As a mother, you should establish good breastfeeding skills as it helps in effective milk transfer from you to your baby. Good breastfeeding skills include proper positioning of the baby at the breast and effective feeding.

You can feed your baby in any comfortable position such as lying (sideways) or sitting. The baby needs free access to the breast. This is important because poor positioning often results in poor attachment.

For feeding, the baby you should hold him with head straight, facing the breast with his nose opposite to your nipple and his body close , supporting infant's whole body not just the neck and shoulder. Your nipple should touch the infant's mouth.Wait till his mouth opens wide, and offer the whole breast to your baby to get as much as he can into his mouth.

Good body positioning is recognized by the following signs (Fig. 8) :

His neck is straight or bent slightly back. His body is turned towards you. His body is close to you . His whole body is supported. There is eye contact between you and your baby.

Fig 8

Poor positioning is recognized by any one of the following signs (Fig. 9):

• His neck is twisted or bent forward.
• His body is turned away from you
• His body is not close to you.
• Only his head and neck are supported.
• There is no eye contact between you and your baby.

How your baby should suckle at the breast

Babies suckle for closeness, comfort and pleasure as well as because they are hungry. To suckle effectively, your baby must take enough of the breast into his mouth, so that his tongue can press on the lactiferous sinuses. He must pull out or stretch the breast tissue to form a teat that is much longer than the "resting nipple" (Fig.10 a & b). The nipple just forms one third of this teat. You can sometimes see the long, stretched breast tissue for a moment when your baby

Signs of good attachment are Chin touching breast Mouth wide open Lower lip turned outward More areola visible above than below the mouth There should be no pain	Signs of poor attachment are Chin separated from the breast Mouth looks closed Lower lip pointed forward More arelo visible below the mouth and lower lip You feel nipple pain
Fig 10

stops suckling. This is good attachment. This way your baby draws all the milk from your breast.

If your baby is not well-attached(Fig.10 c & d), it may result in pain and damage to your nipples and breast engorgement due to ineffective removal of breastmilk. Your baby feels unsatisfied and he wants feed very often and for along time. He may get too little milk and not gain weight and the breastmilk may dry up.

In effective suckling - baby suckles with slow deep sucks and sometimes pauses and you see or hear the infant swallowing.

How long the baby should suckle?

Duration
The suckling pattern varies, with some babies fulfilling their requirements in 5-10 minutes while others take longer. The baby should be allowed to decide the duration of the feed. But if breastfeeds are very long ( more than about half an hour) or very short ( less than about 4 minutes) it may mean there is some problem. In the first few days, or with a low-birth-weight baby, breastfeeds may be very long and this is normal. You should feed your baby from one breast completely and then put the baby to the second breast, so that both breasts get equal stimulation for milk production.

How many time a day?

Your baby should be fed on demand with at least more than 8 feeds in 24 hours. Initially the demands are very frequent but by 1-2 weeks the frequency decreases. The baby should be fed as frequently and for as long as he wants to, even at night. Breastfeeding at night helps maintain the milk supply as more prolactin is secreted during the night. Satisfied child releases breast spontaneously. Mothers do not have to stop breastfeeding.

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