at regular intervals. Also, feeding a baby with a bottle at this point may lead to a decreased milk supply. Eventually you will get into a rhythm where if you need to be separated from your baby, your will use your pump to substitute for that nursing session. Some mothers never use a pump because they are always with their babies. Other mothers, such as those who go to work, will pump instead of feed during the time they are away from their babies, and the baby will be supplemented until mother returns. Many working mothers have successfully maintained their milk supply.


Thanks for that great information, Ellen! Tomorrow, I'll post Ellen's most important things to have before the baby is born.