For part two in this breastfeeding series I’m going to give the reigns to my amazing friend Sheila. She and I met years ago in high school while working at this wonderful little mountain camp full of 6 graders. After we graduated she went on to nursing school and is now doing amazing work as a childbirth educator, doula and lactation consultant (IBCLC) in Qatar! (you should follow her blog!)
She’s written up a wonderfully helpful piece about the first weeks of breastfeeding that I think will be particularly useful to mama’s-to-be who are wondering how on earth they can prepare to keep their little human(s) alive after birth. (This was my chief concern in those final weeks whenever I wasn’t thinking about how to expel said humans from my body. I trust I’m not the only one!)
As I read her post I realized how much my memories of those difficult weeks have already faded, replaced by a slideshow of sweet milk-faced grins and newborn cuddles. But, remembering the hard work and adjustments of those early days reminds me just how incredible moms are. Breastfeeding, bottle feeding, SNS or tube feedings – we will all do whatever it takes to help our perfect little person thrive, even when it means enduring physical pain, foregoing sleep and neglecting our own needs! I’ve since learned about the wonderful title of “Postpartum Doula” – a role my mother-in-law and then my mom filled for me for the first 6 weeks after the twins were born – but if you’re far from family a doula can be an amazing support to carry you through!
Anyway. Enough blabbering from the non-medically trained milk farm. Let’s get to the expert!
Please note: Although I am an IBCLC, this advice is suited to healthy moms and babies without medical issues. If you have concerns, please contact your doctor or a local IBCLC who can assess your breastfeeding situation in person.
Breastfeeding is a journey, one that is continuously changing and evolving as you and your baby find your way together. The first couple of days and weeks are often the most challenging for a new mom. In the moments after you deliver your little one into the world you are flooded with emotions, hormones, and intense physical exhaustion and learning how to breastfeed may feel like an impossible task. The very best thing you can do to get off to a good start with breastfeeding is just to cuddle your brand new baby on your chest, skin-to-skin. It is the most natural, normal, safe place for your baby to be! In this perfect place his breathing stabilizes and he is less stressed because he can hear your heartbeat and smell your familiar smell. He will be the perfect temperature – your chest will actually warm up or cool down to keep him just right! His heart rate will regulate. You might even keep your baby on your chest until he uses his newborn reflexes (a.k.a. baby super powers) to “crawl”, squirming and wiggling up to your breast where you can support him in latching and starting to suckle. Even if your birth didn’t go exactly as planned or if you aren’t able to cuddle your little one right after birth, skin-to-skin contact has many benefits and should be practiced whenever possible in those early days!
The first 2 hours after a baby is born is the perfect time for your little one to have her first feed. She is most awake at this time and has the energy to latch and get her first dose of colostrum – that liquid gold, magic milk that your breasts have been producing during the last months of pregnancy. This first milk is thick and concentrated and packed with miracle food for your baby. One of the most important components of this first milk are the antibodies – the immune protection that you pass on to your baby. Your colostrum will also line your baby’s digestive tract with good bacteria to give her the best start for a healthy tummy. Many moms worry that they don’t have enough milk in those first days but remember: colostrum is so concentrated that babies only need a very little bit. In fact, on the first day your baby will take in less than a teaspoon at each feed because her tummy is only the size of a chickpea! As long as she is born full term and healthy she has extra fat on her body to “tide her over” until your milk supply is becoming established, giving you both time to learn how to breastfeed!
After the first feeding most babies have a long nap. Newborns tend to be very sleepy especially on their first day, this is why we encourage moms to nurse right after birth when your baby is most alert. Over the next 24 hours he will probably be hungry whenever he is awake. Let him nurse as often as he likes! Whenever he is sleeping, try to get some rest. your body needs to recover from the hard work of pregnancy and labor and falling into a rhythm of rest with your newborn is a wonderful way to do it!
So what is the “feeding on demand” thing all about? It simply means to feed whenever your baby is hungry. Forget about a schedule or pattern, every baby is different and each day will be different, just aim to feed your baby 8-12 times per 24 hours. When your baby starts to “root,” smack her lips, or suck on her hand, she is telling you she is ready to eat! To ensure that she is getting enough milk, look at her output. She should have 1 wet diaper per day of age for the first 5-6 days, and then at least 5-6 wet diapers/day after that. Newborns will poop at least 2-3 times a day in the first weeks. Breastfeeding also helps move his bowels to help get rid of meconium – that tarry black first poop that babies have to pass in the first few days.
Let’s talk about latch. You want as much breast in your baby’s mouth as possible. Remember: babies breastfeed, not nipple feed. It is normal to feel some initial discomfort when you baby first latches but the pain should subside as he continues to feed. If it keeps pinching, break the latch by wiggling your finger between his gums and try again. Point your nipple to his nose so he has to take more of the bottom of your areola into his mouth. Please don’t grit through the pain and just let him feed with a shallow latch, this will only lead to more pain and potentially nipple damage. If you are concerned about your latch or having pain, ask to see a lactation consultant or a nurse with breastfeeding knowledge. Sore, cracked, blistered or bleeding nipples are not normal! If this happens, ask for help from an expert! Don’t suffer in silence. If your nipples are sore, use your hands to express a bit of milk after feeding and rub it on your nipples. Those same antibodies that give your baby immune protection are great for healing sore nipples! Pure lanolin cream also works well and is safe for your baby.
Once you have gotten through the first day and night (congratulations!) the next milestone is…the second night. This is the infamous time of “topping up” and “cluster feeding”. By this time your baby will be taking in more colostrum at each feed and every time he suckles at the breast your body is receiving messages to make more milk. This is a very important part of establishing your long-term milk supply. For the first 6 weeks you are developing milk-making hormone (prolactin) receptors in your breast. When you let your baby nurse as much as he needs, your baby’s suckling develops and cues these receptors to continue to produce more milk. It might feel like the nursing will never end and you might worry that all the nursing means baby isn’t getting enough to eat. Try not to worry! Keep at it and note the number of wet and dirty diapers your little one has over the course of the day. And remember, your sweet baby is likely over-stimulated from all the new smells, sounds and feelings in their new world and the place she feels most safe is cuddled close to her mama. Breastfeeding is more than just nutrition for your little one, it provides comfort, pain relief and relaxation and releases hormones in you that nurture your bond with your little one!
In a day or two your milk will start to come in and your breasts will feel more full. If your breasts feel painfully heavy or are so full that you baby can’t latch, try to gently express some milk with your hands. Continue to feed your baby often and on demand and use cool compresses (cold cabbage leaves work well) on your breasts after nursing to help reduce some of the swelling. By 2 weeks post delivery, this balance of too little or too much milk will start to even out and your body will move to a supply and demand method of milk production. This means you will only make more milk when your baby feeds and empties your breast.
The first two weeks are a challenge for everyone. Be patient with yourself and your baby – you are both learning and experiencing this new journey together. In a few short months you will be that expert mom – easily breastfeeding her 4 month old baby one handed, while talking on the phone and eating dinner!