The First Days of Breastfeeding
August was National Breastfeeding Month and celebrated in many important ways. I’ve been thinking all month of what to write about breastfeeding - what would be most helpful to families. I’ve decided to start at the very beginning and talk in more detail about the first few days of breastfeeding - as these early special days are incredibly important to establish milk supply, increase mom’s confidence, and succeed with a comfortable (pain free!) and efficient (baby weight gain!) breastfeeding relationship.
Day 1 - Whether you intend to breastfeed or not, immediate, continuous and uninterrupted skin to skin contact after birth is highly recommended for many reasons. This means that as soon as the baby is born, they are placed naked on mom’s chest (or laying sideways below breasts after a c-section). No blankets, no hats necessary as mom’s body alone will regulate the baby’s temperature. The baby needs 60 - 90 minutes (Golden Hour) to smell, nuzzle, move, rest, familiarize with mom, and instinctively find the nipple all by themself. Routine care for a healthy baby can be done while the baby is skin-to-skin. Baby kneads mom’s breasts and stomach which helps the placenta fully deliver. As soon as this happens, mom begins making transitional milk.
Moms start making newborn milk about halfway through pregnancy (colostrum) and this yellow, nutrient rich milk is perfect for baby and immediately provides antibodies to protect the baby’s immune system. During Day 1-2, mom will make teaspoons (milliliters) of colostrum (not ounces) and that is enough for baby! It is so common for people to worry that mom doesn’t have enough milk at first, especially if she is trying to pump. Pumping is not recommended this early. Transitional milk is then made starting Day 1 and this milk is specifically designed for that baby.
It is important that the newborn baby suckle at the breast often (10-12 times) those first 24 hours. Typically the baby will only nurse for a few minutes. Each time the baby suckles, the milk making hormones (prolactin) increase. Each time the nipple is stimulated (either by baby or hand expression), the milk ejection hormone (oxytocin) is triggered to release milk.
Day 2 and Day 3 - Transitional milk is being produced and appears less yellow than colostrum. Mom’s milk is a scientific masterpiece. There are still not ounces, but teaspoons worth, and that is what baby needs 10-12x/day. At this point we start to look at baby’s latch and there are a few tips to establishing a great latch that will not hurt, and will allow baby to transfer milk quickly. An efficient latch means the baby is able to transfer what they need in 10 - 15 minutes total. The goal is to have baby open their mouth to 140 degrees to take in more breast than the nipple, and to have a tight seal (lips flanged out). There are ways lactation professionals can help with this!
Pain is never a necessary part of breastfeeding. We don’t want this to hurt you momma for even a minute. When moms describe feeling significant pain or even nipple damage, this indicates that a slight adjustment of the latch and position needs to happen. This is why early help and support with breastfeeding is so important. Please - if you are experiencing pain while nursing or have nipple wounds, PLEASE reach out for help.
For those moms with pain and bleeding nipples, I relate to you - that was me with my first baby. It was so hard and while I so wanted to breastfeed, I would cringe when he became hungry in anticipation of the pain. Thankfully, I was involved with a La Leche League group of experienced moms who helped me readjust his body, line him up tummy to tummy and use the boppy pillow differently. Very soon my pain was gone!
Day 4 - Typically, around day 4 or 5, mature milk is being produced. There is more of this milk and it often appears like 1% or skim milk. Baby still needs to nurse 10-12x/day and indications they are getting enough milk are if their weight is increasing (about 1 ounce/day) and they are producing 4 poopy diapers/day.
Research supports what I have heard moms say firsthand - getting support, encouragement and information those first few days is really helpful and a strong indicator of a happy nursing relationship in the early weeks of breastfeeding with no pain for mom, and a happy growing baby.
For more information on early feeding cues and when to feed the baby, please visit: https://www.earlycaredoula.com/blog-1/how-do-we-know-when-baby-is-hungry-12
For frequently asked questions about infant feeding, please visit: https://www.earlycaredoula.com/blog-1/infant-feeding-faqs-4
For more information on the benefits of skin-to-skin for mom and baby, please visit: https://www.earlycaredoula.com/blog-1/three-cheers-and-reasons-for-skin-to-skin-11
