It is important to ensure your baby is properly positioned for nursing. Improper positioning is one of the biggest causes of sore nipples. You'll find it helpful to alternate positions with each feeding, since always feeding in the same position can make your nipples sore. Be sure to alternate breasts during each feeding.
It's best to start with the breast that your baby finished with at the last feeding. Because your baby will typically drain the first breast more completely, alternating allows adequate emptying of both breasts. This is important for milk production and to ensure that your baby drinks the last milk in each breast, which contains the majority of the calories.
If possible, express a small amount of milk or colostrum onto the end of your nipple before bringing your baby to your breast. If your baby's mouth is wide open, place your nipple well into her mouth. You may need to "tickle" your baby's lower lip with your nipple if her mouth is not already open. Make sure you wait for your baby to open WIDE. This helps to make sure that your baby latches onto more than just the end of your nipple, which can really hurt! In addition to your nipple, a good portion of the areola, or dark, circular area surrounding your nipple should be in her mouth as well. If she's properly latched on, your baby's nose will be against your breast. Don't worry about whether she's getting enough air. Your baby's nose is specially designed to breathe effectively while she's nursing at your breast.
Once your baby has latched on, you should feel a firm pull as she sucks. Although your breasts may be tender, it should not hurt to feed your baby. If you notice more than some initial discomfort as your baby begins to nurse, take her off of your breast and begin again. This can be very frustrating, particularly if you've been at it for a while. Although it may be tempting, don't let your baby keep nursing if you're experiencing pain because this can result in damage to your nipples. Your baby's mouth must also be properly positioned for her to suckle milk effectively, so it's very important to make sure she's latched on correctly.
If you have flat or inverted nipples, it can be harder for your baby to latch on to your breast. But that doesn't mean you can't breast feed; it just means you may have to work a little harder to get started. Try gently rolling or brushing your nipple. This stimulates the nipple and will often elongate it enough for your baby to grab hold. For very flat or inverted nipples that do not respond well to stimulation, breast shells may be helpful. These are small plastic cups worn inside the bra, which exert gentle pressure around the nipple to help pull the nipple out. It's recommended that these be worn several hours a day during the last month of pregnancy and the initial days of breast-feeding. Your baby too, will help to pull the nipple out over time, as she breast feeds.
Once your baby has latched on and begins to nurse, you'll experience the "let down" or "milk ejection" reflex. This can take several minutes. As this happens, you will notice your baby's sucking pattern change. Infants take quick, short sucks when they're attempting to increase your milk flow. As your milk begins to flow more freely, your baby will change to longer, gulping sucks. This is how you'll know your baby is drinking. You should even be able to hear her swallowing. In about 2 or 3 weeks, after your milk supply is well established, you may notice a tingling sensation in your breast when your milk is letting down. You may also notice milk leaking from the opposite breast during "let down" or when it's time for your baby to be fed. Sometimes just hearing a baby cry, not necessarily your own, can also stimulate your milk to flow. "Let down" can be easily stopped by putting your hand or forearm across your breast and pressing straight back against the nipple until the leaking stops.
There's no hard and fast rule as to how long a baby should nurse during each feeding. Generally speaking, most babies will nurse between 5 and 20 minutes at each breast. Every baby is different, so you and your baby will discover together what's right for you. At first, it may be helpful for you to time how long your baby nurses at each breast. This isn't always necessary, particularly if your baby is nursing well, but it can help the nursery staff gauge how well your baby is feeding. Your baby will let you know when he's had enough to eat. Newborn babies will usually nurse 6-10 times a day, for at least 10 minutes on each breast. But remember; your baby is your best guide. If he appears satisfied between feedings, and, after your milk comes in, he is having at least 6 wet diapers in 24 hours, then you can be sure that he's getting plenty of milk.
Once he's finished nursing, break your baby's suction before removing him from your breast. You do this by gently inserting your finger into the side of your baby's mouth until the seal is broken. If you don't break the suction before pulling your baby from your breast, it will hurt! After each feeding, express a small amount of your breast milk and rub it around the nipple and areola because this has natural lubricants and healing properties. Try to give your nipples 5 to 15 minutes to air dry before putting on your bra. If you're wearing nursing pads, be sure to change them frequently so that the moisture from your breasts won't cause an infection.