Getting Started With Breastfeeding

Day One Breastfeeding Tips

Breastfeeding in the first 24 hours

• A mother is all that a baby needs during its first 24 hours of life. You provide the colostrum (early breast milk), warmth, and tenderness needed to help your baby adapt to life outside the womb. Trust nature! You and your baby are learning to breastfeed together. It takes practice and patience.
• Unless there are medical problems, supplementing with formula during the first 24 hours is unnecessary, and it can actually create problems.
• For most babies, the sucking reflex is most intense within the first two hours of birth. Breastfeeding right after delivery is ideal for mother and baby.
• Many babies tend to spend much of their first 24 hours after birth sleeping.
• Some babies are only soothed by nursing frequently, which is also very normal.

What is colostrum?

Colostrum is early breast milk that is rich in ingredients that fight infection and help your baby resist germs. It is produced in very small amounts—the average total volume during the first day postpartum is eight teaspoons. Your baby’s nutritional needs are very low at this time. That is why nature has provided small volumes at first. Colostrum is yellow and sticky, and it can be very difficult to express by pumping. If you are collecting milk for your baby, be sure to save every drop. Your baby’s feeding skills need not be perfected to obtain colostrum.

What your baby really needs

• Babies naturally consume very little during the first day of life. Making a baby feed from a bottle may reduce your anxiety related to fear of underfeeding, but it is usually not what your baby needs. Bottle feeding on the first day is not part of the natural process. It can result in over-feeding your baby, and it significantly undermines breastfeeding success.
• Bottle feeding and breastfeeding behaviors are very different. Unlike you can with bottle feeding, you cannot force a baby to breastfeed. It is normal for babies to take small feedings inconsistently during the first day of life.
• Using pacifiers and bottles does not help a baby learn to breastfeed, and it may hinder progress. These items should be avoided until breastfeeding is well established unless they are medically indicated or there is mom/baby separation.

Second Night Breastfeeding Tips

What is baby’s “second night”?

This is an event recognized by mothers, nurses and lactation consultants around the world. It occurs about 24 hours after birth (generally the second night). This is what happens:

• It may seem as if baby wants to be on the breast nonstop.
• Baby may fall asleep at breast, but wake as soon as put down or moved.
• Baby is most content at breast.
• Mothers don’t get much sleep.

What is really going on?

• Baby “wakes up” that second day.
• Baby is adjusting to the new environment.
• Baby needs what is familiar (mom) to soothe him or her.
• Putting baby to or near the breast will bring him or her closest to the womb and provide many of the same sounds as and security of prenatal life.
• These behaviors are not about hunger, starving, or not getting enough milk; they are about using mom as a pacifier, which is totally normal and expected.
• These behaviors are not about your baby being manipulative or spoiled. They are about baby coping with a new and sometimes overwhelming environment.

Signs of over-stimulation

• facial grimace, worried expression and frowning
• irritability, arching of back and splaying fingers
• excessive alertness or holding hands in front of face
• stiffening and extending limbs
• turning away from eye contact or closing eyes
• difficult to comfort

So what can you do?

• Be aware of what may happen on the second night, and know that it is normal.
• It is fine to hold your baby all the time and nurse whenever baby seems hungry or needs to nurse.
• If baby falls asleep at your breast, slide your nipple out of baby’s mouth and continue holding him or her until deep sleep occurs, then transfer to the crib, if necessary.
• Put your baby skin-to-skin.
• Darken the room.
• Limit noise levels.
• Treat baby gently, and avoid passing the baby from visitor to visitor all day.

Day Three Breastfeeding Tips

Days three to five: milk is on the way!

The amount of milk that you make goes up dramatically about three to five days after birth; this is often referred to as when your milk “comes in.” During this time you may see changes in both yourself and your baby. Once your milk begins to come in, your breasts may feel full and heavy for two to three days and then return to a softer state.

• Your baby will still nurse eight to 12 times in 24 hours for a total of up to 15 to 45 minutes each feed. Your baby may choose whether to nurse from one or both breasts at each feeding.
• Your baby’s stool will change from dark, sticky meconium (stool) to a yellow, seedy and looser stool.
• Your baby will urinate six to eight times a day.
• Your breasts may feel full, heavy and warm to touch. This is because blood supply to the breast increases as your breasts begins to produce more milk.
• It is important to breastfeed often during this time. Moving the milk out of your breast will make you more comfortable and teach your body how to make milk.
• Some women may experience engorgement during this time. This is when the breast gets too hard and tight. The areola and nipple may be stretched and flat making it challenging for your baby to latch on. You may express some milk to soften the areola and then latch your baby on. You may put warm compresses on your breasts for 10 minutes before nursing and cold packs for 10 to 15 minutes after nursing. A warm compress can help widen the ducts and help the milk to come into the ducts in the breast. Cold packs after can reduce swelling. Engorgement can be a sign that baby isn’t nursing properly. If you experience engorgement, please contact your lactation consultant or health care provider.
• If you are unsure of how to manage your breasts or how to latch your baby onto your breasts, please contact a lactation consultant or your health care provider.