Welcome to our new series, I’ve Had My Baby - Now What?  This is a guide with basic information to help you navigate the first days, weeks, and months of breastfeeding your new baby.  

Today we would like to talk about that first week after your baby has arrived.  Breastfeeding can often seem overwhelming and  unfamiliar.  New moms often receive a *huge* amount of differing advice from many well-intentioned people, which can be incredibly confusing and discouraging.  Below is a quick guideline to what “normal” breastfeeding looks like, as well as some examples of when things aren’t going as they should and when you might want to seek help.

How often should my new baby be eating and how long should each feeding take?

A baby needs to breastfeed 8 or more times in 24 hours.  It’s especially important in the early days to feed your baby “on demand”, or whenever the baby shows signs of hunger, regardless of when baby ate last.  If your baby is not asking to eat every 2-3 hours, or 8 or more times in 24 hours, it is important to wake the baby to feed him/er, until they have regained their birth weight.  A feeding session should take approximately 30-45 minutes, and both breasts should be offered during this time.  It’s important to keep the baby stimulated and actively feeding during those 30-45 minutes.

How do I know my baby is getting enough milk?

A great way to be sure baby is getting enough breastmilk is to keep a physical log of all feedings (start time and length), as well as all pees and poops. A baby who is taking enough milk from mom will be feeding 8 or more times in 24 hours, for 30-45 minutes, and having 1 pee diaper and 1 poop diaper per day of life, until day 5.  For example, on day 1, baby should be having 1 pee and 1 poop diaper, day 2, 2 of each, etc.  After day 5, baby should be having 5 or so of each per day.  A baby who is getting enough should be satisfied for approximately an hour or two after feeding.  However, most babies will cluster feed for a 4-5 hour period during the day, when they may want to eat more frequently.  This is normal baby behavior!

How much milk does my baby actually need?

A baby needs very little milk per feeding during their first few days of life.  This is because they’re born full of meconium, which is that first poop.  This is a perfect fit for you, as your first milk, colostrum, is low in volume.  The small amount you make is just the right amount for your baby.  The amount the baby needs slowly increases, and as your milk makes the transition from the low volume colostrum, to the higher volume mature milk between day 3 and day 5, your baby’s needs go up as well.  Nature works beautifully!

I need to supplement my baby, what are my options?

Sometimes, a baby may need to be supplemented with additional milk.  There are many reasons for this - a baby has jaundice,  is unable to latch onto mom’s breast, there is a delay to mom’s milk “coming in”, etc.  When supplementation is necessary, it’s important to remember that you can use your own pumped milk.  If you aren’t able to pump the amount you need, you can use donor breast milk instead.  Formula is the last resort option.  There are various methods to use when supplementing your baby as well.  You can supplement your baby at your breast using a supplemental nursing system, you can finger feed your baby, or cup/spoon feed your baby.  A slow flow bottle is always an option as well and a lactation consultant can show you how to feed your baby a bottle in a breastfeeding-friendly manner.

Holy moly,  my boobs are like rocks!  They hurt and I can’t get baby latched on, what can I do?

As  your milk transitions from the low volume first milk, to the higher volume mature milk, it is common for moms to feel uncomfortably full and sometimes experience engorgement.  Engorgement occurs when the breasts fill up with so much milk that they become hard and  uncomfortable.  It can sometimes be difficult to get the milk flowing and baby sometimes has a hard time latching on.  Some tricks to latch your baby on during this time are: pump or hand express for a few moments before latching your baby to soften your breasts and get milk moving; use warm compresses or take a shower just before feeding; use cold compresses between feedings.  If you still  feel incredibly uncomfortable after your baby feeds, you can pump or hand express some additional milk - but it is important to only pump to comfort as you don’t want to send the message to your body to make even more milk.  Please be aware that if you begin to run a high fever, have flu-like symptoms, and hot or red spots on your breast, you may be developing a breast infection (mastitis) and it’s important to seek medical attention immediately.  

Why do my nipples hurt and what can I do to heal them?

It’s normal for all moms to feel some initial tenderness and discomfort in the first days and weeks of breastfeeding.  Anything beyond tenderness is a sign that something may not be going right, especially if there is any tissue breakdown, damage, cracks or bleeding.  If you experience any of these, please seek the help of a lactation consultant.  Great healing items are organic coconut oil and hydrogels, or soothing gels, sold by many different companies and available at big box stores.  The best prevention for sore nipples is a good latch - if you are having trouble finding a correct latch, get help!

When should I seek help?

There may be times when things aren’t going the way they should.  If you find this, please contact an International Board Licensed Lactation Consultant to help you.  Some signs that you might need some additional help:

• Damaged/cracked/bleeding nipples.

• Baby isn’t gaining weight/mom’s milk hasn’t “come in” by day 5.

• You suspect your baby is tongue-tied.

• Baby isn’t peeing or stooling the amount that they should.

• Breast infection/Breast abscess

• Oversupply

• Extremely fussy/gassy baby

Join us next time, when discuss breastfeeding your baby during weeks 2-6!