• A proper latch is crucial to success. This is the key to successful breastfeeding. Unfortunately, too many mothers are being "helped" by people who don't know what a proper latch is. If you are being told your two-day old baby's latch is good despite your having very sore nipples, be sceptical and ask for help from someone else. Before you leave the hospital, you should be shown that your baby is latched on properly and that he is actually getting milk from the breast and that you know how to know he is getting milk from the breast (open mouth wide—pause—close mouth type of suck). See also the videos on how to latch a baby on. There are also video clips of babies younger than 48 hours who are breastfeeding not just sucking. If you and the baby are leaving hospital not knowing this, get experienced help quickly (see also the information sheet When Latching).
Note: Mothers are often told that if the breastfeeding is painful, the latch is not good (usually true), so that the mother should take the baby off and latch him on again and again and again... This is not a good idea. Instead of delatching and relatching, fix the latch that you have as best you can by pushing the baby's bottom into your body with your forearm. The baby's head is tipped back so the nose is in "sniffing position." If necessary, you might try gently pulling down the baby's chin so he has more of the breast in his mouth. If that doesn't help, do not take the baby off the breast and relatch him several times, because usually, the pain diminishes anyway. The latch can be fixed on the other side or at the next feeding. Taking the baby off the breast and latching him on again and again only multiplies the pain and the damage and the mother's and baby's frustration.
• The mother and baby should room in together. There is absolutely no medical reason for healthy mothers and babies to be separated from each other, even for short periods, even after caesarean section. Health facilities that have routine separations of mothers and babies after birth are not doing right by the mothers and babies. Studies showing that rooming-in 24 hours a day results in better breastfeeding success, less frustrated babies and happier mothers date back to the 1930's. Too often, irrelevant excuses are given why baby should be separated from the mother. One example is that the baby passed meconium before birth. A baby who passes meconium and is fine a few minutes after birth will be fine and does not need to be in an incubator for several hours' "observation."
•Separation of mother and baby so the mother can rest. There is no evidence that mothers who are separated from their babies are better rested. On the contrary, the mothers are better rested and less stressed when they are with their babies. Mothers and babies learn how to sleep in the same rhythm. Thus, when the baby starts waking for a feed, the mother is also starting to wake up naturally. This is not as tiring for the mother as being awakened from deep sleep, as she often is if the baby is elsewhere when he wakes up. If the mother is shown how to feed the baby while both are lying down side by side, the mother is better rested.
•The baby's feeding cues. The baby shows long before he starts crying that he is ready to feed. His breathing may change, for example. Or he may start to stretch. The mother, often being in light sleep in sync with her baby, will wake up, her milk will start to flow and the calm baby will usually go to the breast contentedly. A baby who has been crying for some time before being tried on the breast may refuse to take the breast even if he is ravenous. Mothers and babies should be encouraged to sleep side by side in hospital. This is a great way for mothers to rest while the baby breastfeeds. Breastfeeding should be relaxing, not tiring.