Breastfeeding – First Weeks
Producing breastmilk is part of the physiological process of pregnancy, birth and postpartum.
No matter if you are planning to breastfeed your baby for one month or one year, ensuring that she gets every drop of breastmilk she can in the first hours and weeks of life is an investment in her health and yours. Breastfeeding immediately after birth helps lower your risk of excessive postpartum bleeding, helps bring your hormones into alignment and helps your baby’s immune system and digestive bacteria develop. Breastfeeding is especially important after a caesarean or challenging birth.
Simply put - breastfeeding is the biological norm. That doesn’t mean that it’s easy, which is why some knowledge and support can go a long way.
Breastfeeding reduces your chances of breast and reproductive organ cancers, helps you recover after birth and makes sleep easier for you and baby. Breastfeeding is an investment in your baby’s short and long-term health, and provides her with protections and benefits through childhood and beyond.
Colostrum
The first milk you produce is sticky, thick and golden-coloured colostrum. This is an immune and calorie bombshell. You only produce a few drops at a time, but that’s enough for your baby’s stomach which is only about the size of a cherry on the first day of life. A little goes a long way.
Getting baby to latch on comfortably
Having a good latch is key for the baby to drink from and empty the breast effectively. Position baby so that you bring baby to the breast (as opposed to bringing breast to baby) with her head back, bring her head towards the nipple ensuring that her mouth is open as wide as possible. Once she takes in the nipple, most of the dark area around the nipple (areola) should be in her mouth, especially the lower part, and her lower lip should be turned outwards. You might be able to see
her tongue between her lower lip and the nipple. A good latch has no friction and should not hurt - during the first few days you may feel some pain for the first few seconds of a feed and then feel better, and your skin may be sensitive or you might be feeling your let-down reflex - but this is short-term and passes as the feed goes on. You should not hear baby making clicking noises.
Learning how to get a good latch is a process for you and baby – it takes a while for you to know what a good latch feels like and it takes a while for baby to learn how to achieve it, but it’s essential to your breastfeeding success. Get assistance from your midwife or nurse for the first few feeds until you get the hang of it. Your comfort is important while breastfeeding, take the time to get into a position you can be comfortable in for at least twenty minutes - use pillows to prop your arms up and support your back as needed.
If you need help, get it early. A lactation consultant can be a godsend and save you time, stress and problems. See if there is a lactation clinic in your area that you can call or visit.
Making Milk
Milk is created through a system of supply and demand - the more milk your baby takes from your breast, the more milk your body will make. This requires that your baby empties your breast as much as possible at every feed - by putting your baby on the breast more often, your body will make more milk. Milk production is also technique-sensitive – that means that you will have more milk if you are breastfeeding efficiently. Try the laid-back breastfeeding method shown in the illustration – it isn’t a position you commonly see but can be very effective and comfortable.
Things that don’t affect your ability to make milk include the size and shape of your breasts, whether your mother breastfed you, or the food you eat.
Baby’s stomach
Your baby’s stomach is quite tiny in the first few weeks of life, which means that she will be asking to eat frequently. There’s no need to worry about the amount of milk you are producing in the first week or two, since babies prefer to eat often as opposed to eating large amounts. The illustration shows how baby’s tummy grows.
Milk Coming In
Your milk tends to “come in” around day two or three after birth, but can take up to five days (especially after a caesarean). When this happens, you will feel that your breast tissue feels full and sometimes warm to the touch. Ideally, baby will be able to drink all the milk that is inside, and your tissues will feel soft to the touch after a feed.
Just because baby is on the breast doesn’t mean he is drinking - baby is drinking when his jaw is moving up and down and you can see a pause every few seconds followed by a swallowing sound. It’s ok for the baby to stay on the breast for comfort and a cuddle once an active feed is over, just know that he is getting some, but not much food then. He is also stimulating your breasts to make more milk.
How do I know baby is getting enough?
After the first day of life, babies should have ten to twelve feeds in twenty-four hours. Some babies may sleep longer because of the effects of drugs given to you during labour and birth or because they are developing jaundice. The first six weeks are critical and if your baby is not waking to eat by herself, you should be waking her. Either way it is important to make sure your baby is eating regularly. The time between feeds is measured from the beginning of one feed to the beginning of the next feed.
From the fifth day of life onwards, your baby should have five to six wet diapers per day (a wet diaper has 2-3 tablespoons of liquid - measure this amount of water out in a dry diaper to get a feeling of how much liquid it is) and 3-4 soiled (pooed) diapers in 24 hours (one soiled diaper has a stain at least about 2.5 cm wide). If you are meeting these requirements, you can be confident that your baby is getting enough milk.
**These numbers are only valid if your baby is only getting breast milk and no other liquids.
Baby should be feeding about every two hours during the day and every three hours at night. If your baby is sleeping too much, try putting her on your chest, skin-to skin and see if she starts looking for milk – babies need the right conditions to show that they are hungry, and that means being near the food source.