How to Breastfeed

How to Breastfeed

As natural as nursing is, it can prove difficult for some women. We show you how to get it right.

By Dana Sullivan

Photography by Amy Neunsinger

A mother nursing her baby -- it's one of the most beautiful images nature could create. It's also one of the simplest. Breastfeeding is so natural, in fact, that we've been doing it for millions of years. (Indeed, without it, the human race wouldn't have survived.)

But don't be fooled: For some women, the first few days or weeks of breastfeeding are a challenge. "Breastfeeding is natural, but it's a practiced skill, almost an art form," says Corky Harvey, R.N., M.S., a lactation consultant and co-owner of The Pump Station, a breastfeeding-support center in Santa Monica, Calif. "You could read a book about playing the flute and learn a lot about the instrument," she explains, "but you won't really learn how to play the flute until you actually do it." Breastfeeding is no different. As with learning to play a musical instrument, success comes from a combination of motivation, knowledge of essential skills, and practice.

latch: step a

latch: step b

And as the old saying goes, a picture is worth a thousand words. Use the photos here as your guide to the techniques and positions you need to know for successful breastfeeding.

latch: step c

latch: step d

The latch
Any good lactation consultant will tell you: Latching is everything. Here's how to do it:

  • Position the baby on her side so she is directly facing you, with her belly touching yours. Next, prop up the baby with a pillow, if necessary, and hold her up to your breast; don't lean over toward her.
  • Place your thumb and fingers around your areola (see step a).
  • Tilt your baby's head back slightly and tickle her lips with your nipple until she opens her mouth wide (see step b).
  • Help her "scoop" the breast into her mouth by placing her lower jaw on first, well below the nipple (see step c).
  • Tilt her head forward, placing her upper jaw deeply on the breast. Make sure she takes the entire nipple and at least 1 1/2 inches of the areola in her mouth (see step d).

How to Breastfeed

As natural as nursing is, it can prove difficult for some women. We show you how to get it right.

By Dana Sullivan

Photography by Amy Neunsinger


1. cradle
Position your baby on your forearm, her head in the crook of your arm. Support her bottom with your other hand. Pull her in close to you, belly to belly, with her ear, shoulder and hip in a straight line.



2. football
While useful for all women, this position is particularly helpful for mothers who have had a Cesarean section. Place your baby on a pillow, tucked close to your side. Rest your arm on the pillow to bring your baby's mouth up to your breast; support her head with your hand.


3. side-lying
This position is also helpful if you had a C-section or want to rest while nursing your baby. Lie on the side you will be breastfeeding on. Place your head on a pillow and draw your baby in close to you, using your arm to support her bottom. Use your other hand to bring your breast up to baby's mouth.

Just Had a Baby? A Six-Week Survival Guide

Just Had a Baby? A Six-Week Survival Guide

Your first weeks home with a new baby can be awkward and scary. Here‘s what to expect and how to stay sane.

Linda Estrin

Plenty has been written on just how to make it through the first few disorienting weeks at home with a newborn. The problem is, at the center of that maelstrom, who has the time to read all of it? This pull-out postpartum survival guide culls our favorite experts' tried-and-true tips about how to make the best of this challenging rite of passage. Here's what you'll need to know:

Brace Yourself
At the hospital, your baby is examined by the pediatrician, who will explain to you any obvious curiosities (for example, birthmarks or a pointy head shape). After you get home, however, your baby may produce some unexpected sights and sounds; most are normal.

The umbilical cord
The stump of the cord may seem very black and unwieldy for such a tiny infant. This is OK; it will disengage within three weeks. Until then, keep it clean (fold diapers down clear of it), dry (give sponge baths only until it falls off), and dab the base with alcohol twice a day.

The spit up
Not to worry, just keep lots of cloth diapers at the ready. Two effective ways to diminish returns, offered by the American Academy of Pediatrics' (AAP) Caring for Your Baby and Young Child (Bantam Books, 1994) are to burp your baby every three to five minutes during feedings, and to place the baby in an upright position in an infant seat or stroller right after feeding her. Or just do what comes naturally: Hold her.

The color poopoo
In the very beginning, it's blackish green, and then it approximates certain shades of green, yellow or brown, and it can be runny, pasty, seedy or curdy. Unsettling as this may be, it's all normal. An early breastfeeding bonus: Baby's poop usually doesn't smell at all.

Baby's breath
You won't believe how you'll crane to hear your baby respire. Any fewer than 60 breaths per minute is normal, as are pauses of about six seconds, according to Barton D. Schmitt, M.D., in Your Child's Health (Bantam Books, 1991). Take note of any wheezing or rapid breathing, since this could indicate a respiratory problem (see "Early Visitors" on page TK). New research shows that sleeping with your baby will help her regulate her own breathing, possibly reducing the risk of sudden infant death syndrome (SIDS).

ust Had a Baby? A Six-Week Survival Guide

Your first weeks home with a new baby can be awkward and scary. Here‘s what to expect and how to stay sane.

Linda Estrin

Bathing a newborn can be a challenge. You can either do this by holding her in a big bowl or plastic tub or by wetting a washcloth and washing her on her changing table. Here are some other tips: Baby needs a full bath only about once or twice a week, but she needs to be "topped and tailed" (a Penelope Leach term) every day. This means washing the baby's head, face and bottom.

Make sure she's been fed (but not right before the bath), that the room is warm and that you have everything at the ready (you can't leave her for even a nanosecond to retrieve something you've forgotten).

Shampoo the scalp first (only once or twice a week), shielding the water from Baby's eyes. Supporting her head, start washing Baby from the top down, using soft cloth and tap water or mild baby soap. Moving down, be sure to get in all those nooks and crannies. Be sure to wash her face well. Left around the mouth, milk and spit-up may cause a rash. Wash eyelids and under the chin. Rinse baby well and pat her dry with a towel.

Getting Through the Night
Since their tiny tummies cannot hold much milk, newborns must be fed often, which is one reason they wake so frequently. Still, you can begin the process of getting the whole household on the same schedule.

  • Establish a routine early on: Bathe, dress, play and stroll around the block at about the same time every day.
  • Place your baby in the crib while drowsy. This way he learns to fall asleep on his own and associates the crib with bedtime.
  • Swaddle him. An unswaddled baby's own movements may startle and awaken him. In Your Baby & Child (Knopf, 1984), Penelope Leach writes: "At night you want him so securely wrapped that he will not wake even during the normal periods of light sleep." Keep him face-up to reduce risk of SIDS.

"Keep night feedings as sleepy and brief as possible," Leach also suggests. "When he cries, go to him immediately so he has no time to get into a wakeful misery. Don't play or talk while you feed him." Bring him to bed with you if you want to fall back to sleep quickly.

Newborns often sleep for four hours at a stretch and a total of 16 hours or more a day. As for how quiet the house should be while Baby sleeps, Leach says the following: "A sleeping baby need not mean a hushed household. Ordinary sounds and activities will not disturb him at this early age. However, if everybody creeps about and talks in whispers while he is asleep, there may come a time when he cannot sleep unless they do. It is therefore important to let him sleep through whatever sound level is normal for your household so that he does not come to expect a quietness that will make all your lives misery."

ust Had a Baby? A Six-Week Survival Guide

Your first weeks home with a new baby can be awkward and scary. Here‘s what to expect and how to stay sane.

Linda Estrin

Calming a Crying Baby
Crying is the only means an infant has to communicate. Your quandary: What is she telling you? Check her out. Is she hungry? Too cold or hot? Is her bedding or clothing tangled? Is her diaper dirty? Are the lights too bright, noises too loud? Is a burping in order? Is she ill? If you've run this gauntlet and put things right and she's still inconsolable:

Experiment to discover the most comforting way for her to be rocked (side to side, back and forth), spoken and sung to.

  • Pat or rub her back.
  • Walk the floor with her.
  • Offer a finger, breast or a pacifier to suck on.
  • Swaddle her.

All babies have their fussy period during the day (for many it's between 6 and 10 p.m.); at a certain point there is nothing you can do. Although trying to calm a distressed infant can be exasperating, always respond to the cry. "You cannot spoil a young baby by giving him attention; and if you answer his calls for help, he'll cry less overall," suggests the AAP.

What to Do for Yourself
The physical recovery from giving birth along with sleep deprivation can conspire to make big dents in your maternal self-esteem. Particularly for a new mother who has previously spent years being independent, the realization that you are responsible for another human so dependent on you can throw you for a loop. To help you get through this period, you owe it to yourself to...

  • get enough sleep. Yeah, right, you're probably thinking. However, "the way to avoid sleep deprivation," proposes Schmitt, "is to know the total amount of sleep you need per day and to get that sleep in bits and pieces. Go to bed earlier in the evening. When your baby naps, you must also nap."
  • take breaks. Take a walk, no matter how short; run your own errands, to get away. Of course, this involves asking your spouse, other family members or friends for help. If you have to, hire someone. Consider it money well-spent.
  • get Dad into the picture. Allow him to care for the baby so that you get time alone. (You might even be able to enlist him, another relative or a friend to prepare a meal for you. See "One Great Recipe" on page TK).
  • continue to eat properly, and keep taking your vitamins. accept that progress now is incremental. Break projects into smaller tasks. Wash a couple of dishes at a time if you have to.
  • wear a snug-fitting, nonpendulous front baby carrier so you can work while holding Baby. Being close to you is familiar; she'll love the sounds and sensations and maybe even nap.
  • delegate more. Enlist any and all visitors. Remember what they say: It takes a whole village to raise a child.

You may be vulnerable to uninvited advice as well as the most well-intentioned misguided comments of friends and family. If someone doesn't approve of your mothering techniques, Leach suggests lending him or her a parenting book that supports your philosophy (then soliciting a discussion about the differences in your opinions).

Hang in There
The first six weeks can be a real trial. You and your baby are getting to know each other, and you and your partner are adjusting to your new roles. Hold on to the thought that right around that six-week mark you will be rewarded with one of the most gratifying milestones in your entire parental career--your baby will beam a genuine smile at you. Yes!

Do you have diastasis?

Do you have diastasis?

Diastasis is a separation of the two halves of the rectus abdominis muscle in the middle of our belly that sometimes occurs during pregnancy. You can check for it by lying on your back with your knees bent. (If you start to feel faint while on your back, roll to your left side; then use pillows under your shoulders to prop yourself up.) Place your fingertips 1 to 2 inches below your bellybutton, fingers pointing toward your feet. Lift your head as high as you can and see if you feel a ridge protruding from the midline of your abdomen - that's diastasis. If you have it, take care to not exacerbate the separation when you do abdominal exercises. Try a modified ab crunch: If you are past your first trimester, prop yourself up with pillows so your shoulders are higher than your belly. Wrap a sheet or towel (folded lengthwise to about 8 inches wide) around your waist and criss-cross it in front. Don't knot it. Grasp and pull the ends up and outward at 45-degree angles as you contract your abdominal muscles, exhale and raise your head. Do not lift your shoulders. Diastasis often heals after childbirth. If yours does not, talk to your OB-GYN.

Top 5 Nutrients

Top 5 Nutrients

Include these in your daily diet:

Calcium: 1,000 mg
Where to get it: Dairy foods, dark leafy greens, calcium-fortified soy milk, calcium-fortified juices and cereals

Folate (folic acid is the synthetic form, available in supplements): 600 mcg
Where to get it: Dried beans, peas, lentils, orange juice, oranges, dark leafy greens, soy nuts, avocados, broccoli, asparagus

Iron: 27 mg
Where to get it: Liver, meat, seafood, prune juice, dry beans, wheat germ, oatmeal, tofu, soy nuts, grains

Protein: 70 g
Where to get it: Meat, poultry, seafood, dairy foods, beans and legumes, nuts

Vitamin C: 85 mg
Where to get it: Citrus fruits and juices, strawberries, bell peppers, tomatoes, dark leafy greens, broccoli, Brussels sprouts

Nutrients You Need

Nutrients You Need

Essential Pregnancy Nutrients
The Institute of Medicine at the National Research Council in Washington, D.C., has established Dietary Reference Intakes (DRIs) for pregnant women for some vitamins and minerals; values for some nutrients have been increased by prenatal nutrition experts. Focus on including these nutrients in your diet every day. Check with your doctor or midwife regarding supplements.

Biotin: 30 micrograms
Calcium: 1,200 milligrams
Choline: 450 milligrams
Flouride: 3 milligrams
Folate: 400 micrograms
Iodine: 220 micrograms
Iron: 30 milligrams
Magnesium: 350 milligrams for women ages 19-30; 360 milligrams for women ages 31-50.
Niacin: 18 milligrams
Pantothenic acid: 6 milligrams
Phosphorus: 700 milligrams
Protein: 71 grams
Riboflavin: 1.4 milligrams
Selenium: 60 micrograms
Thiamin: 1.4 milligrams
Vitamin A: 750 micrograms RAE (retinol activity equivalents)
Vitamin B6: 1.9 milligrams
Vitamin B12: 2.6 micrograms
Vitamin C: 85 milligrams
Vitamin D: 5 micrograms
Vitamin E: 15 milligrams
Vitamin K: 90 micrograms
Zinc: 15 milligrams

Exercise Guidelines

Exercise Guidelines

An update on exercise during pregnancy, plus the safest place in the car for your baby.

The following is a summary of the American College of Obstetricians and Gynecologists' revised guidelines for exercising while pregnant (from Obstetrics & Gynecology 2002; 99: 171-173).

  • In the absence of contraindications (see below), pregnant women are encouraged to engage in 30 minutes or more of moderate exercise a day on most, if not all, days of the week. As always, check with your doctor before beginning an exercise program.
  • After the first trimester, pregnant women should avoid supine (on your back) positions during exercise. Motionless standing should be avoided as well.
  • Participation in a wide range of recreational activities appears to be safe. However, activities with a high risk for falling or abdominal trauma should be avoided during pregnancy, such as ice hockey, soccer, basketball, gymnastics, horseback riding, downhill skiing and vigorous racquet sports.
  • Scuba diving should be avoided throughout pregnancy.
  • Exertion at altitudes of up to 6,000 feet appears to be safe; however, engaging in physical activities at higher altitudes carries various risks.
Absolute Contraindications to Aerobic Exercise During Pregnancy

  • Hemodynamically (pertaining to the movements involved in circulation of the blood) significant heart disease
  • Restrictive lung disease
  • Incompetent cervix/cerclage
  • Multiple gestation at risk for premature labor
  • Persistent second- or third-trimester bleeding
  • Placenta previa after 26 weeks of gestation
  • Premature labor during the current pregnancy
  • Ruptured membranes
  • Preeclampsia/pregnancy-induced hypertension
Warning Signs to Stop Exercising and Call Your Doctor
  • Vaginal bleeding
  • Dyspnea (difficult or labored breathing) prior to exertion
  • Dizziness
  • Headache
  • Chest pain
  • Muscle weakness
  • Calf pain or swelling
  • Preterm labor
  • Decreased fetal movement
  • Amniotic fluid leakage

How Much Weight Should I Gain?

How Much Weight Should I Gain?

Rate your prepregnancy weight (pounds)
height underweight normal overweight obese
5' <> 102-132 133-147 > 148
5'2" <> 107-141 142-157 > 158
5'4" <> 116-152 153-170 > 171
5'6" <> 123-161 162-180 > 181
5'10" <> 138-181 182-202 > 203
Your gain plan (pounds)
if you
were . . .
underweight normal overweight obese
you should
gain a
total of . . .
28-40 25-35 15-25 <>

Where do the pregnancy pounds go?
maternal stores of fat, protein, and other nutrients 7 lbs
increased body fluid 4 lbs
increased blood 3-4 lbs
breast growth 1-2 lbs
enlarged uterus 2 lbs
amniotic fluid 2 lbs
placenta 1.5 lbs
baby 6-8 lbs
total 26.5-30.5 lbs
source: American College of
Obstetricians and Gynecologists

A To Z Glossary

active labor
Thinning and opening of the cervix, usually between 4–10 centimeters, with contractions typically 2–5 minutes apart
afterbirth Placenta and membranes expelled by the uterus after the baby is delivered
alpha-fetoprotein test (AFP) Blood test given between the 15th and 20th weeks of pregnancy to screen for abnormalities, including neural-tube defects and Down syndrome
amniocentesis Extracting a sample of the amniotic fluid to test for fetal abnormalities
amniotic fluid The fluid inside the amniotic sac (aka bag of water) that surrounds and protects the baby during pregnancy
anterior presentation The most common position for babies during birth, with the face turned toward the mother’s spine

back labor Contractions primarily felt in the mother’s lower back; sometimes caused when the baby is facing the mother’s front
blastocyst The fertilized egg (zygote) once it enters the uterus
Braxton-Hicks contractions False labor pains that occur throughout pregnancy
breech birth When the baby’s buttocks, knees or feet appear first during delivery; usually results in a Cesarean section

cephalopelvic disproportion (CPD) When a baby’s head is too large to fit through the mother’s pelvis
cerclage A stitch placed in a weak cervix to help prevent premature delivery
cervical incompetence Premature opening of the cervix (without contractions)
cervical ripening Softening and thinning of the cervix in preparation for labor
cervix The narrow lower end of the uterus
Cesarean section (C-section) Surgical removal of the baby and placenta through an incision made in the mother’s uterus
chloasma (mask of pregnancy) Brownish patches that sometimes develop on the face during pregnancy
chorionic villus sampling (CVS) Removal of a small amount of tissue from the placenta to test for chromosomal or metabolic abnormalities; usually performed between weeks 10–12
colostrum Fluid produced by the breasts in the latter months of pregnancy (and soon after birth); transfers proteins and immunities to the baby
contractions (labor pains) Tightening of the uterus to expel the baby; contractions become stronger and more frequent as labor progresses
cord compression Squeezing of the umbilical cord that leads to slowing or interruption of blood flow to the fetus
crowning When the baby’s head has descended so far into the birth canal that it can be seen

diastasis A vertical separation of the two halves of the abdominal muscles that can occur in late pregnancy
dilation Opening of the cervix during labor to allow the baby to pass through; 10 centimeters is considered fully dilated
Down syndrome A genetic disorder caused by extra chromosomes and characterized by mental retardation, medical problems and abnormal facial features
dystocia Slow-progressing, difficult labor

eclampsia (toxemia) A life-threatening high-blood-pressure condition marked by seizures and coma; usually occurs after the 20th week and can only be “cured” by delivering the baby
ectopic pregnancy Implantation of the fertilized egg in a place other than the uterine wall, usually in a fallopian tube
effacement Gradual thinning and shortening of the cervix during labor
embryo The developing fertilized egg until the eighth week of pregnancy
epidural A spinal injection that numbs the lower half of the body to decrease or eliminate pain during labor; the catheter that delivers the drugs is left in place
episiotomy A surgical incision in the perineal area to widen the vaginal opening for delivery; the procedure is increasingly considered unnecessary or even harmful
external version The attempt to manually move a breech baby into the head-down position

failure to progress A slow or stopped labor
fetal distress (nonreassuring fetal status) When the baby does not move for a time or has a slower-than-normal heartbeat; may indicate he is not receiving enough oxygen
fetal monitor Device used to listen to and record the heartbeat of the fetus; normal range is 110–160 beats per minute
fetus The developing baby from the end of the eighth week of pregnancy until birth
forceps delivery Placing spoon-like instruments around the baby’s head to facilitate delivery
foremilk The breast milk the baby gets during the first few minutes of nursing; it has a high volume and low fat concentration
full term A baby born after the 36th week
fundus The top of the uterus; after 20 weeks, the height in centimeters is generally equal to the number of weeks a woman is pregnant


gestational age The fetus’s age measured from the first day of the mother’s last menstrual period; an average pregnancy lasts 280 days, or about 40 weeks, from that day
gestational diabetes Diabetes that arises during pregnancy; usually subsides after delivery

hindmilk The milk a baby gets after the first few minutes of nursing; it’s lower in volume, but higher in calories and fat
human chorionic gonadotropin (hCG) A hormone produced by the embryo and thought to be related to nausea in early pregnancy
hyperemesis gravidarum Very severe nausea and vomiting during pregnancy

induction Using artificial means to start labor, such as puncturing the membranes or giving oxytocin (Pitocin)

kick count A record kept during late pregnancy of the number of times a fetus moves over a certain period of time

labor stages 1: from the onset of labor until the cervix is completely thinned and dilated; 2: the pushing stage, during which the baby emerges from the vagina; 3: expulsion of the placenta and membranes
laboring down Allowing a mother who’s had an epidural to hold back from pushing until she has the urge or until certain signs of readiness to deliver appear
lactation Milk production by the breasts
large for gestational age A newborn weighing approximately 9 3/4 pounds or more
latching on When a baby takes the nipple and areola properly into his mouth to nurse
letdown reflex The breasts’ release of milk for the nursing baby
lightening Dropping of the fetus deeper into the pelvis in the weeks prior to birth
linea nigra A dark line that can appear from the navel to the pubic bone during pregnancy
lochia Vaginal discharge after delivery
low birthweight A baby weighing less than 5 1/2 pounds at birth

membranes The amnion and chorion, which make up the amniotic sac
miscarriage The spontaneous loss of a pregnancy before the fetus can survive outside the uterus; most common in the first trimester
morning sickness Nausea and vomiting, usually occurring during the first 13 weeks of pregnancy
mucus plug A jellylike plug that seals off the cervix and is expelled before delivery

neonate The newborn until 4 weeks of age
neural-tube defect A birth defect, such as spina bifida, that results from improper development of the brain, spinal cord or their coverings
nonreassuring fetal status (fetal distress) Concern that the baby is not receiving sufficient oxygen from the placenta

obstructed labor Slowing or cessation of labor
oxytocin (Pitocin) A drug used to help start or intensify labor contractions

pelvic-floor muscles Muscles that help support the vagina, uterus, bladder, urethra and rectum; can be strengthened by Kegel exercises
perineum The area between the vagina and anus; an incision here to facilitate delivery is called an episiotomy
pica The urge to eat nonfood items
placenta Tissue that connects the mother to her fetus and provides nourishment to and takes away waste from the baby
placental abruption Premature separation of the placenta from the uterus prior to delivery, often causing bleeding or severe, premature contractions; requires an emergency C-section
placenta previa A condition in which the placenta lies very low in the uterus so that the opening of the uterus is partially or completely covered; may require a C-section
posterior presentation When the back of the baby’s head presses on the mother’s back; causes “back labor” and may make pushing difficult
post-term pregnancy A pregnancy that lasts beyond 42 weeks from the first day of the mother’s last menstrual period
preeclampsia A complication involving high blood pressure, swelling and abnormal kidney function; occurs after the 20th week and, left untreated, can lead to seizures and even death
premature baby A baby born before 37 weeks
preterm labor Labor that starts after 20 weeks but before the end of the 37th week
prolapsed cord Slipping of part of the umbilical cord into the birth canal during delivery; can result in oxygen deprivation to the baby

quickening When the mother first feels the fetus move, usually between weeks 18–22

rooting reflex When touching a baby’s lips or stroking his cheek causes the baby to open his mouth and turn his head toward the stimulus
round-ligament pain Pain caused by stretching of the ligaments surrounding the uterus
rupture of membranes (breaking of waters) Breaking of the membranes that make up the amniotic sac during or before labor

show Vaginal discharge, often mucus and blood, that occurs as labor approaches
spinal anesthesia Numbing of the lower half of the body; unlike an epidural, the catheter is not left in place
station The relationship of the baby’s head during labor to bony knobs in the pelvis; positive numbers indicate delivery is closer

transition stage The period during labor when the cervix dilates from 8–10 centimeters
transverse lie When the baby lies crosswise in the uterus
trial of labor Choosing to attempt a vaginal birth after having had a prior C-section
trimesters 1: up to 14 weeks; 2: 14–27 weeks; 3: 28 weeks–delivery

ultrasound (sonogram) A device that uses high-frequency sound waves to produce a picture of the fetus in utero
umbilical cord The structure that connects the baby’s bloodstream to the mother’s

vacuum extraction The use of suction to help guide the baby’s head out of the birth canal
VBAC Vaginal birth after C-section

zygote A fertilized egg; becomes embryo