For getting colostrum into the baby, no, 'attempts' do not count.  For
satisfying our expectations about what the baby in question can do then and
there, yes, they do.  A baby who tries to attach and suckle should be
allowed to wait rather than be badgered to keep trying.  But babies who
don't sort out attachment to the point of actually suckling in the first day
can't be expected to get things going, and if they are in an institution and
going home shortly after birth with less than daily in-person follow-up,
their mothers need to know how to hand express so the colostrum can be given
to the baby.  

Personally I think most babies can manage just fine without getting the
colostrum until they are hungry and alert enough to root and attach, but the
staff usually can't manage it.  And some babies, especially in the
hospital-born population, take so long to get interested that they do need
to be actively fed colostrum in the meantime. For all babies, feeding
colostrum reduces the chance of staff giving something inappropriate like
formula.

Nothing works better than keeping mothers and babies in close physical
contact, preferably without clothes on.  Trying to wake the baby by lifting
it up, changing it, bathing it, prodding it, pressing its face into the
breast, stuffing the nipple into its mouth - mothers need to know before
they are subject to these far too common transgressions that THEY WILL NOT
WORK and are a Waste of Time and Energy.  The mothers also need to avoid
being infected by the staff's sense of urgency about this. If it doesn't
happen the first day, odds are it will on the second, and if not then, by
the third.  Follow-up is essential for all newborns, and should be
individually tailored to ensure that breastfeeding is adequately supported
and protected, and the plan will vary depending on whether the mother and
baby are in an institution or living in their natural habitat.

The energy of both mother and baby is conserved in the strategy of skin to
skin contact in a reclining position, together, while mother practices hand
expression, either right onto baby's lips or into some small container that
can be used to serve it to the baby afterwards.  Most hesitant babies start
to show more interest when they have gotten hooked on the taste of expressed
colostrum.    

If the baby still shows no signs of being able to attach and suckle by the
time the mother is expressing copious amounts of mature milk, she may be
interested in learning about using a pump - or she may not, if she has
really gotten the hang of hand expression by then.  Skin to skin contact is
still for my money the most effective and the least complicated technique to
use all along. 

Funny (not) how one seldom sees a problematic delay in feeding behavior
after home birth, and yet how common they are in most hospitals.  Even with
little intervention, most women are less in charge of themselves when in
hospital, and that passivity may affect the initiation of breastfeeding.

Rachel Myr
Kristiansand, Norway

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