Usually, hospitals with liberal rooming-in practices also have the most liberal visitation policies. The popular trend toward family-centered maternity care is highly commendable, and certainly a vast improvement over the arbitrary rules in place when I was having babies. It can be a wonderful thing to bring a child into your family surrounded by all your loved ones, but I must warn you about turning your room into a block party. Having all your extended family and friends can be fun for a time, but you may be left feeling like an entertainment coordinator. Limit visitors to those you really want to have present, and then keep visits short. Remember, the purpose of your hospital stay is to learn to care for and feed your baby, not make small talk with visitors. Demand Feedings Be prepared to nurse your baby at the first sign that she is interested in feeding. Put her to the breast as often as necessary to satisfy her. You may nurse as frequently as every hour or so, but don’t let more than about three and a half hours elapse without attempting to get your baby to breastfeed. Frequent feedings are important to help your baby become proficient at latching on and sucking properly and to help bring in a milk supply that matches your baby’s requirement. The best advice is “watch the baby, not the clock.” Unrestricted Duration of Feedings In the past, it was common hospital policy to restrict the duration of feedings when a woman first started breastfeeding. Typically, a mother might be advised to nurse only three to five minutes on a side, perhaps increasing the length of feedings by a minute each day. This misguided policy was based on the mistaken belief that sore nipples could be prevented by keeping feedings short at first and building up the sucking time slowly. This common policy was flawed for several reasons. We now know that the most important cause of sore nipples is improper infant latch-on, rather than prolonged duration of feedings. Severe restrictions on the length of feedings can cause mothers to become preoccupied with watching the clock. By restricting feedings to five minutes or less, many frustrated babies were removed from the breast before the let-down reflex was triggered! Numerous breastfeeding experts today insist that no restrictions should be placed on the length of feedings. They argue that an infant who is latched on correctly will not cause any nipple trauma regardless of how long she suckles. Certainly, a newborn should be allowed to nurse at least ten to fifteen minutes if she desires, once a nurse has verified that the baby is latched on correctly. However, I have encountered some women who nursed for prolonged periods in the first two days and developed severe nipple trauma and pain, despite having their infants positioned correctly. I think this results because some babies create excessive negative pressure when they nurse before the milk comes in abundantly. For this reason, I prefer to aim for moderation in feeding times, say perhaps twenty minutes maximum per side at each feeding during the first three days. If your nipples are becoming painful, I suggest you make sure the infant is latching correctly and then shorten feedings to about ten minutes per side. Frequent shorter feedings are preferable when nipple tenderness is developing.
