Woman's exceptional care, centered on you

Subscribe Now Looking for tailored content delivered straight to you? Sign up for our e-newsletters today!
 
Pregnancy & ChildbirthWellness & PreventionTreatment & Care

Getting Started Breastfeeding


Breastfeeding Positioning Tips
Your milk and the process of breastfeeding adapt to your baby's needs as he or she grows and develops. However, there are certain breastfeeding milestones you should recognize.

Early Breastfeeding

The first weeks of breastfeeding should be considered a learning period for both you and your baby. Do not expect to work as a coordinated team immediately. Although breastfeeding is natural, it doesn’t always feel natural at first. Be patient with yourself and your baby and ask for help in the early days.

Remember, breastfeeding your baby should always take priority over visitors and non-emergent events.

It is important to remember that babies do not eat on a schedule, and breast milk is produced on a supply and demand basis. Therefore, the more often you breastfeed, the more breast milk you make. If you give formula, your baby will feel too full to nurse frequently.

Long-term success with breastfeeding greatly depends on what is done the first few weeks after you deliver.

Day 1

  • Most full-term, healthy babies are ready and eager to begin breastfeeding within the first half hour to two hours after birth.
  • Skin-to-skin care: Research shows that skin-to-skin care for your baby promotes bonding, and helps stabilize your baby's body temperature. Breastfeeding shortly after delivery is the perfect time for the first feeding to occur, as your baby is usually alert and interested in sucking then. We encourage you to continue to provide your baby with skin-to-skin care as much as possible during your hospital stay. Dad can even do it!
  • Many become sleep or drowsy after the initial feeling for the next two to 20 hours. However, a baby should breastfeed several times that first day.

Woman's Breastfeeding Guide
Woman's Breastfeeding Guide [pdf]
Days 2 to 4

  • A newborn needs very little breast milk for the first 3 to 4 days of life. Your baby will get colostrum from your breasts to meet this need. Colostrum is the thick, golden “pre-milk” that offers many immunity benefits for your baby.
  • On average, you can expect your milk to “come in” by the third day after delivery, and you volume will dramatically increase.
  • Once your milk has come in, your baby may become more relaxed or even drift off to sleep after feedings and act more satisfied after feedings.
  • Weight loss in your baby of up to 7% from birth weight is normal. Your baby should regain his/her birth weight by 10 to 14 days of life.

Days 5 to 28

  • Your baby will become more proficient at breastfeeding as the first month progresses.
  • Expect to feed your baby about 8 to 12 times in 24 hours.
  • Usually, a baby will breastfeed for a shorter period at the second breast, and sometimes may not want to feed on the second breast at all.
  • Simply offer the second breast first at the next feeding. Allow your baby to choose when to detach from the breast, as self-detachment will increase the amount of higher fat/higher calorie milk (“hindmilk”) your baby gets.

Beyond

  • Your baby will probably go through several two- to four-day growth spurts. During this time he/she will seem to want to breastfeed around the clock.
  • Babies commonly experience growth spurts between 2 to 3 weeks, 4 to 6 weeks, and again at about 3 months of age. During these times, it is important to allow your baby to breastfeed more frequently since breast milk is produced on a supply and demand basis.

Physical Side Effects

You may feel uterine (menstrual-like) cramping when breastfeeding during this time, especially if this is not your first baby. This is a good sign that the baby's sucking has triggered your milk to let-down. It also means your uterus is contracting, which helps minimize bleeding.  These symptoms are caused by the hormone oxytocin that is releases when your baby nurses. This causes your uterus to return to its normal size quickly. Relaxation techniques, such as slow breathing, can help you cope with these contractions.   A nurse can give you medication before feeding if needed for the discomfort. Some mothers briefly feel a tingling, "pins and needles," or a flushing of warmth or coolness through the breasts with milk let-down; others notice nothing different, except the rhythm of baby's sucking.

Because your baby is still learning, you may experience nipple tenderness when she latches on or during a breastfeeding. Usually it is mild and disappears by the end of the first week. If tenderness persists, develops into pain or nipple cracking is noted, call “The Warmline” to speak with a lactation consultant.

Diapers

Within 12 to 24 hours, you should be changing a lot more wet diapers. The number of dirty diapers also increases, and the stools should be changing in color and consistency. From the dark, tarry meconium stool, they should progress to being softer and a brown color before becoming a mustard yellow and loose and seedy. Weight gain should also pick up within 24 hours of this increase in milk production, so your baby begins to gain at least half an ounce (15 grams) a day.

Breast Changes

You may notice that your breasts feel fuller, heavier, or warmer when your milk comes in. Some mothers find their breasts become uncomfortably engorged due to increased milk volume and tissue swelling. Breasts will feel hard and tight; the areola and nipple may seem stretched and flat, making it difficult for a baby to latch-on. The most important thing to do when your milk first comes in is to move the milk out of your breasts by feeding your baby frequently.

If your baby has difficulty latching on:

  • Soften the nipple and areola by expressing some milk and then let baby latch on.
  • Breastfeed or express milk by hand or breast pump frequently (every one to two hours). Your breasts should feel noticeably softer after breastfeeding or pumping.
  • Apply cold packs or sandwich bags filled with ice or frozen vegetables to the breasts for 20 to 30 minutes after a feeding or pumping session. The application of cold packs has been shown to relieve the swelling that may interfere with milk flow. Some women do report improved milk flow if they also apply warm compresses to the breasts for a few minutes immediately before breastfeeding or milk expression, but there are no studies that support this as effective. Using heat for more than a few minutes could increase the amount of swelling.