Essential breastfeeding knowledge for the first weeks.

Breastfeed as soon as possible. Place baby to breast right after birth, this is when baby’s sucking instincts are strongest. Babies are most alert for the first hour after birth. Unless mommy or baby are in some form of distress where medical attention is required, the other things can wait. Measuring, bathing, immunizations, temperatures, etc, all of it can wait. This hour is precious time and passes with the blink of an eye. I was so happy I had the opportunity to begin nursing my baby right after birth. I was nervous, anxious, excited, and overwhelmed with emotion during this time. With all the commotion and emotion of that hour, I am still shocked at the calm and natural way my little one took to my breast so quickly.

After this initial hour of life, baby will become tired and settle into a sleepy state that could last hours or days. Because of this, if you are able, try and utilize as much of that initial hour of life as possible to nurse baby. Utilizing this hour gives baby an opportunity to practice on your breast and nipple when it is still soft and easy to grasp because your milk hasn’t come in yet. Practicing gives baby the opportunity to burrow your breast, smell mommy, lick the nipple and areola area, all of which will help for nursing later on. Furthermore, any nursing that can take place is a benefit to mommy as well; nursing will help contract the uterus, reduce bleeding, and speed up delivery of the placenta. My little one was nursing away and I was soaking in her cuddles right after birth so much, I didn’t even notice my OB/GYN finishing up my delivery and getting me stitched up.

To ensure you have this time, make sure to let your OB/GYN (and the medical staff assisting you) know you are choosing to nurse straight after delivery. Remember, you are in charge. If this is your wish, make it known to the medical team assisting you so they follow your wishes. Furthermore, do not allow the nursing staff to give baby a bottle or pacifier if you’ve cleared stated to them you will be breastfeeding. It’s okay to tell a nurse NO; they are not the parent, you are. Unless there is some kind of medical necessity that requires them to do so, a baby doesn’t need the extra fluids or nipple confusion at that time.

Room in and nurse often. Room in with baby. If you absolutely need some sleep or rest, don’t feel guilty having baby go to the nursery or nurses station for an hour or two. After all, one has to take care of oneself in order to effectively take care of another. But, if you are able, keep baby close. This is a learning period for both parents and baby, it’s an ideal time for parents to begin learning their baby’s feeding cues. Some of these cues could be sucking their hand, puckering and/or smacking their lips, putting hands to their mouth, moving head side to side (instinct to search for the breast), wriggling around, accelerated eye movement, etc. I want to make a point to note: CRYING IS A LATE FEEDING CUE. If baby is already agitated and crying, there is less chance baby will calm and nurse well. So, try and observe baby’s initial cues and begin feeding before baby becomes upset.  

An average size newborn will typically nurse 10-12 times or more in a 24 hour period. Since my baby was a preemie and small, she nursed more like 12-16 times in a 24 hour period because her tummy was smaller than an average 7 1/2 pound newborn and she couldn’t consume as much food in a feeding . So, the amount of times your baby will require feedings will largely depend on their weight and size. The more a baby nurses, the sooner mommy’s milk will come in and the more milk mommy’s body will make. For more information on newborns’ feedings please read: Loving Little Lambs: Week One, baby routine & schedule and Loving Little Lambs: Week One, the bullet point baby basics. If you are unable to be with baby after birth, or nursing doesn’t initially go well, use a hospital grade pump (the hospital will provide you with one while there) to stimulate and maintain milk supply. 

Plan to allocate most of your time to breastfeeding during baby’s initial weeks of life. I was so naive to think I would have any semblance of a “life” outside my baby and the house during her first few months (let alone her first few weeks) of life. I literally went from being a human incubator to becoming a human dairy cow and pacifier. I spent approximately 8-10 hours a day breastfeeding and an additional 4-6 hours a day pumping in the initial weeks of my baby’s life. For a period of time, breastfeeding will consume mommy and baby’s life. So if you’re a recovering mommy, try and remember the essentials: shower or bath, eat, hydrate, brush teeth, change into fresh clothes. I give major props to an mama who can manage the essentials and breastfeed with a smooth balance from the get go, it is a huge accomplishment.  

During this time, it’s not uncommon for friends and family to try and/or offer help. Take them up on it!! But, LET THEM HELP YOU and you take care of baby. Yes, everyone wants to hold to precious newborn, I know I am one of those people. However during those initial weeks of baby’s life (while getting a handle on breastfeeding and one’s milk supply) the best help friends and family can provide is help directly to you. They can do this by helping with the cooking, cleaning, helping with other children, assisting with carpools, running errands, etc. By providing assistance to “mommy,” mommy can actually rest when baby is resting. My mother was an answer to prayer during this time and made it possible for me to focus on baby and my recovery. This kind of help is invaluable to any woman recovering from childbirth.

I recommend setting up a space in your home dedicated to nursing. We called ours “the nursing nest.” Think of it as a one stop shop nursing station, it should have everything one would require or utilize during a breastfeeding session. Some things to have on hand at a “nursing nest” would be: a nursing pillow, extra pillows for mommy, diapers, wipes, diaper cream, change of baby clothes, towel and burp cloths for diaper leaks and spit ups, nursing pads, breast pump (I recommend a hands free suction pump for these instances), bassinet/moses basket (place for baby to sleep), change of bassinet linens, water for mommy, snacks for mommy, laptop or ipad, cell phone, chargers, remote control(s), book, etc. It is helpful to having one “station” set up in both the living room and bedroom.

You will be a human dairy cow and pacifier, and its actually helpful to nurse for both sustenance (dairy cow) and comfort (pacifier) during baby’s initial weeks of life. Newborns need to suck and mommy is the “original pacifier.” So if and when baby begins to fuss, put baby to the breast–this works! It is okay to be a human pacifier during baby’s initial weeks of life, it makes baby happy, builds a one’s milk supply, and allows mommy and baby time for restful bonding.

Nipple confusion is a real thing, it does exist. I can’t even remember how many people laughed at me when I said I wasn’t offering my baby a pacifier during her initial weeks of life to avoid nipple confusion and establish a solid milk supply and breastfeeding. Some babies may be able to switch from breast to bottle or breast to pacifier efficiently during the newborn period, however a large majority of babies will become confused before solid breastfeeding is established. I was taught and would recommend waiting at least 6-8 weeks before introducing an artificial nipple in the form of a bottle or pacifier. If your baby needs supplemental feedings during this period, there are ways to do so without introducing artificial nipples. I will discuss this more later.

Breastfeeding sessions. I recommend not putting a time limit on how long baby spends nursing. If baby remains interested and wants to nurse, let baby nurse. The hindmilk comes later in a nursing session after mommy’s milk has let down. This hindmilk will hold more calories and will be more filling. Initially, toward the beginning of a woman’s nursing journey, it may take longer for her “milk let down” to start. So letting a baby nurse longer will (more than likely) help fill them up more not only because they are getting more breast milk, but because they are getting more fatty/high calorie “hindmilk” that comes later in a nursing session.

Try and offer both breasts during a feeding session. I recommend trying to nurse baby at least ten to fifteen minutes on the first side before burping and switching breasts. At the beginning of my nursing journey, my baby would actually nurse approximately 20-30 minutes on each side. She was tiny, so she was slow. Then, at the next feeding session, start with the breast baby nursed on last. Both breasts need to be stimulated, but sometimes a baby can only handle nursing on one side during a feeding session once a milk supply is established. If that’s the case, pump off the milk from the side not being used (or not being used well) during that session. You want the milk in both breasts completely drained after each feeding session, so if baby is unable to do this, use a pump to finish what baby could not. 

Support the breast with your free hand when offering it to baby and monitor baby’s latch to ensure effective nursing. You want baby’s mouth wide open, their lips flared out, their tongue drawn-out over their gum and under your nipple (or cupped at the bottom of your nipple), and their chin touching the lower part of mommy’s breast. Baby should have the nipple and some (or all) of the areola in their mouth. You want to try and avoid having baby turn their head to nurse, so ideally, you want baby’s entire body facing yours. You want baby’s nose almost touching or brushing your breast; baby should breathe easily with nostrils flaring while nursing. When baby is nursing effectively, you will see a rhythmic motion along their jaw. Additionally, you can hear baby swallowing. If baby is latched incorrectly or isn’t nursing effectively, they won’t get the nourishment they need and mommy will not get the stimulation she needs for her body to produce more milk so it is important to monitor the process carefully in the beginning. 

Colostrum, transitional milk, and mature milk. Colostrum is the ideal first form of nourishment for baby. Baby will not starve in the days before mommy’s milk comes in, colostrum will meet all of baby’s nutritional needs. Colostrum is full of antibodies and provides essential immune elements newborns can’t get anywhere else; it is arguably better than vaccines baby can get. During baby’s first days of life, he will consume only teaspoons of colostrum at a time. Baby’s kidneys can’t handle large feedings during these early days because they are still in the process of maturing. Colostrum acts as a newborn laxative and clears the meconium out of baby’s system; this will assist in avoiding jaundice.

Transitional milk will “come in” two to five days after giving birth. I was informed it typically comes in on day three for most women, personally mine really came in on day five and six. Transitional milk is a mix of mature milk and colostrum. Over the course of the next couple weeks, mommy’s body produces less colostrum. Once baby reaches approximately two weeks of age, colostrum is no longer produced and mature milk replaces transitional milk.  

Extra fluid in baby’s tissue. During the first day or so of life, baby will pee and poop out the extra fluid they are born with. Because of this, in the first couple days after birth, most babies will lose some weight. An average seven and a half pound baby will lose around 7% of their birth weight (approximately 8 ounces). This is normal and to be expected. Once baby purges this extra fluid from their body, they will naturally experience hunger pains for the first time. This typically occurs around day three and four, after baby and mommy have come home from the hospital.

Forewarning, this can be a rough few days!!! This is the time period when mothers who cease breastfeeding are most likely to stop. Baby nurses a lot during their first day or two of life because they want to suck, they really aren’t even that hungry due to their extra body fluid. However, by days three and four, hunger sets in and baby can become fussy. This is also when mommy’s milk has come in or is coming in; meaning her breasts are hard and sore, mommy is most likely very uncomfortable and could be in some degree of pain.

Try and avoid giving baby supplements during their early days of infancy. Supplementing at such an early point in a breastfeeding journey can create several problems, first and foremost being a decrease in milk supply. Here is why, formula takes longer for baby to digest than breast milk. Because of this, baby stays full longer on formula so they are less likely to nurse as often. This would create a lack of essential stimulation required for a healthy milk supply. Furthermore, the sooner baby is introduced to artificial milk, the higher chance baby will have of allergies and/or digestive problems.

Supplements are rarely medically advised and directed. However, if they are, there are alternate feeding methods instead of bottles. As previously stated, I had a preemie, she had a low birth weight and was small. Because of this, regaining the weight she lost during her first day or two of life was extra imperative. It was medically advised and directed to me to begin triple feeding her on her first day of life. So, I was to supplement feed her more of my own breast milk.

In short sum, triple feeding is 1) breastfeeding from the breast 2) pumping away the unused breast milk from that feeding session and 3) force feeding baby the additional milk that was pumped. I triple fed my daughter for her first month of life. She regained her birth weight within two weeks, however, I continued to triple feed in order to try and get her weight up even higher. Triple feeding was very helpful in regaining her birthweight!!

My baby was never given a bottle or artificial nipple during these supplemental feedings. I used syringe feeding, tube feeding, and finger feeding to supplement the extra breast milk to her. My lactation consultant taught myself and my own mother how to do these different kinds of feeds, she was beyond patient and helpful. It is helpful to have my mom know how to do the triple feeds so she could begin the supplemental feeds while I was pumping or doing self-cares. It is important to note, a woman’s fingers tend to work better because we typically have smaller hands and fingers that closely mimic a natural nipple in texture. A man’s fingers are often too large (and often rough) for a newborn’s little mouth.

Keep track with a baby log. Since baby’s milk consumption from the breast can’t be measured like formula or breast milk from a bottle, it is essential to keep track of baby’s output and weight. It is very hard for any mom to keep track of all of baby’s feeding details during these first weeks by memory alone. There is so much happening those first few weeks, details simply get lost in translation or the brain fog of fluctuating hormones and sleep deprivation. So, do yourself a favor and write it down in some kind of written log or digital app tracker. It’s the best way to make sure baby is getting enough to eat, and it makes communicating any and all necessary information to baby’s doctor so much easier. I kept a three ring binder log for my baby’s first four months, IT WAS A LIFESAVER!!

So, after that massive amount of content (and more than likely a fair amount of typos and grammatical errors), I am signing off for now. More to come soon, so stay tuned 🙂

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