I’ve Had My Baby - Now What?: Breastfeeding During the First Week

Originally published on Jan 24, 2014; Revised Feb 22, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

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 chest/breastfeeding your new baby.  

Today we would like to talk about that first week after your baby has arrived.  Chest/breastfeeding can often seem overwhelming and  unfamiliar.  New parents 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” chest/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.

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

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

A newborn needs to feed 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/her, until they have regained their birth weight.  A feeding session typically takes approximately 30-45 minutes, and both breasts should be offered during this time.  It’s important to keep the baby 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 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 are those first few poops.  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 your 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 not latching well, there is a delay in the parent’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 milk instead.  Formula is the last resort option.  There are various methods to supplement your baby as well.  You can supplement your baby at your chest/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 chest/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 your chest/breasts to feel full and sometimes experience engorgement.  Engorgement occurs when the chest/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 chest/breasts and get milk moving

• Use warm compresses or take a shower just before feeding

• Use cold compresses in between feedings to reduce inflammation.  

  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 chest/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 parents to feel some initial nipple tenderness and discomfort in the first days and weeks of chest/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, give us a call!

When should I seek help?

There may be times when things aren’t going the way they should.  Our IBCLCs can absolutely help you with all of this!  Some signs that you might need some additional help:

• Damaged/cracked/bleeding nipples.

• Baby isn’t gaining weight/parent’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

If you’re unsure about your baby’s latch, milk intake, or feeding patterns, know that you’re not alone—we’re here to help!

The first week of breastfeeding comes with many changes, and it’s completely normal to have questions or concerns along the way. Whether you need guidance on positioning, reassurance about your baby’s feeding cues, or support with any challenges that arise, our team is here to provide the care and expertise you deserve. Schedule a one-on-one appointment (consider a virtual appointment, if you don’t live in San Diego!) with one of our lactation consultants for personalized care and expert advice tailored to your baby’s unique needs.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

Support Group or IBCLC: What's the Difference?

When a mom is looking for breastfeeding assistance, it can often be difficult to know where to get this help and from whom.  There are so many options…. Facebook, breastfeeding support groups, lactation consultants… where to go can be confusing, especially if she feels like she needs to get help immediately!

So, what is the difference between the breastfeeding help you will get at a support group and at a private lactation consultant visit?

What you can expect at a breastfeeding support group:

Let me preface this by saying that not all groups are the same and it really depends on the level of expertise of the person running the group and how busy the group is.  There are different levels of experience and training in the field of lactation, depending on how many hours a person has spent in class and in an internship.  The level of expertise are demonstrated by the letters that follow the person’s name (IBCLC, CLC, CLE, etc), which is all explained in this fantastic article, What’s the Difference Between LC, IBCLC, CLE, etc?

At a breastfeeding support group, you will find a leader who is there to offer general breastfeeding assistance and support.  This leader can assist with positioning and latch (although often times this leader will not be able to actually touch you or the baby), basic information about normal breastfeeding/pumping strategies, normal baby feeding patterns, normal baby weight gain, breast and nipple care, and ways to maintain and protect your milk supply.  Often times there is a scale where you can weigh your baby before and after a feeding to see how much your baby is taking in (which is AWESOME!)  Attendance at the support group can range from a few moms to over 20, depending on how big the space is and how well attended the group is.  Support groups are often free, depending on where you live.  Support groups are fantastic for getting basic breastfeeding support, getting help while you wait for an appointment with an IBCLC, meeting other breastfeeding moms in your community, and practicing breastfeeding outside of your home.  

What you will not receive at most breastfeeding support groups is a personalized plan of care for difficult breastfeeding situations.  To create a personalized plan of care, a mother and baby’s medical history need to be discussed, as well as mom and baby both need to be assessed, which requires a consent form.  Therefore, most advice given at a breastfeeding support group is general, not specific for mom and baby’s personal situation.  

What you can expect at a private lactation consultant visit:

If you are meeting with an International Board Certified Lactation Consultant (IBCLC), you are now moving from general advice to a personalized assessment and plan of care.  The IBCLC should conduct a suck assessment on your baby, collect medical histories of both you and your baby, assess a feeding session, and offer guidance on how to improve your personal breastfeeding experience.  

Reasons you would want to see an IBCLC rather than just attend a support group:

• Cracked, bleeding nipples

• Painful latching that isn’t improved with positional changes

• Baby not gaining weight well

• Mom’s milk has not come in by day 3-5

• You suspect your baby has a tongue tie and/or lip tie

• Baby has signs of colic or reflux

• Mom has a low milk supply/supplementing baby

• Mom has an oversupply

• Premature baby

• Challenges with breastfeeding multiples

Each of these situations requires that someone provides a medical assessment and advice beyond what’s normal or typical with breastfeeding, therefore, it goes beyond what a mom can seek help for at a support group.  These private visits can take place in mom’s home, in the IBCLC’s office, at an outpatient clinic, at a medical practitioner’s office, or similar places.  Most of the time these visits have a fee associated and sometimes insurance will pay for these visits.

Where you can find an IBCLC in your area:

• Ask your friends

• Ask your baby’s pediatrician

• Search for a local breastfeeding coalition

• Call the breastfeeding warm line at the hospital or ask your midwife/OBGYN

• Ask your WIC Peer Counselor

• Search for an IBCLC in your area on the ILCA website

• Google “IBCLC” and the name of your town or city

• Ask for a recommendation on Facebook

• Attend a support group led by an IBCLC

Where have you found breastfeeding support in your neighborhood?  

Was it easy to find this support?