Everyone always told me that breastfeeding would be the most natural and fulfilling thing I would ever do. Not to say they were wrong, but it did take a significant amount of time (and three babies worth of practice) to get to the “natural and fulfilling” part. If I had known then, what I know now about breastfeeding as a whole and the “little things” specifically about getting started and newborn care, it might not have taken me three babies to feel confident and satisfied with my early postpartum journeys.
As a Doula and Breastfeeding Educator, I am passionate about helping to set parents like you up for breastfeeding success with realistic expectations and helpful, evidence based information! Here is a basic guide to help you know what to expect and conquer the first week of breastfeeding your sweet newborn!
First Things first
The first week of your newborns life is full of firsts and things that you will have to figure out how to make work together. That includes breastfeeding. Breastfeeding is a complex system that, while natural, can take time and practice to achieve success.
Here are my (and your newborns) top tips to getting the best possible start to breastfeeding!
- Keep me close! LOTS of skin to skin makes it easy for me to ask for food when I need it and helps us bond in those first few weeks!
- Quality over Quantity when it comes to feeds! The number of times I feed and for how long is less useful the how WELL I feed!
- My tummy is tiny! I need to feed frequently even at night time! If I’m cuing, try feeding me even if my last feed was recent!
- Sometimes I’m latched but not drinking! Help me learn this skill by doing compressions and feeding me on both sides to help keep milk flowing freely!
- Help me learn to breastfeed well with the real thing! Soothers and nipple shields can prevent us from getting our system established (optimally 6 weeks). After we have it down is a better time to introduce artificial nipples!
Print your own helpful hints card to have handy!
Keys to a good latch
One of the main keys to successful breastfeeding is making sure your baby has a good latch. When I first started breastfeeding my first, I had ZERO clue what that meant. Does it mean I can feel her sucking? Is it supposed to pinch? Is half my areola supposed to be in her mouth, or just my nipple? I had SO many questions. Eventually we figured it out but I would have loved to have spared myself the sore nipples and worries over whether we were “doing it right”. Achieving this WILL take practice and it’s OK if you don’t get it right away. Sometimes it’s helpful to ask your nurse, an LC or even your Doula to help show you what this looks like before you leave the hospital so you have a frame of reference.
Signs of a good latch:
- Babys nose is AWAY from the breast. Newborns noses are designed to drink and breath at the same time, however women with larger breasts may have to hold the tissue away from babys nose during feeds.
- Babys chin is TOUCHING (or close) to the breast
- Babys mouth is wide open and his/her lower lip is turned out (fish lips)
- Areola is more visible above than below the mouth (asymmetrical latch)
- If a baby is tummy-to-tummy, help get an effective latch by holding your breast tissue in a hamburger (or “c”) hold.
- If baby is in the football hold, help get an effective latch by holding your breast tissue in a taco (or “u”) hold.
Signs of effective drinking:
- Slow and deep sucks with swallowing sounds
- Cheeks full (drawn in cheeks indicates a poor latch)
- Baby will unlatch and seem satisfied and full when finished.
If baby unlatches but still seems hungry, try re-latching him/her and encouraging them to continue drinking with breast compressions. If baby will not stay latched but is still fussy, continue feeding from the other breast also using compressions to help milk flow freely.
If you are still unsure about whether you baby is latching correctly, don’t be afraid to reach out to your Doula or Lactation Consultant!
How often and how much?
In the first week (and the early weeks to follow), frequent feeding encourages good milk supply and reduces engorgement that can make it difficult for your newborn to get a good latch. It’s normal to feed between 10-12 times or more in a 24 hour period. It’s IMPOSSIBLE to breastfeed too much; however it IS possible to breastfeed too little. Here are some helpful guidelines
To ensure your newborn is getting everything s/he needs, avoid feeding on a schedule. Doing your best to feed your baby at their earliest hunger cues (see printable download below) will help them to be calm and ready to feed. Waiting until they are crying can mean you need to sooth them before they will successfully go to the breast.
Allow your baby to feed for as long as they like and attempt to feed on both sides.
In the first few days after birth, your newborn may be extra sleepy! Attempt to rouse/wake baby to nurse every 2-3 hours during the day (never more than 4) and 4 hours at night.
“Is my newborns pee/poop normal?”
This is probably one of the most common questions I get asked, often accompanied by pictures. There’s a reason I wait until after breakfast to open client texts and emails! Truth is, as a new parent, you are doing your best to make sure everything is working normally for your newborn and watching for any sign that something might be amiss. I completely understand that! I would much rather get an email and reply “All normal!” than not receive one and hear there was something wrong.
Interestingly enough, your baby’s urine and bowel movements can be a great indication of their overall health! So no, you aren’t crazy for examining your newborns every diaper with a magnifying glass! Here is a great guideline for what is considered “normal” in the first 7 days for everything from the number of wet/dirty diapers to the color and consistency! (Hoping this saves me a few diaper pic emails)!
**Fun Fact**Exclusively Breastfed newborns metabolize more of their intake than babies fed with formula! This means that they may have fewer dirty diapers as there is very little “waste” in your breast milk!
It may seem as though newborns “don’t really do much” when in fact, they are doing SO MUCH to learn, develop, and attach in the first few weeks of life! These behaviors are all intentional and help newborns signal to their caregivers what they need! Here are some important notes about your newborns behavior during the first week after birth!
- I may be sleepy, but I am most comfortable and calm when I am skin to skin with you rather than in my bassinet or crib.
- If I am being swaddled tight I may not be able to ask for food when I need it. If I can’t be skin-to-skin, un-wrap me after a few hours so I can tell you if I am hungry.
- If I am upset, root around, am sticking my tongue in and out, making smacking sounds or bring my hands to my mouth, it may mean that I am still hungry.
- My fussing may also be a sign that I need your contact and cuddles. You won’t spoil me with all that attention – I am relying on you for security and comfort so I can grow and develop.
**Note** Breast milk metabolizes much faster than formula! Exclusively breastfed babies may seem hungry more often or “never full”. See the “helpful feeding tip” section above for tips on efficient feeding.
a note about your newborns weight
Your newborn will very likely lose some weight in the first few days after birth. This is NORMAL and shouldn’t be a cause for worry. Remember that your newborns birth weight might also be inflated because of IV fluids during birth. If you do weigh your baby, try to use the same scale if you can to make sure readings are consistent. Your newborn should start to gain weight again by the second half of the first week. On average, newborns are back to their birth weight (sometimes more, sometimes a touch less) by the end of the second week. Every baby is different! If you have concerns about your baby’s weight, don’t be afraid to bring them up to your Dr.
When to call your Midwife, Dr or Lactation consultant
- Baby isn’t having any wet or dirty diapers
- Babys urine is dark colored after day 3 (pale yellow to clear is what we like to see)
- Your newborn is having dark colored stools after day 4 (by then they should be mustard yellow with no meconium)
- Baby nurses less frequently than the number of times listed above
- Baby is having fewer wet/dirty diapers than indicated above
- You begin experiencing symptoms of mastitis (sore breast with fever, chills, flu-like aching)
- If you have any other concerns about yourself or your newborn. It never hurts to ask.
When Breastfeeding is hard
Breastfeeding really IS natural and fulfilling. That doesn’t mean it doesn’t take time, effort and practice. In these early days and weeks, challenges with breastfeeding can seem insurmountable. Whatever you feel about it is valid and you have the right to be heard and supported. Don’t be afraid to get in touch with your local lactation consultant if you find yourself or your newborn struggling to get breastfeeding down. Attending a local La Leche League meeting is another great way to find educated support for any and all of your breastfeeding/infant feeding questions! Community support goes a long way to ensuring your breastfeeding journey is a successful one, no matter what that looks like.
Other great resources include the Kellymom.com and The Womanly Art of Breastfeeding by La Leche League!
The brave new world of parenthood can be daunting and overwhelming to say the least. If anything, even with all the uncertainty, know this is true; YOU ARE ENOUGH! You are the perfect parent for your newborn and you will figure out this “new normal” together.