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Expert Q&A

	By Melissa Clark Vickers International Board Certified Lactation Consultant Moms & Babies Huntingdon, Tenn.

My four week old (first baby) latched on immediately after birth and we have been successfully breastfeeding. My concern is that he is a ""snacker."" He only takes one breast per feeding and feeds for a short time (average ten minutes or less). He feeds frequently during the day (at times he is hungry again 20 minutes after a feeding). It is typical for him to fall asleep while nursing. I've tried everything from trying to tickle him to compressing the breast while he is latched on. I would greatly appreciate your advice/opinion. I have not found much about this situation in any of the breastfeeding books I've read. - Jennifer, Connecticut"

Babies typically have their own styles of nursing. Some are snackers, and some dawdlers, and some are take-charge, let-me-have-at-it, all business! Sometimes, however, when a baby is nursing as often as you describe, he's not nursing efficiently and isn't getting enough to sustain him for longer.

A few things for you to try/consider:

1. Make sure your positioning is good. He should be at breast height (use pillows as needed), and lying on his side so that his ear, shoulder, and hip are in a straight line. He shouldn't have to turn his head side to side or front to back to reach your nipple. One of his hands should be on each side of the breast.

2. Check latch-on. Once you have him in a good position, tickle his lower lip and wait for him to open his mouth WIDE like a yawn. Quickly bring him into your breast with that open mouth. His tongue should be down, and when he's latched on properly, you may be able to gently draw back the corner of his mouth and see his tongue cupping your breast. He should have an inch or so of your areola (the dark area) in his mouth so he can compress the breast.

3. Support your breast during feeding. Depending on how big you are, the weight of your breast may still be too much for him to handle on his own. Lift your breast, cupping your hand under the breast, thumb on top, fingers underneath, holding it back from the areola so you don't interfere with his latch-on. Often this one maneuver improves a baby's ability to get a good meal more than any other adjustment.

4. Feeding on one breast per feeding is okay and allows him to get both the initial foremilk that is high in volume, low in fat and initially satisfying, and the hindmilk that is high in fat and calories and will help sustain him longer.

5. Breast compression can help. The idea is to wait until he stops sucking, and then you gently squeeze your breast in and towards the chest wall. This can squirt some milk in his mouth, and that will trigger the suck-swallow reflex. When he stops again, compress the breast again, moving your hands to a new position each time.

6. If he continues to fall asleep after just a few minutes, you might try switch nursing: When he falls asleep on one breast, gently remove him (stick your finger in the corner of his mouth to release the suction) and try the other breast. You can do this a few times, if necessary. This is a short term strategy, though, just until he becomes more efficient at nursing.

7. Often, it helps to have either a La Leche League Leader or a lactation consultant (preferably one with ""IBCLC""--International Board Certified Lactation Consultant--after her/his name) watch you while you nurse. Often a minor change in positioning makes a major change in how well baby nurses.

Hope this helps!"

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