Breastfeeding Basics

Allyson Wessells, PT, IBCLC

Breastfeeding is a developmental milestone that optimizes the health of baby, mother and the environment. Understanding why a baby breastfeeds, knowing how to be prepared to get breastfeeding started, and being familiar with signs that milk supply and baby’s growth are plentiful help minimize challenges that may occur with this natural progression.


Why Does a Baby Breastfeed?

A baby breastfeeds for nourishment that is uniquely made to meet evolving needs. A mother produces colostrum in small amounts designed for frequent feedings during the first days of a baby’s life. Consistent latching in this phase is imperative for learning how to coordinate feeding in preparation for transition to more abundant milk by days 3-5. A baby also breastfeeds for emotional attachment and comfort. This is the first of many relationships encountered in a long life ahead, and it is the start of developing trust in others. A baby breastfeeds as well for strength and development. As a baby breastfeeds, head and neck muscles are optimally growing to develop a foundation for the strength needed to eventually sit, stand and walk; jaw and mouth muscles are working toward future word formation; and the oral cavity is being expanded and molded for optimal tooth eruption and spacing.

How is Breastfeeding Best Initiated?

The initiation of breastfeeding is optimized with skin to skin contact early and often. A newborn baby’s sense of smell is strong and is designed to guide the baby toward the breast when frequent skin to skin contact is provided. Ideally, a baby will latch onto a breast to suckle within the first hour of life. This, along with continued skin to skin contact, helps establish the foundation for breastmilk supply in the weeks ahead. Seeking help to optimize position for a comfortable latch is important, especially if a baby is unable to latch early and often. Simple changes to positioning can make a big difference for latch comfort and efficiency, and prevent avoidable problems for mother and baby. If latching is difficult, massage and/or pumping to express milk as often as baby should feed helps establish a mother’s milk supply and provide calories for baby until an effective latch is achieved.

How Does Breastfeeding Work?

Breastfeeding is a supply and demand process throughout its duration, whether for 2 weeks or 2 years, as recommended by the World Health Organization. The frequency of feeding varies depending on a mother’s unique breast storage capacity. If fed on cue, babies will feed as often as needed to establish and maintain a mother’s supply relevant to storage capacity. Babies are amazing communicators through cues. Cues include turning head to one side with mouth open and bringing a hand to mouth. A baby may show cues every 30 minutes some parts of 24 hours, with a couple of 3-4 hour stretches other parts of 24 hours, with daily and weekly variations in frequency and duration corresponding with ever changing developmental needs and a mother’s storage capacity.

How Does a Family Know a Baby is Getting What is Needed?

A baby’s output is usually the best reassurance that milk supply and growth are plentiful. By day 6, a baby should sustain an output of 6-8 wet diapers/day and 3-4 soiled diapers/day. The volume a baby needs as milk supply is established remains steady if growth and output are consistent, with average total intake around 24 ounces per 24 hours from 1 to 6 months of age. Milk composition, however, changes to meet developmental needs, and any emerging needs, such as an immune boost, when mother and/or baby are exposed to an illness. Safely sleeping with or near baby is biologically normal, researched to be most restful for new families, good for a mother’s milk supply and is an important aspect of giving baby what is needed throughout the day and night.

What Kind of Support is Helpful?

While the natural progression to breastfeeding from pregnancy and childbirth has sustained humans for millennia, each modern family is unique with personal circumstances and goals when it comes to nourishing a baby. Knowing that breastfeeding is a developmental milestone no different than walking for which care is available to optimize, and that breastmilk is a living tissue no different than blood in its replicability, underscores the importance of this natural progression. Initiation of breastfeeding in our modern culture is best sustained by knowledge and understanding of how breastfeeding works, and ultimately support from family, friends and healthcare providers. Seek support early and often to establish understanding of how breastfeeding works, your unique goals and an awareness of any changing circumstances that may impact breastfeeding function. It is not an all or nothing process. While recommendations encourage exclusive breastfeeding, we strive to empower each family we see to define their own success with as much information and help as possible. Any amount of breastfeeding or breastmilk is beneficial!

Some tips on latch:

Laid back position, tummy to tummy, chest to chest, baby’s arms are out hugged around breast
Nipple aimed to nose to trigger a wide gape
Hug baby closely at shoulder blades when gape occurs, keep hands away from baby’s head; let their natural reflexes work to actively latch!

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About the author: Allyson Wessells is a physical therapist and International Board Certified Lactation Consultant (IBCLC) with Nurture Columbus, in Columbus, Ohio.  As a PT and IBCLC, she focuses on optimizing nourishment and growth for lifelong health. Other services include presentations emphasizing the importance of breastfeeding and infant neurodevelopment as foundations for preventative healthcare.

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