Breastfeeding: Getting Started

Breastfeeding: Getting Started

Breastfeeding your child

Breastmilk is the perfect food for your baby. It gives your baby many advantages compared with formula. Your milk contains just the right amount of nutrients. And it is gentle on your baby’s developing stomach, intestines, and other body systems. 

The American Academy of Pediatrics
(AAP) strongly recommends exclusive breastfeeding for at least 6 months. Exclusive
breastfeeding means that your baby has only breastmilk for 6 months. That means giving
your baby breastmilk from your breasts or from bottles. Don’t give your baby water,
sugar water, or formula.

Pacifier use

The AAP recommends using pacifiers
to decrease the risk of sudden infant death syndrome (SIDS). For breastfeeding mothers,
the AAP recommends waiting until breastfeeding is well established. Then the pacifier
isn’t replacing the feedings babies need to grow. Well-established breastfeeding means
that:

  • Your baby can easily put
    their mouth around the nipple and latches on

  • Breastfeeding is comfortable for you

  • Your baby weighs more than
    their original birth weight

These milestones are often reached
after the first 3 or 4 weeks.

Getting started with breastfeeding

Your milk and how you breastfeed
change as your baby grows and develops. A newborn’s feeding routine is different than
that of a breastfeeding 6-month-old. As your baby grows, the nutrients in your milk
change to meet your growing baby’s needs. The anti-infective properties also increase if
you or your baby is exposed to some new bacteria or virus. Here’s how to get
started:

Early breastfeeding

The first few weeks of
breastfeeding are a learning period for both you and your baby. It takes time for you
both to work as a team. Be patient as you recover from your delivery, create a daily
routine, and become comfortable with breastfeeding. Keep track of feedings and wet
diapers. This can help your child’s healthcare provider assess how your feedings are
going.

Day 1

Most full-term, healthy babies
are ready and eager to begin breastfeeding within the first half hour to 2 hours
after birth. This first hour or 2 is an important time for babies to nurse and be
with their mothers. The AAP recommends that babies be placed skin to skin with their
mother right after birth (or when both you and your baby are able). Skin to skin
means placing your naked baby stomach-down on your bare chest. This keeps the baby
warm, helps keep the baby’s blood sugar up, and helps the baby breastfeed for the
first time. It is recommended that babies be kept skin to skin at least 1 hour. Or
they can be kept this way longer if the baby hasn’t breastfed yet.

After these first few hours of
being awake, babies will often act sleepy or drowsy. Some babies are more interested
in sleeping than eating on their birthdays. You can expect to change only a couple of
diapers during the first 24 hours.

Days 2 to 4

Your baby may need practice with
latching on and sucking. But by the second day, your baby should begin to wake
and show readiness for feedings every 1 1/2 to 3 hours, for a total of 8 to 12
feedings over 24 hours. These frequent feedings provide your baby with antibody-rich
first milk (colostrum). And they tell your breasts to make more milk. Let your baby
nurse on one breast until finished. You can then change and burp your baby before you
offer the other breast. If the baby is not interested in breastfeeding, start with
the second breast at the next feeding.

As with day 1, you likely will
change only a few wet and dirty diapers on baby’s second and third days. Don’t be
surprised if your baby loses weight during the first few days. The number of diaper
changes and your baby’s weight will increase when your milk comes in. 

It’s normal to have uterine
cramping during the first few days of breastfeeding. This is a positive sign that the
baby’s sucking has triggered a milk let-down. It also means your uterus is
contracting, which helps lessen bleeding. A nurse can give you medicine before
feeding if needed for the discomfort. Some mothers briefly feel a tingling, pins and
needles, or flushing of warmth or coolness through the breasts with milk let-down.
Others don’t notice anything different, except the rhythm of the baby’s sucking.

Your baby is still learning how
to latch on and breastfeed. So your nipples may be sore when your baby latches on or
while you are breastfeeding. Other factors also may help lead to this soreness. But
often it is mild and goes away by the end of the first week. Tell your nurse if
soreness continues or gets worse. Or if your nipples are cracked. Your nurse or
healthcare provider may recommend a lactation consultant. This is someone who
specializes in breastfeeding.

Days 3 to 5

You will have a lot more milk 3
or 4 days after birth. When the amount of milk increases, the milk is said to have
come in. Your baby is drinking more at each feeding. So he or she may drift off to
sleep after a feeding and act more satisfied. 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. The baby’s first bowel movements (meconium) are sticky and
dark. They will become a mustard-yellow, loose, and seedy stool.

Weight gain should also pick up
within 24 hours of this increase in milk production. So your baby will begin to gain
at least 1/2 an ounce (15 g) a day. You may notice that your breasts feel fuller,
heavier, or warmer when your milk comes in. The most important thing to do when your
milk first comes in is to feed your baby frequently. This empties your breasts often
and completely.

Breast engorgement

Your breasts may become
overfilled with milk (engorged). This makes them swollen and painful. Your baby may
have trouble latching on if your breasts are engorged. Feeding frequently and on
demand will help prevent this. But if it happens:

  • Express some milk. This
    means squeezing a small amount out of your breasts. And then letting your baby
    latch on. A warm shower or warm compresses right before or during expressing
    may help.

  • Breastfeed or express milk
    by hand or breast pump often (every 1 to 2 hours). Your breasts should feel
    noticeably softer after breastfeeding or pumping.

  • If the pain is severe, you may put an ice pack on your breasts. Keep it on your breasts for 15 to 20 minutes after nursing or pumping. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice or an ice pack directly on your skin.

Days 5 to 28

Your baby will get better at
breastfeeding as the first month progresses. Expect to feed your baby about 8 to 12
times in 24 hours. Let your baby tell you when he or she is finished eating. When the
baby self-detaches from the nipple, you can offer the other breast. Some babies feed
better between breasts if you change their diapers and burp them. Often a baby will
breastfeed for a shorter period at the second breast. Sometimes he or she may not
want to feed on the second breast at all. Simply offer the second breast first at the
next feeding.

Your baby should continue to:

  • Soak 6 or more diapers a day with clear or pale yellow urine

  • Pass 3 or more loose,
    seedy, or curdlike yellow stools every day

  • Gain weight. Babies
    typically gain two-thirds of an ounce to 1 ounce each day, up to 3 months
    old.

Talk with your baby’s healthcare
provider if you think your baby is not eating enough.

General tips beyond the first few weeks

Every baby is different. Some will
eat quickly and some will take longer to enjoy each drop. Others will take frequent
breaks during each feeding. It’s important to let your baby lead each feeding. This
self-detachment will increase the amount of higher fat and higher calorie milk
(hindmilk) that your baby will get. But once the breast is mostly empty, some babies
will keep wanting to suck as a way of self-soothing. Over time you will be able to tell
when your baby is switching to this self-soothing sucking. If your baby keeps sucking in
this way and it’s painful, gently detach your baby. If breastfeeding is well
established, you can offer a pacifier instead. If you aren’t sure if your baby is full,
try offering the other breast.

Your baby likely will go through a
few 2-to-4-day growth spurt periods. During this time, he or she will seem to want to
eat almost around the clock. Babies often have a growth spurt between 2 to 3 weeks, 4
to 6 weeks, and again at about 3 months. It’s important to let a baby feed more often
during these spurts. Within a few days, your baby will go back to a more typical
pattern.

Let your baby set the pace for
breastfeeding. Watch his or her feeding cues. Here are some examples of feeding
cues:

  • Turning the head toward the breast

  • Licking the lips

  • Smacking the lips

  • Being awake

  • Crying (this is a late sign of hunger)

The number of feedings each baby needs and the length of time each feeding lasts will vary from baby to baby. Also, every mother’s milk production and storage capacity is different. Trying to force a breastfed baby to wait longer between feedings, or to fit a certain feeding schedule, can result in poor weight gain.