Birth Partner | For Everyone at the Birth

Source: *The Birth Partner* (5th ed.) — Penny Simkin with Katie Rohs

The Birth Partner's Role in Feeding

The birth partner does not feed the baby — but the birth partner's support is one of the most significant factors in whether breastfeeding or chest-feeding succeeds. Nursing is physically demanding and emotionally vulnerable in the first weeks. Your presence, attention, and practical help change the outcome.

A note on language: breastfeeding, chest-feeding, nursing, and lactation are used interchangeably throughout this guide and are meant inclusively for all parents who are producing and feeding milk.

Why It Matters: Benefits of Human Milk

**For the baby:**

Perfect nutrition that adjusts as the baby grows
Right temperature, always
Contains immunoglobulins (antibodies) that protect against infections
30% of the baby's beneficial gut bacteria comes from the milk itself; another 10% from skin-to-skin contact
Human milk oligosaccharides (sugars in the milk) feed and sustain the bacteria
Linked to fewer respiratory infections, ear infections, allergies, eczema, GI problems, and SIDS
Better jaw and facial development than bottle feeding
Associated with lower rates of childhood obesity, diabetes, and leukemia

**For the nursing parent:**

Contractions during nursing help the uterus return to pre-pregnancy size
Hormonal relaxation response (prolactin and oxytocin)
Lower lifetime rates of type 2 diabetes, breast cancer, and ovarian cancer
No formula costs; always ready; no preparation needed

Getting a Good Start

Colostrum (Days 1 to 4)

The first milk is colostrum: a small amount of thick, yellowish fluid. It looks like very little but it is exactly what the baby needs. A newborn's stomach holds about a teaspoon. Colostrum is high in protein, antibodies, and laxative properties that help clear meconium.

Do not supplement colostrum with formula based on concerns about supply — the supply is calibrated to the baby's actual needs in the first days. If supplementation is medically indicated, colostrum can be hand-expressed and given by spoon.

Transitional Milk (Days 2 to 7)

Volume increases. The nursing parent's breasts feel fuller, sometimes dramatically. Many parents think this means they are suddenly producing too much — it is just the transition.

How Supply Works

Milk supply is driven by demand. The more the baby nurses, the more milk is produced. Every nursing session sends a hormonal signal to produce more. Skipping feedings or adding formula without pumping reduces supply over time.

**Nursing frequency:** 8 to 12 times per 24 hours in the early weeks. This sounds like a lot. It is a lot. It is also normal. Cluster feeding (several feedings close together, then a longer gap) is normal.

**Signs of adequate supply:**

Breasts feel fuller before a feeding and softer after
Milk drips or sprays during feedings
6 to 8 wet diapers per day once milk is in (after day 4)
At least 4 bowel movements per day in the first 4 weeks
The baby swallows after every few sucks, not just at the start
The baby is gaining weight (a 10% weight loss in the first days is normal; weight should return to birth weight by 10 to 14 days)

The Latch

The most important thing to get right in the early weeks.

**What a good latch looks like:**

The baby's mouth is open wide — a 120-to-140-degree angle
The baby takes a large amount of the areola, not just the nipple
Lips are flanged out (not tucked under)
Chin is touching the breast; nose is free for breathing
There is a visible swallowing motion after every few sucks
After the initial latch (which can sting briefly while the milk lets down), nursing is not painful

**The laid-back breastfeeding position (biological nurturing, developed by Suzanne Colson):**

The nursing parent reclines at a comfortable angle (45 to 60 degrees, not fully flat). The baby is placed on the chest and belly. Gravity holds the baby against the body. The baby's rooting and crawling reflexes guide them to the breast and help them self-attach.

This position reduces the work of positioning for both parent and baby and often produces a better latch than upright positions because the baby controls the approach.

**Other useful positions:**

**Cradle hold:** Baby across the body, head in the crook of the arm. Classic position, good once latch is established.
**Cross-cradle hold:** Opposite hand supports the baby's head, allowing more control. Useful while learning.
**Football (clutch) hold:** Baby tucked under the arm, legs extending toward the parent's back. Good after cesarean (no pressure on the incision), for large-breasted parents, and for premature babies.
**Side-lying:** Both parent and baby lying down facing each other. Best for night feeding and for a parent recovering from cesarean.

Common Early Concerns

Nipple Pain

Some tenderness is normal when milk first lets down (a sharp sensation lasting 30 to 60 seconds). Persistent, ongoing pain is not normal and is almost always caused by a poor latch.

**Do not limit time at the breast** to manage nipple pain. A baby who nurses on a poorly latched breast for 10 minutes causes as much damage as one who nurses for 30 minutes. Fix the latch.

**If the baby makes a clicking sound or appears to be nibbling:** these are signs of poor latch. Remove the baby (break suction with a clean finger at the corner of the mouth), wait for a wide open mouth, and try again.

**Nipple healing:**

Rub a few drops of colostrum or expressed milk onto the nipple after each feeding and allow to air dry
Nipple balm or modified lanolin (lanolin purified for nursing) is helpful; does not need to be wiped off before feeding
Start each feeding on the less sore side if pain is asymmetric

Engorgement

Days 2 to 4, when milk comes in, the breasts may become very full, hard, and uncomfortable. This can make latching difficult for the baby.

**Treatment:**

Nurse frequently (the best solution)
Before each feeding: hand express or pump just enough milk to soften the areola so the baby can latch
Warm shower or warm compresses just before nursing help with letdown
Cold compresses after feeding reduce swelling and inflammation
Ibuprofen for pain and inflammation
Supportive bra

Engorgement resolves within 2 to 3 days in most cases as supply adjusts to demand.

**For parents who are not breastfeeding:** Wear a firm supportive bra (not a tight binder), do not express milk, and apply cold packs. Milk production suppresses itself when not stimulated. Avoid heat and stimulation.

Tongue-Tie (Ankyloglossia)

A short or unusually tight frenulum (the band of tissue connecting the underside of the tongue to the floor of the mouth) restricts the tongue's range of motion and can prevent a deep latch.

**Signs:** Persistent nipple pain despite correct positioning; the baby cannot extend the tongue past the lower lip; clicking or slipping off the breast.

A lactation consultant or an ENT can assess. If it is significant, a frenotomy (clipping the frenulum) is a brief, simple procedure that can dramatically improve latch. Ask early if you suspect this is the problem.

Thrush

A yeast infection that can colonize the baby's mouth and the nursing parent's areolas simultaneously.

**Signs in the baby:** White patches on the cheeks, gums, tongue, or roof of the mouth that do not wipe off.

**Signs in the nursing parent:** Shiny or flaky areola; deep, burning breast pain during or between feedings; nipple pain that was previously resolved.

Thrush often follows a course of antibiotics. Both the baby and the nursing parent must be treated simultaneously, or they will re-infect each other.

Treatment: antifungal gel for the baby's mouth; antifungal cream for the nursing parent. Wash bras and breast pads daily in hot water.

The 24-Hour Cure

When milk supply seems low, the baby is not gaining well, nipple confusion has set in, or the nursing parent is exhausted and considering stopping: try this protocol before giving up.

1. Set aside one full day with adequate support at home

2. The nursing parent and baby go to bed together in minimal clothing, maximizing skin-to-skin

3. The nursing parent rests, reads, sleeps, and dozes all day; they get up only to use the bathroom

4. The baby nurses on demand every time they show hunger cues; no bottles

5. The nursing parent drinks 2 to 3 quarts of fluid over the 24 hours

6. Nutritious meals and snacks are brought to them in bed

Results: increased milk supply, better milk transfer, more rested parent, stronger suckling reflex.

Special Circumstances

Transgender and Non-Binary Parents

Chest-feeding is possible for transgender men and non-binary parents. Previous chest surgery affects milk production but does not eliminate the possibility entirely. A lactation consultant experienced with transgender parents is invaluable. Start the conversation before birth.

Adoptive Parents, Co-Parents, and LGBTQ+ Families

Lactation can be induced in parents who have not been pregnant. This involves a combination of hormones, medications, breast stimulation, and patience. The milk volume may be lower but the benefits are real, and even partial nursing is valuable.

A supplemental nursing system (SNS) is a small container of supplemental milk (pumped milk or formula) connected to a thin tube that runs along the parent's finger or nipple. The baby nurses and receives supplemental nutrition simultaneously, maintaining the nursing relationship even when supply is low.

Bottle Introduction

Introducing a bottle before the baby has mastered breastfeeding (usually before 3 to 4 weeks) can create nipple confusion: the baby learns that minimal effort at the bottle produces fast flow, and may then refuse to work at the breast.

Once breastfeeding is well established: introduce a bottle 3 to 5 times per week to maintain the skill. After a break of several weeks, some babies refuse bottles entirely.

**Tips for bottle introduction:**

The nursing parent should not be the one to offer the bottle. The baby associates the nursing parent with breastfeeding. Another person giving the bottle is far more likely to be accepted.
Offer the bottle when the baby is content but starting to be interested in feeding — not frantic, and not drowsy.
Try several bottle shapes/nipples. Some babies are particular.
If the baby persistently refuses a bottle: try an open cup (a small amount of milk in a shot glass) or a medicine dropper as backup methods.

The Birth Partner's Practical Role

During the newborn period, the birth partner's most useful contributions to feeding:

**Bring water and a snack before each feeding.** The nursing parent will be thirsty and hungry every single time.
**Handle diaper changes before and after feedings.** This keeps the baby at the breast longer and the nursing parent from having to interrupt latching.
**Burp the baby between sides** if the nursing parent wants a break.
**Keep the environment calm.** Visitors, noise, and stimulation make nursing harder, especially in the early weeks.
**Bring the baby at night.** If you are sleeping nearby and the baby wakes, bring them to the nursing parent, do the latch assist if needed, and return the baby when the feeding is done. This allows the nursing parent to doze through the middle.
**Learn what a good latch looks like.** When the nursing parent is too tired to assess, you can look and say "that looks good" or "that sounds like clicking — try breaking and re-latching."
**When to call a lactation consultant:** persistent nipple pain after two weeks; suspected tongue-tie; baby not regaining birth weight by two weeks; nursing parent in pain that is not improving.

**Resources:**

La Leche League (llli.org): peer support, free local meetings
Breastfeeding USA (breastfeedingusa.org): trained counselors, local chapters
WIC: free lactation support for eligible families
Baby's pediatrician: first call for weight concerns
International Board Certified Lactation Consultant (IBCLC): highest credential for hands-on help

Once Feeding is Established

Around 3 to 6 weeks, nursing typically becomes:

Faster (some newborns nurse for 45 minutes; an established nursing baby takes 10 to 15)
More comfortable (the tenderness resolves)
More predictable (the baby settles into a loose rhythm)
Less anxiety-producing

It takes time to get there. The first weeks are the hardest. If you can get through the first 4 to 6 weeks, you will likely find that breastfeeding becomes easy and rewarding for both of you.