When my first baby was born I knew I wanted to breastfeed. I only wanted the best for my baby and breastfeeding was supposed to be #1. I assumed it would come naturally, after all my mom nursed all 3 of her children. She always talked about how wonderful it was and the bond she shared with us.
I always thought breastfeeding would come naturally, I never thought about taking a class. Boy, was I wrong!
Nursing a Newborn
I was totally unprepared for how hard breastfeeding was. The first few weeks my nipples were raw and sore. I couldn’t understand why my newborn wanted to nurse ALL the time. I woke up with engorged breasts every morning. Pumping was a nightmare. I ended up with what I thought was a low supply issue so I stopped nursing him at 6 weeks.
Fast forward to baby #2 some years later. By this time I am an RN and have been working in postpartum care and breastfeeding education for a couple of years. The things I learned about breastfeeding in between my two children BLEW MY MIND.
I am completely convinced that my success in nursing my second child was totally because of what I am about to tell you.
The first thing you NEED to understand is how milk is made! Breast milk is made on a supply vs. demand relationship. This means if you DO NOT remove milk from your breasts often enough (either nursing your baby or pumping) it does not signal your brain and body to make more. The more often you empty your breast and your baby nurses, the more milk you will make.
Does breastfeeding hurt?
Yes and no. If you are a first time mom who has never breastfed a baby or a third time mom who nursed her last baby 18 months, YES, it can be uncomfortable in both cases. Why? Think about this… your nipples are not used to having a baby latch onto them every 2-3 hours. Around the clock!!! What I mean is, there will probably be pain from the initial latch, however, it should NOT continue for the duration of the feeding!!!
If you are in excruciating pain the entire time your baby is latched to the breast it is time to get help. Ask for your nurse or lactation consultant in the hospital. If you are at home get in touch with an LC right away. Breastfeeding does not have to hurt.
The Golden Hour
Newborns usually feed well in the first hours after birth. Women are encouraged to put baby skin to skin within the first hour of birth as it has been shown to increase early initiation of breastfeeding, promote bonding between mother and baby, regulates your baby’s breathing, heart rate, temperature and glucose as well as protecting the mother from postpartum hemorrhage by increasing the release of oxytocin naturally.
In the first hours that follow birth your baby will most likely be quiet but alert, nestled in the comfort of your arms. Then you may notice they become very sleepy and difficult to wake. This birth thing is hard work! Just like you, they are tired. You may have to work very hard to wake and rouse them from sleep to eat, in fact they probably will show little interest, THAT’S OK! Their feeding schedule may be sporadic in the first 24-48 hours. If your baby is hard to wake up for feedings try:
- taking their clothes off, down to the diaper
- wipe their face and/or body with a cold cloth
- tickle their feet
If you don’t find success with any of those, put them skin to skin, wait one hour and try again! If it has been several hours and your baby has not fed and shows no interest, call your nurse and ask for the lactation consultant.
Around the 48-72 hour mark your baby will start to become more alert and awake and initiate feeding more often. Like A LOT. You may even think you are starving your baby because they seem hungry all the time and it appears they cannot nurse enough to stay satisfied very long. THIS IS NORMAL.
This is called cluster feeding and happens for different reasons.
- Baby is more awake now and making up for lost time on day one.
- The more your baby nurses the quicker it helps transition your colostrum to mature milk.
You may feel exhausted, overwhelmed and scared as days two and three look drastically different from day one. Hang in there, this is not permanent and will pass soon! Try to let your baby nurse on demand when they show signs of hunger as mentioned above. Ask for help from your spouse or family if you need a break.
Getting a good latch.
If you don’t pay attention to anything else here, THIS IS SO IMPORTANT!! Getting a good latch will prevent breastfeeding pain, ensure your baby is transferring milk effectively and promote a healthy full milk supply.
As a nursing mom and postpartum nurse, the best video resource I have ever seem about getting a deep effective latch with your baby comes from Global Health Media. It is so informative and REALLY breaks it down. I encourage every mom thinking about breastfeeding to watch it.
How often does you baby need to nurse?
In the days that follow, infants need to nurse 8-12 times in 24 hours. That’s about every 2-3 hours. However there is no need to create a strict schedule just yet. Let your baby tell you when they are hungry and let them nurse on demand. This will initiate and build your milk supply look for your baby’s signs of hunger such as:
- stirring in his sleep and opening his eyes
- turning his head when something touches his cheek
- poking his tongue out
- smacking his lips
- trying to eat his hand
Offer the breast at the first signs of hunger. If your baby is crying because they are hungry, it is often more difficult to get them to latch on.
How will I know if my baby is getting enough to eat?
This is one of the MOST common questions I get as a postpartum nurse. It is scary when you are a new mom breastfeeding your baby having no indicator of how much they might have eaten at the breast. Rest assured, there are ways to know.
In the hospital, your pediatrician and nurses will be monitoring your baby’s wet/dirty diapers. In the first few days babies should have AT LEAST one wet diaper for each day of life. (Ex: First 24 hours= 1 wet diaper, Second 24 hours = 2 wet diapers ect…) Until the end of the first week of life when they should produce between 6-8 wet diapers on a daily basis.
Babies should have at least 2 dirty diapers per day in the first few days and after that at least 3 per day minimum. Watch the color of the stools as well. Breastfed babies stool should transition from dark, sticky meconium stools to then green/brown stools and eventually yellow seedy stools.
You pediatrician will also monitor how much weight your baby is losing in the hospital. It is normal for babies to lose some weight in the hospital, up to 10% in fact. Anything beyond that requires intervention.
After discharge from the hospital your pediatrician will also want to make sure your baby is gaining weight at an appropriate weight.
If you are concerned about your baby not getting enough to eat, you can try hand expression. This is a great way to help get colostrum to a sleepy baby in the first 24 hours or as a way to help supplement their time at the breast!
The Basics of Breast Massage and Hand Expression- Maya Bolman, IBCLC and Ann Witt MD, FABM and IBCLC.
There are instances when you should be concerns about your baby and breastfeeding. Some signs that your baby may not be getting enough to eat at the breast include:
- Baby not regaining their birth weight by 2 weeks of age.
- If your baby is not producing enough wet/dirty diapers as described above OR if their stools stay dark (meconium). *Older babies may have less frequent stools.
- If your baby nurses less the 8-12 times in a 24 hour period in the early weeks.
- Baby never seems satisfied after feeding.
- Your baby does not wake at night to nurse in the early weeks and months.
- Breastfeeding is painful until the very end of the feeding.
- You see no signs of your milk coming in after day 3.
- You have raw, blistered, cracked nipples.
- Baby spits up forcefully and frequently after being fed.
- You do not see or hear baby swallowing during a feeding.
Seek Immediate Medical Help If:
- Baby produces less than 2 wet diapers in a 24 hour period after day 3.
- Weak Cry.
- Dry mouth and eyes.
- The fontanel (soft spot on top of the baby’s head) is sunken down or depressed.
These are signs your baby may be dehydrated and requires immediate assistance by a medical professional.
What Do I need to Breastfeed ?
If you are interested in what is absolutely necessary and what is just nice to have head over to my post about Essential Breastfeeding Products for New Moms.
How to get Breastfeeding Support.
Does this sound familiar?
“I’m worried I won’t produce enough milk for my baby.”
“How will I know if I have a good latch?”
” Nursing my first baby was a struggle and I’m afraid I will go through the same thing with this baby!”
If so, you are NOT alone! Breastfeeding doesn’t have to hurt or be scary.
Many moms find they need additional help when it comes to breastfeeding their baby. First time moms or moms of many children! Each child and breastfeeding experience can produce it’s own challenges and trials.
Many of the mothers I see in the hospital need help with some aspect of breastfeeding. The majority in fact! Does that surprise you? It might but it shouldn’t.
Breastfeeding is natural and instinctual but it does not always come easily. It is a learned art as well for both mom and baby.
If you find that you need support with nursing your baby:
- Try this online course, it will cover EVERYTHING you need to know, without ever having to leave your couch!
- Reach out to a local IBCLC.
- Breastfeeding support groups such as Le Leche League.
- Friends and family that have had a positive successful experience with nursing their children. Often they are a WEALTH of knowledge.
I hope this resource covers many of the questions or concerns you may have about breastfeeding for the first time! Breastfeeding can be challenging at first but with the right support it will become easier. Remember as with any new skill we are expected to learn it takes practice, patience and often someone who has been there before us to show us the way! Don’t give up mama, you’ve got this!
Let me know in the comments below were there any challenges you faced in the early weeks of breastfeeding?