You hear that you are supposed to empty your breasts of milk in order to maximise milk production but how to do this is sometimes not so clear, particularly if you have a sleepy newborn or a distracted four month old who has no patience. Jack Newman advises breast compressions to help the baby empty one side and perhaps even be satisfied with one side. His explanation is very clear. This video also explains how very young babies like a flow of milk to help them stay awake. He explains how you can help your baby drink effectively using breast compressions. Emptying your breasts effectively also helps to establish and maintain a good supply, and enables the baby to get extra milk that gets fattier and fattier as the drinking continues. Everyone's a winner.

I tried this just now with my three month old and it really worked! Especially the bit about releasing the pressure when the baby starts sucking again - that really made him do some big swallows. And I was pretty sure he'd done a good job of emptying it already - I was surprised at how much milk there was left from when I started doing the compressions to when he finally seemed to have finished!
The chin is pretty important in latching your baby on.  Getting the chin to the breast first will help the baby get a good mouthful of breast, with more of breast in her mouth on the chin side than on the top lip side.  You can often see more areola (the pinky brown bit surrounding the actual nipple) by the baby's top lip than by her chin as the nipple by her chin should be in her mouth as this is how she can compress the milk sinuses and get lots of milk.  

A baby can feed for a short time with a good latch and good drinking, and be happy for a few hours before she needs more. If your baby is spending hours at the breast, it might be worth working on the latch to help the baby get more milk in a shorter amount of time so you can both take a break! 

This Jack Newman video is quite a good demonstration of what I am talking about. 
This is arguably one of the most important aspects of establishing breastfeeding. If your baby is latched on well all (or at least most - it can be hard at first!) of the time, breastfeeding is unlikely to be painful for you and it will be satisfying for her as she will be able to get milk easily - and along with connection with mum, this is what every tiny baby wants: milk.  A 'good latch' will also keep your supply going effectively. 

It appears that the best way to latch your baby on initially is by using the birth crawl or 'biological nurturing' approach in the hour or two after birth. (See Basics - The First Days for a link to the birth crawl video). After that it is up to you whether you wish to continue with the biological nurturing style of latching on (See Useful Information for a link to a biological nurturing explanation) or you wish to pursue other ways of latching your baby on so you can breastfeed any time, anywhere, as comfortably as possible. 

The cradle hold is the most commonly taught way of latching your baby on. Not always the most comfortable incidentally - it can tire your shoulders, until later when perhaps you are stronger - but useful if you wish to enjoy breastfeeding while out, or discreetly with other people around.  For the cradle hold position, start off by getting as comfortable as possible yourself. Some people find having cushions behind your back and under your arms can support you and take the weight of your baby, particularly early on when you are recovering from the birth and later when you are just plain exhausted! Some people find it useful to have a cushion on your lap to support your baby's weight and a few books on the floor to put your feet on so your legs are also supporting the weight of the baby. Whatever position works so that you are not straining to hold a position in order to feed your baby - you might be there some time!  It can be a good idea to hold the baby firmly and confidently at the base of the skull or back of the shoulders so that you are supporting the weight of her head. You can hold her like this so that she feels comforted and reassured by your touch. 

At this point, touching your nipple to her top lip may make her open her mouth wide and lift her head up to come up and over the top of the nipple, so that there is more of the whole nipple in the bottom gum side of her mouth and her top jaw has just gone sort of up and over - you will probably be able to see more areola this side.  Don't be afraid to hold her head and shoulders slightly away from your breast for a little bit while keeping the rest of her close to you with your elbow.  This is all part of the process of her learning that getting a good mouthful of breast enables her to transfer milk effectively which in turn prevents you suffering any nipple trauma.  It may be worth making her wait to enable this learning to take place. 

Anyway, once she has her mouth wide open, quickly bring her to the breast, chin first so that she can get her gums underneath the milk sinuses (just behind your nipple - these will squirt milk into her mouth if she compresses them effectively). Her top lip will then come up and over the nipple to compress the other side of the milk sinuses.  You want to aim for an asymmetrical latch - her bottom lip and gum should cover more of the nipple than her top one - most of the areola on the side where her top lip is will probably be visible and her chin should be massaging the breast as she sucks.  

Once a baby is latched on effectively, they will often start with quite fast sucking with a few swallows, depending on how much milk has collected in the milk ducts (like the pipes in your breast that channel the milk down to the nipple and out), and then progress to larger gulps as the milk is let down from deeper inside the breast.  He or she will probably 'finish' that side with lots of sucks and the odd swallow as the milk flow slows.  A very young baby, and some older ones!, will fall asleep at this point, which is when it is a good time (although not imperative) to change sides and start the whole process again.  Sometimes a baby wants the second side, sometimes they are quite satisfied with one side.  It is a good idea to be led by your baby.

Having said all of that, like most things where breastfeeding is concerned if your baby appears to be doing none of these things, or didn't like one of these methods or techniques for latching a baby on to the breast, but is thriving on your milk, that is really all that matters. 

This is an absolute classic, particularly in the first month or two. Mum's got milk, but baby won't drink it! She keeps falling asleep after a few minutes or even a few sucks. Mum has to supplement with her own milk, someone else's milk, or formula, and baby doesn't get much practice at the breast. 

Why does this happen?  Babies love to be held by mum, and they love to be nestled into the breast skin to skin with mum. It is warm, safe, there is warm milk to be had whenever they choose, so they fall asleep and would happily spend 24 hours at the breast, constantly snacking. Indeed, in some cultures, this is what they do. 

So how to wake a sleepy baby and get her to take a good feed. This page has some excellent advice. 

Did you have a sleepy baby?  When did they start waking up?  Were you worried?
How many times have you had your baby's latch checked and it's been decided its fine? Often the first thing midwives do in hospital is to help latch the baby on, check it and pronounce it a good latch or otherwise. However, countless women online write posts to say that they have had the latch checked many many times and been told it is fine. But there might be problems present: the mother has sore nipples, or even cracks, the baby is slow to gain weight, and perhaps wants to feed every hour, for an hour, 24 hours a day! Or sometimes the baby falls asleep soon after feeding and then as soon as it is moved wakes up and wants to feed again! In many of these cases, the baby is not latched on properly at all, probably gets tired from all the inefficient suckling so sleeps to conserve energy, and wants to feed all the time to get the milk it needs. 

So what can you do to make sure your baby is drinking well from the breast? The first thing is to watch your baby, not the clock. Sure, you want your baby to get a good bellyfull in a relatively short time so they can fall asleep in that milk drunk way and use all that milk to grow and develop, but using the clock, rather than your baby, as a measurement of whether he or she is drinking well is just not going to give you an accurate assessment.  In this culture, we are often scared of spoiling the baby, or allowing the baby to use the breast 'like a dummy' - a dummy is a fake breast - not the other way around!  So we try to limit the time at the breast, whereas women from other cultures, unconstrained by modern life perhaps, wouldn't think of limiting a young baby's time at the breast. 

Anyway, I digress. Your baby still needs to be able to drink well, regardless of whether he or she hangs around after the main course for a long and luxurious five course dinner.  So how to know your baby is drinking well. Look for the pause. When the baby is latched on, and sucking and swallowing, if your baby is drinking lots of milk, there will likely be a pause when the baby's mouth opens to its widest. This is when the baby's mouth fills with milk. Then they close their mouth and swallow.  This video by my favourite breastfeeding oracle, Jack Newman, demonstrates it better than I can probably explain it.

    All information in this blog is the result of my own research, reading and personal experience of breastfeeding.  It should not be taken as professional advice, nor be associated with any organisation that I give my time to or represent.  


    Breast Compressions
    Breastfeeding Statistics
    Breastfeeding Support
    Distractible Baby
    Early Breastfeeding
    Enough Milk
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    Formula Feeding
    Four Months
    Good Drinking
    Latching On
    Peer Support
    Skin To Skin
    Sleepy Baby
    Supply And Demand
    Supply Issues
    The Politics Of Breastfeeding

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