Breastfeeding Basics
Breastfeeding is natural but not instinctive. A mother has to learn how to attach her baby correctly to the breast and how to make sure her baby drinks enough milk. Some babies breastfeed very easily and others seem to have no idea what to do. If your baby is not a “natural” do not blame yourself and do not keep struggling – tell your baby’s physician and ask for help. We want to make this work for you!
For most healthy, full-term babies, we recommend
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In the first 48 hours feed your baby on both breasts at least 8 to 10 times in 24 hours.
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Breastfeed your baby when you see feeding cues.* This means she’s ready to eat!
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Place baby skin to skin as often as possible.
Babies will often feed very frequently the first few nights of life. It’s called “cluster feeding.” Don’t worry – this is normal!
How do I know my baby is ready to eat?
These are called “feeding cues”:
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Putting hands near her mouth
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Eager to suck anything that touches her mouth
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Becoming more awake
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Turns his head towards your breast (rooting)
Crying is a late sign of hunger. Newborns become disorganized and harder to latch when they are crying. Let you baby suck on your clean finger until she calms down before trying to latch her.
Almost every mother can make plenty of milk. It would be ideal if every mother immediately made enough milk to support her baby exclusively with breastmilk and, although this is a reasonable goal, it is not always the case. Some mothers make milk early and generously, but some may take up to six weeks to bring in a full supply. If your milk is late we will work with you to make sure your baby continues to thrive and your breasts are given the right message to bring that milk in.
What should you do if your milk is delayed?
Don’t panic – it will come!
But your baby must feed in the meantime. We can help you select the best formula and explain how to use a bottle in a way that supports your baby’s breastfeeding skills.
We’ll also ask you to start some pumping to tell your breasts to speed things up! We will help you keep breastfeeding on track while you need to use some formula supplement.
Babies need a lot of milk!
A full-term baby with good weight is born with fluid and energy reserves to last through the first two days when feeds consist only of small quantities of colostrum. By day three newborns have used up these reserves and they need a rapidly increasing quantity of milk.
How much milk?
Your milk ideally will arrive on day 3 providing feeds of 1+ ounces (30 plus mL) about every 3 hours. Your breasts will feel heavier, warmer, and probably a bit uncomfortable. You may notice some milk dripping out and you will hear your baby swallowing. Your baby will act content after a feed.
On day 4 and following your milk will be fully “in” allowing your baby to take whatever quantity he or she wants – typically 1.5-2 ounces (45-60 mL) – or more. By the end of the first week an 8 pound (3.6 kg) baby will need at least eight 2.5 ounce (75 mL) feeds!
How do I know the breasfeeding is going well?
Your baby’s urine is the best indicator of milk intake. Look for increasingly heavy, colorless pee diapers. If the pee looks concentrated with perhaps some orange-red traces on the diaper then your baby may be dehydrated. See your baby’s physician immediately for help. By day 4 your baby should be producing 4 or more brown-yellow, runny poops which will turn completely yellow on day 5.
Did you know?
Some moms are likely to make less breast milk. If you have a history of PCOS, infertility, obesity, or breast surgery, talk to your doctor about how to maximize your milk production.
How do newborns operate?
By reflex.
There is no thought (as we would know it) in the first month. Your newborn’s feeding responses are reflexive and triggered by touch. For example, if your baby’s chin touches your breast he will open wide. If your nipple touches his palate he will latch onto your breast. If milk lands on the back of his tongue he will swallow and continue to feed.
How do breasts operate?
In the first week milk comes in under hormonal control. Within 72 hours of delivery of the placenta you will notice a jump from colostrum to copious quantities of milk. From this point on the amount of milk you make is under local control – each breast makes milk according to what is taken out either by a pump or by the baby.
Top 10 Questions asked by new parents about breastfeeding:
My nipples hurt – is this normal?
Your nipples may be sensitive in the first week due to hormonal changes and all this new activity! There may be discomfort with the latch but there should be no pain, and no visible damage.
Why is my baby lazy at breast? He falls asleep then wakes as soon as I put him down.
It’s the flow of your milk that keeps your baby active at breast. Watch your baby’s swallowing pattern. If your baby is mostly suckling, not swallowing, he may fall asleep before he’s full. Please look at this video so you can recognize good feeding.
https://globalhealthmedia.org/portfolio-items/is-your-baby-getting-enough-milk/
How long should a breastfeed take?
With good swallowing your newborn may fill her tummy in 10-20 minutes. ther babies may need 30-45 minutes to be full.
How do I keep my baby swallowing?
Likely she is swallowing very well when you first latch her. s soon as you see her slowing down, compress (squeeze and hold) the base of your breast, pushing more milk to her. When she slows down again, take her off, wake her well then offer the second breast. She’s full when she leaves your breast and is totally content. She will be quietly awake or asleep, not fussing.
Why does my baby keep getting his hands in the way when I try to latch?
If he cannot feel the breast against his face, he will flail his arms and wiggle his head, searching for you. Place him snugly against you so that his cheek or chin touches your breast. Now he knows where he is.
Is my baby using me as a pacifier? Sucking just for comfort?
Every time your baby wants to suck, she is looking for milk. A baby certainly is comforted while feeding at breast but will not seek the breast “just for comfort.” Your milk supply will keep pace with your baby’s appetite if you offer your breast for all hunger cues. You cannot overfeed.
What if I must use a bottle in the first weeks?
A carefully given bottle will not automatically undermine your baby’s hard-wired reflexes to breastfeed, even if given in the first week. Please ask for our handout on avoiding nipple confusion. Pump every time your baby takes a bottle so that your milk supply will increase.
I’m getting conflicting advice- how do I know what to do?
The number one complaint from new parents is conflicting breastfeeding advice. How can you swiftly sort out the good from the not-so-good ideas? Imagine living a thousand years ago and ask yourself whether the advice you just received would make any sense. For example, would you be using a clock? A pacifier? Breasts and babies haven’t changed!
What if my baby does not burp after a feed?
Sometimes they don’t, and that’s ok. Keep your baby upright for about ten minutes at the end of a feed, patting gently.
I thought breastfeeding would be natural. Why does it feel like so difficult?
Babies instinctively search for the breast, but most mothers have to learn how to help babies use these reflexes, and how to help them feed efficiently. By baby’s second month this learning is done!