Feeding baby colostrum
Breastfeeding: the first few days
In the first few days, you and your baby will be getting to know each other. It may take time for both of you to get the hang of breastfeeding.
This happens faster for some women than others. But nearly all women produce enough milk for their baby.
Preparing to breastfeed before the birth
It's good to find out as much as you can about breastfeeding before you have your baby. It may help you feel more confident when you start breastfeeding your baby.
Antenatal classes usually cover the most important aspects of breastfeeding, such as positioning and attachment, expressing, and how to tackle common breastfeeding problems.
Find antenatal classes near you.
You can find out about breastfeeding from your midwife, family and friends, and useful helplines and websites.
There are lots of groups and drop-ins, some specially designed for pregnant women who want to know more about breastfeeding. You can find out more by asking your midwife, health visitor, local peer supporter or GP. Or visit your local Children's Centre.
Skin-to-skin contact
Having skin-to-skin contact with your baby straight after giving birth will help to keep them warm and calm and steady their breathing.
Skin-to-skin means holding your baby naked or dressed only in a nappy against your skin, usually under your top or under a blanket.
Skin-to-skin time can be a bonding experience for you and your baby. It's also a great time to have your first breastfeed. If you need any help, your midwife will support you with positioning and attachment.
Skin-to-skin contact is good at any time. It will help to comfort you and your baby over the first few days and weeks as you get to know each other. It also helps your baby attach to your breast using their natural crawling and latching-on reflexes.
You'll still be able to bond with and breastfeed your baby if skin-to-skin contact is delayed for some reason, for example if your baby needs to spend some time in special care.
If necessary, your midwife will show you how to express your breast milk until your baby is ready to breastfeed. They can also help you have skin-to-skin contact with your baby as soon as it's possible.
Skin-to-skin after a caesarean
If your baby is delivered by caesarean, you should still be able to have skin-to-skin contact with your baby straight after delivery.
Colostrum: your first milk
The fluid your breasts produce in the first few days after birth is called colostrum. It's thick and usually a golden yellow colour. It's a very concentrated food, so your baby will only need a small amount, about a teaspoonful, at each feed.
Your baby may want to feed quite often, perhaps every hour to begin with. They'll begin to have fewer, but longer feeds once your breasts start to produce more "mature" milk after a few days.
The more you breastfeed, the more your baby's sucking will stimulate your supply and the more milk you'll make.
Your let-down reflex
Your baby's sucking causes muscles in your breasts to squeeze milk towards your nipples. This is called the let-down reflex.
Some women get a tingling feeling, which can be quite strong. Others feel nothing at all.
You'll see your baby respond when your milk lets down. Their quick sucks will change to deep rhythmic swallows as the milk begins to flow. Babies often pause after the initial quick sucks while they wait for more milk to be delivered.
Occasionally this let-down reflex can be so strong that your baby coughs and splutters. Your midwife, health visitor or breastfeeding supporter can help with this, or see some tips for when you have too much breast milk.
If your baby seems to be falling asleep before the deep swallowing stage of feeds, they may not be properly attached to the breast. Ask your midwife, health visitor or breastfeeding supporter to check your baby's positioning and attachment.
Sometimes you'll notice your milk letting down in response to your baby crying or when you have a warm bath or shower. This is normal.
How often should I feed my baby?
In the first week, your baby may want to feed very often. It could be every hour in the first few days.
Feed your baby as often as they want and for as long as they want. They'll begin to have fewer, but longer feeds after a few days.
As a very rough guide, your baby should feed at least 8 to 12 times, or more, every 24 hours during the first few weeks.
It's fine to feed your baby whenever they are hungry, when your breasts feel full or if you just want to have a cuddle.
It's not possible to overfeed a breastfed baby.
When your baby is hungry they may:
- get restless
- suck their fist or fingers
- make murmuring sounds
- turn their head and open their mouth (rooting)
It's best to try and feed your baby during these early feeding cues as a crying baby is difficult to feed.
Building up your milk supply
Around 2 to 4 days after birth you may notice that your breasts become fuller. This is often referred to as your milk "coming in".
Your milk will vary according to your baby's needs. Each time your baby feeds, your body knows to make more milk for the next feed. The amount of milk you make will increase or decrease depending on how often your baby feeds.
Feed your baby as often as they want and for as long as they want. This is called responsive feeding. In other words, responding to your baby's needs. It's also known as on-demand or baby-led feeding.
In the beginning, it can feel like you're doing nothing but feeding. But gradually you and your baby will get into a pattern and the amount of milk you produce will settle down.
It's important to breastfeed at night because this is when you produce more hormones (prolactin) to build up your milk supply.
In the early weeks, before you and your baby have become comfortable with breastfeeding, "topping up" with formula milk or giving your baby a dummy can lower your milk supply.
Speak to a midwife or health visitor if you are worried about breastfeeding or you think your baby is not getting enough milk.
They might suggest giving your baby some expressed breast milk along with breastfeeding.
Find out more about how to tell if your baby is getting enough milk and tips for building up your milk supply.
Dealing with leaking breasts
Sometimes, breast milk may leak unexpectedly from your nipples.
Wearing breast pads will stop your clothes becoming wet with breast milk. Remember to change them frequently to prevent an infection.
Expressing some milk may also help. Only express enough to feel comfortable as you do not want to overstimulate your supply.
If your baby has not fed recently, you could offer them a feed as breastfeeding is also about you being comfortable.
Help and support for breastfeeding
- Find out more about positioning and attachment, including how to get comfortable and make sure your baby is properly attached.
- If you are having difficulties with breastfeeding, take a look at breastfeeding problems.
- Ask a midwife or health visitor for help. They can also tell you about other breastfeeding support available near you.
- Search online for breastfeeding support in your area.
- Call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm daily).
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Community content from HealthUnlockedWhat Is It, Benefits & What To Expect
Overview
What is colostrum?
Colostrum (kuh-loss-trum) is the first milk your body produces during pregnancy. It forms in your mammary glands (breasts) and plays an important role in building your baby's immune system. If you plan on breastfeeding (nursing or chestfeeding), it's the first milk your baby will get from your breasts. If you don't want to breastfeed or if your baby is struggling to breastfeed, you can hand express colostrum. It's high in protein, vitamins, minerals and immunoglobulins (antibodies) that help build your baby's immune system. It's often called "liquid gold" because of its rich, golden color and valuable benefits.
What is colostrum made of?
Colostrum is high in protein and low in fat and sugar. It's filled with white blood cells that produce antibodies. These antibodies strengthen your baby's immune system, protecting him or her from infection. Colostrum is highly concentrated and nutrient-dense even in tiny doses, so your baby's tummy doesn't need a lot to reap its benefits.
What kind of nutrients are in colostrum?
Colostrum is rich in nutrients that protect and nourish your baby unlike anything else. It's made up of things like:
- Immunoglobulin A (an antibody).
- Lactoferrin (a protein that helps prevent infection).
- Leukocytes (white blood cells).
- Epidermal growth factor (a protein that stimulates cell growth).
It gets its color from carotenoids (an antioxidant) and vitamin A. Vitamin A plays a vital role in your baby's vision, skin and immune system. Colostrum is rich in magnesium, which supports your baby’s heart and bones, and copper and zinc, which also support immunity.
What's the difference between colostrum and breast milk?
Colostrum is a nutrient-rich first milk produced by your breasts during pregnancy. It changes to transitional breast milk a few days after your baby is born. However, small amounts of colostrum remain in your breast milk for several weeks.
There are distinct differences between colostrum and breast milk:
- Colostrum is filled with immunoglobins to boost your baby's immune system and protect it from illness.
- Colostrum has two times as much protein.
- Colostrum has four times as much zinc.
- Colostrum is lower in fat and sugar so it's easier to digest.
- Colostrum is thicker and more yellow.
What are the stages of breast milk?
There are three different stages of breast milk: colostrum, transitional milk and mature milk.
- Colostrum: Your first milk that lasts between two and four days after birth.
- Transitional milk: Begins approximately four days after birth and lasts about two weeks.
- Mature milk: Milk that lasts from approximately 14 days after birth until you are done producing milk.
When does colostrum turn to milk?
After approximately three or four days, colostrum will turn to transitional milk. This is often referred to as someone's milk "coming in." Your breasts will feel firm, tender and full. It means your milk supply has ramped up. By this time your baby's stomach has expanded and they can drink more milk each feeding. Once your milk supply is established and your body has stabilized, transitional milk changes to mature milk.
What makes colostrum turn to breast milk?
The pregnancy hormones created by the placenta help you create colostrum. The hormone progesterone drops significantly when the placenta separates from your uterus (after your baby is born). This drop in progesterone triggers your breasts to create milk.
Function
What is the purpose of colostrum?
The function of your breasts, or mammary glands, is to produce milk to feed your baby. Colostrum is more than the first milk your baby consumes after birth. It's highly concentrated with nutrients and antibodies to fight infection and protect your baby. It provides a powerful, unique immunity that only it can provide. Because your baby only needs a little bit of colostrum, it also helps them learn to suck, swallow and breathe during feeding.
What are the benefits of colostrum?
Colostrum builds your baby's immune system and provides concentrated nutrition. Some of the benefits of colostrum are:
- Helps strengthen your baby's immune system.
- Helps to establish a healthy gut by coating the intestines. This helps keep harmful bacteria from being absorbed.
- Offers ideal nutrition for a newborn.
- Has a laxative effect that helps your baby clear meconium (your baby's first poop) and lessens the chance of jaundice.
- Easy to digest.
- Helps prevent low blood sugar in full-term babies.
Why is colostrum good for newborns?
Colostrum has all the nutrients your baby needs in the first few days of life. It's also packed with nutrients and vitamins to strengthen your baby's immune system.
The flow of colostrum from your nipples is slow so your baby can learn to breastfeed (nurse). Learning how to breastfeed takes practice and requires your newborn to not only learn to suck and swallow but breathe at the same time.
Does leaking colostrum mean labor is close?
Colostrum leaking from your breasts doesn't mean labor is coming. Leaking colostrum is normal and some people notice it as early as the second trimester. Some don't notice any signs of leaking colostrum while others will see dried colostrum on their nipples. If you are leaking colostrum, you can wear disposable or washable breast pads.
Can you express colostrum if you're pregnant?
Colostrum can be expressed by about week 37 in pregnancy and is beneficial for some people. Using your hands to compress your breasts in a rhythmic pattern so that milk comes out is called hand expressing. Expressing colostrum before your baby is born carries some risks like contractions or premature labor. It can be beneficial to those at risk for premature birth, low milk supply or when certain health conditions present.
Speak with your healthcare provider before you remove colostrum from your breasts. If you are leaking colostrum, it may be safe to collect and store it for when your baby is born.
Can you pump colostrum?
It's difficult to pump colostrum with a breast pump because of its thick consistency. Most people recommend and prefer using their hands to express colostrum. Hand expressing colostrum usually produces more colostrum than a pump.
Anatomy
What does colostrum look like?
Colostrum is often a deep, rich yellow or orange color, almost like the yolk of an egg. This is because it contains high levels of beta carotene. It can sometimes appear white, clear or creamy. It's a thicker consistency than breast milk (or cow's milk), but the thickness varies from person to person. Colostrum is often sticky and can contain faint traces of blood (this is normal).
How do I know I am making colostrum?
Your body begins producing colostrum between 12 and 18 weeks in pregnancy. Most people will produce anywhere from a tablespoon to an ounce of colostrum within the first 24 hours of delivery. This slowly increases until transitional milk comes in around the third or fourth day. In most cases, you will not know if you are making colostrum, however, it's very rare to be unable to produce colostrum. You will know if your baby is getting colostrum if he or she is maintaining their weight and wetting diapers.
How long do you have colostrum?
Your body produces colostrum for up to about five days after your baby is born. It changes to transitional milk around this time, then changes again to mature milk after about 14 days. Traces of colostrum are present in your breast milk for up to six weeks.
Conditions and Disorders
What happens if you don't produce colostrum?
Most people will produce some colostrum — not producing it is rare. It's normal to feel like nothing is coming out of your breasts and worry that your baby isn't getting enough. Your baby only needs a few teaspoons of colostrum to fill their tiny stomach.
Care
How do you store pumped colostrum?
If you and your healthcare provider decide it's safe to express and store colostrum, there are a few rules to follow. First, you should ensure the colostrum is stored in a sterile container or syringe. It can be kept in your refrigerator for about two or three days. It must be moved to a freezer after three days. Colostrum can be kept in a freezer for at least three months.
Frequently Asked Questions
How much colostrum does a newborn need?
Your newborn's tummy is about the size of a marble. They only need about an ounce of colostrum per day. This equals about a teaspoon each feeding (you can expect to feed your newborn eight to 10 times the first few days). The amount of colostrum (and then transitional milk) your baby needs increases slowly each day as their stomach expands. As your body transitions to producing regular breast milk, your milk production will increase to meet their needs.
Do I need to supplement?
No, you shouldn't need to supplement. A tiny bit of colostrum goes a long way in filling up your baby. Check with your healthcare provider to make sure your baby is gaining weight. If your baby is wetting diapers and seems pretty happy, supplementing is usually not necessary.
Is it okay to squeeze out colostrum?
Yes, it's usually OK to squeeze out colostrum once you reach full-term pregnancy (37 weeks). Check with your healthcare provider if you wish to do this prior to your baby being born. If you want to hand express colostrum for your newborn, follow these steps:
- Cup your breasts with your hand in a "C" shape. Four fingers should be under your breast and your thumb should be above your nipple.
- Use your thumb and index finger to gently squeeze your areola and nipple.
- Repeat several times and in a pattern. Apply firm pressure but do not slide your fingers. If colostrum doesn't come out, try moving your fingers to another spot.
- Colostrum should slowly flow out within minutes. It's thick and comes out in drops.
- You can repeat this a few times per day.
Please note that expressing colostrum before your baby is born carries risks. Some people can go into premature labor or begin having contractions. Talk to your healthcare provider before you express colostrum.
A note from Cleveland Clinic
Colostrum is the first milk produced by your breasts. It's rich in nutrients and high in antibodies and antioxidants. Getting started with breastfeeding can be difficult and usually requires assistance, so don't be ashamed to ask your healthcare provider for help. Breastfeeding early and often is the best way to make sure your baby gets the many benefits from colostrum. Hand expressing colostrum and feeding your baby with a syringe is also an option. Ask your healthcare team for help if feeding your baby colostrum is something you wish to do.
Breastfeeding a newborn | What to Expect in the First Week
The first week of a baby's life is a wonderful but hectic time, especially if you haven't breastfed before. Our breastfeeding tips will help you settle in as quickly as possible
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The first time after childbirth, mothers are often confused. The body is still recovering, and you are already starting to get to know your newborn baby. The emotional state during this period can be unstable, especially between the second and fifth day, when many women have milk 1 and at the same time postpartum depression begins 2 . In addition, people around often expect (and demand) that a woman come to her senses as soon as possible and become a “super mom”. But the best thing to do this first week is just to be with your baby and get breastfeeding going.
When should I start breastfeeding my newborn?
Try to breastfeed your baby within the first hour after birth. When the baby latch onto the breast and begins sucking rhythmically, it stimulates the mammary gland cells and starts milk production. 1 It is not for nothing that this time is called the “magic hour”!
“Ideally, the baby should be placed on the mother's stomach immediately after birth so that it can immediately attach to the breast. He won't necessarily eat, but he should be able to,” explains Cathy Garbin, an internationally recognized expert on breastfeeding.
“Hold your baby and let him find the breast on his own and put the nipple in his mouth. This is called the breast-seeking reflex. On the Internet you can watch videos that show what this process looks like. If the baby does not latch onto the nipple on its own, the midwife will help to properly attach it to the breast. But for starters, it’s good to give the baby the opportunity to do it on their own. In this case, the optimal position for the mother is reclining. ”
Don't spend that special first hour of your baby's life weighing and swaddling—or at least wait until he's suckling for the first time. Enjoy hugs and close skin-to-skin contact. This promotes the production of oxytocin, the hormone of love, in you and your baby, and oxytocin plays a key role in the supply of the first breast milk - colostrum. 3
“As soon as the obstetricians were convinced that our son was healthy, the three of us — me, my husband and our baby — were left to give us the opportunity to get to know each other. It was a very special hour - an hour of awkwardness, turbulent emotions and bliss. During this time, I breastfed my son twice, ”recalls Ellie, a mother of two from the UK.
Did you know that breastfeeding helps to recover after childbirth? This is because oxytocin stimulates uterine contractions. In the first hours after childbirth, this contributes to the natural release of the placenta and reduces blood loss. 4
What if the birth did not go according to plan?
If you had a cesarean section or other complications during childbirth,
You can still make skin-to-skin contact with your baby and breastfeed him in the first hours after birth.
“If you can't hold your baby, have your partner do it for you and make skin-to-skin contact with the baby. This will give the baby a sense of security, care and warmth so that he can hold on until you recover, ”Katie advises.
If the baby is unable to breastfeed, it is advisable to start expressing milk as early as possible and do so as often as possible until the baby is able to feed on its own. “While breastfeeding in the first hours after birth lays an excellent foundation for the future, it is not so important,” Cathy reassures. “It is much more important to start lactation so that in the future, if necessary, you can start breastfeeding.”
To start milk production, you can express milk manually or use a breast pump that can be given to you at the hospital. 5 And with expressed precious colostrum, it will be possible to feed the child. This is especially important if the baby was born premature or weak, since breast milk is extremely healthy.
If a baby was born prematurely or has a medical condition and cannot be breastfed immediately, this is no reason not to continue breastfeeding. “I have worked with many new mothers who were unable to breastfeed their baby for the first six weeks due to preterm labor or other reasons. Nevertheless, all of them later successfully switched to breastfeeding,” says Kathy.
Does the baby latch on correctly?
Correct breastfeeding is essential for successful breastfeeding 6 , as it determines how effectively the baby will suckle milk and hence grow and develop. Latching on the breast incorrectly can cause sore or damaged nipples, so don't hesitate to ask your doctor to check that your baby is properly attached to the breast, even if you are told that everything is fine and you do not see obvious problems - especially while you are in the hospital.
“While I was in the hospital, I called the doctor at every feed and asked me to check if I was breastfeeding correctly,” says Emma, mother of two from Australia. - There were several cases when it seemed to me that everything seemed to be right, but it was painful to feed, and the doctor helped me take the baby off the breast and attach it correctly. By the time I was discharged, I had already learned to do it confidently.”
When applying to the breast, point the nipple towards the palate. This will allow the baby to take the nipple and part of the areola under it into their mouth. It will be easier for him to suck if he has both the nipple and part of the areola around in his mouth. 6
“When a baby latch on properly, it doesn't cause discomfort and it causes a pulling sensation, not pain,” Cathy explains. - The baby's mouth is wide open, the lower lip may be slightly turned outward, and the upper one lies comfortably on the chest. The body language of the child indicates that he is comfortable. There isn't much milk at this early stage, so you probably won't notice your baby swallowing, but he will suckle a lot and nurse frequently."
How often should a newborn be fed?
The frequency and duration of breastfeeding in the first week can vary greatly. “The first 24 hours of life are completely different for different children. Someone sleeps a lot (after all, childbirth is tiring!), And someone often eats, says Katie. - Such a variety greatly confuses young mothers. Everyone gives different advice, so it's important to remember that every mother and child is different."
“Colostrum is thicker than mature breast milk and is produced in smaller amounts, but has many benefits. When the baby eats colostrum, he learns to suck, swallow and breathe until milk begins to flow in more volume, ”explains Cathy.
Milk usually arrives on the second or fourth day after birth. Until this time, the baby is applied to the breast 8-12 times a day (and sometimes more often!), including at night. 7 Feeding may last 10-15 minutes at this stage, or 45 minutes or even an hour, as the baby is just beginning to develop the muscles and coordination needed to suckle effectively.
“At first, the intensity of feeding is very high, often higher than many people realize, and this is shocking to most new mothers,” says Cathy. - Sometimes mom has no time to go to the toilet, take a shower and have a snack. It usually comes as a surprise."
Camille, a mother from Australia, experienced this. “The first week, Frankie ate every two hours, day and night, and each time it took half an hour to an hour to feed,” she recalls. “My husband and I were completely exhausted!”
Do I need to feed my newborn on a schedule?
The good news is that frequent feeding promotes lactation and stimulates milk production. 7 The more your baby eats, the more milk you will have. Therefore, forget about feeding your newborn on a schedule - this way he will have less chance of feeding. Try to feed your baby when he signals that he is hungry 8 :
- tossing and turning in her sleep;
- opens eyes;
- turns his head if he feels a touch on his cheek;
- sticks out tongue;
- groans;
- licks lips;
- sucks fingers;
- is naughty;
- whimpers;
- is crying.
Crying is the last sign of hunger, so when in doubt, just offer your baby the breast. If he bursts into tears, it will be more difficult to feed him, especially at first, when both of you are just learning how to do it. As your baby grows, he will likely eat less frequently and take less time to feed, so breastfeeding will seem more predictable.
Does breastfeeding hurt?
You may have heard that breastfeeding is not painful at all, but in fact, in the first days, many new mothers experience discomfort. And this is not at all surprising, given that the nipples are not used to such frequent and strong sucking.
“Breastfeeding can be uncomfortable for the first couple of days – your body and your baby are just getting used to it. If a baby eats for too long and does not latch well, the sensations are almost the same as from unworn new shoes, Cathy compares. Just as tight shoes can rub your feet, improper suckling can damage your nipples. Prevention is always better than cure, so if the pain persists after a few days of feeding, contact a lactation consultant or healthcare professional.”
Maria, a mother from Canada, agrees: “Although my son seemed to latch onto the breast well, he damaged his nipples while feeding, and I was in pain. As it turned out, the reason was a shortened frenulum of the tongue. The breastfeeding specialists at our city clinic have been of great help in diagnosis and treatment.”
In addition, you may experience period cramps during the first few days after breastfeeding, especially if this is not your first baby. This is the so-called postpartum pain. The fact is that oxytocin, which is released during breastfeeding, contributes to further contraction of the uterus to restore its normal size. 4
When milk arrives, the breasts usually become fuller, firmer and larger than before delivery. In some women, the breasts swell, harden and become very sensitive - swelling of the mammary glands occurs. 10 Frequent breastfeeding relieves these symptoms. For more breast care tips, read our article What is Breast Swelling?
How often does the newborn urinate and defecate?
What goes into the body must go back out. Colostrum
has a laxative effect, helping to eliminate meconium - the original feces. It looks a little scary - black and sticky, like tar. 11 But don't worry, it won't always be like this. Breastfed babies usually have a slightly sweet smell of stool.
How many times a day you will need to change diapers and how the contents should look like, see below.
Day one
- Frequency: once or more.
- Colour: greenish black.
- Texture: sticky like tar.
Day two
- Frequency: twice or more.
- Colour: dark greenish brown.
- Texture: less sticky.
Day three
- Frequency: twice or more.
- Colour: greenish brown to brownish yellow.
- Texture: non-sticky.
Fourth day and then the entire first month
- Frequency: twice or more.
- Color: yellow (feces should turn yellow no later than by the end of the fourth day).
- Texture: grainy (like mustard with grains interspersed). Leaky and watery.
The baby's urine should be light yellow. On average, babies urinate once a day for the first two days. Starting around the third day, the number of wet diapers increases to three, and from the fifth day onwards, diapers have to be changed five times a day or more often. In addition, during the first few days, the weight of wet diapers increases. 11
Is the baby getting enough breast milk?
Since very little milk is produced at first,
You may feel that this is not enough for your baby. But if you feed your baby on demand, you will produce exactly as much milk as he needs. If you want to keep the process under control, be guided by the frequency of diaper changes above. If your baby soils less diapers, check with your doctor.
“For the first three or four weeks, most babies just eat and sleep. If the child is worried and constantly asks for a breast, you should consult with your doctor, ”Katie recommends.
Sometimes the baby may vomit after feeding. If the vomit is the color of milk, this is not a cause for concern. But if there are orange, red, green, brown or black blotches in it, or the child vomits with a "fountain", consult a doctor. You should also consult a doctor if the baby has a high temperature, the fontanel (soft spot on the head) has sunk, blood is found in the stool, and also if the weight recorded at birth has not recovered within two weeks. 11
But if there are no frightening symptoms and the baby is growing at a normal pace, it means that he has enough milk. Soon you will both get used to breastfeeding and establish a more stable routine.
For the next step in breastfeeding, see Breastfeeding in the First Month: What to Expect.
Literature
1 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia 2007;12(4):211-221. - Pang, W.W., Hartmann, P.I., "Lactation initiation in the lactating mother: secretory differentiation and secretory activation." G Mammary Gland Biol Neoplasia. 2007;12(4):211-221.
2 Shashi R et al. Postpartum psychiatric disorders: Early diagnosis and management. Indian J Psychiatry . 2015; 57( Suppl 2): S 216– S 221. - Shashi R. et al., Postnatal mental disorders: early diagnosis and treatment. Indian J Saikiatri. 2015; 57(App 2):S216-S221.
3 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206. - Moberg K, Prime DK, "The effects of oxytocin on mother and child during breastfeeding." Infant. 2013;9(6):201-206.
4 Sobhy SI, Mohame NA. The effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. J Egypt Public Health Assoc . 2004;79(1-2):1-12. - Sobhi SI, Moham NA, "Early initiation of breastfeeding and its effect on vaginal bleeding in the fourth stage of labor." G Egypt Public Health Assoc. 2004;79(1-2):1-2.
5 Meier PP et al. Which breast pump for which mother: an evidence-based approach to individualizing breast pump technology. J Perinatol . 2016;36(7):493. - Meyer P.P. et al., Breastpump Selection: A Scientific Approach to Customizing Pumping Technology. J Perinatol (Journal of Perinatology). 2016;36(7):493-499.
6 Cadwell K. Latching - On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery & Women ’ s 2007;52(6):638-642. — Cadwell, K., "Latching and sucking in healthy newborns: evaluation of breastfeeding." W Midwifery Women Health. 2007;52(6):638-642.
7 Kent JC et al. Principles for maintaining or increasing breast milk production. 2012;41(1):114-121. - Kent J.S. et al. , "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121.
8 Australian Breastfeeding Association [ Internet ]. Feeding cues ; 2017 Sep [ cited 2018 Feb ]. - Australian Breastfeeding Association [Internet], Feed Ready Signals; September 2017 [cited February 2018]
9 Jacobs A et al. S3-guidelines for the treatment of inflammatory breast disease during the lactation period. Geburtshilfe Frauenheilkd . 2013;73(12):1202-1208. - Jacobs A. et al., "Guidelines S -3 for the management of inflammatory breast disease during breastfeeding." Geburtskhilfe und Frauenheilkünde. 2013;73(12):1202-1208.
10 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p . - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." Seventh edition. Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2010. P. 1128.
The first hour of life: breastfeeding a newborn
The first day of life largely determines how successful breastfeeding of a newborn will be.
This page explains the important tasks of initiating and establishing lactation in the first 24 hours.
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Early Attachment
The first "magic" hour you will have with your baby will be different from anything you've experienced before.
At this time you will have a unique opportunity to start breastfeeding. If a baby latch on in the first 60 minutes of life, it will set off a chain reaction in your body and you will be able to feed and protect your newborn baby.
In many ways, the mechanisms of breast milk formation are determined by hormones, however, in the first hours after childbirth, for the development of lactation, you will need an active stimulator - your baby, who will latch on and suckle rhythmically at the breast. This will “turn on” her cells to start producing milk.
In addition to its role as a lactation activator, early lactation immediately after birth also helps to calm the baby and give him psychological support. Being at the mother's breast, feeling the familiar beating of her heart, the mother's smell and warmth, the baby feels protected, loved and confident in a new unusual environment.
Even if your birth does not go according to plan and you need an emergency cesarean section or other unforeseen interventions, try to put the baby to the breast as early as possible, as this will have a beneficial effect on the establishment of lactation and, in general, on the well-being of you and the baby.
More about the first "magic" hour is described in this chapter: "Birth and the first hours of life. "
But that's not all. Immediately after receiving the first drops of colostrum, the baby's body becomes stronger and more adapted to the environment.
Colostrum starts the work of the gastrointestinal tract, pancreas and liver.
Among other things, this means the timely removal of excess bilirubin - which means that the sooner the first application is made and the more colostrum the baby receives on the first day, the less risk he has of developing the so-called "newborn jaundice".
Colostrum also plays a protective role in resistance to various diseases, because the baby's immune system is immature at birth.
For example, immunoglobulin A protects the baby's mucous membranes from bacteria, viruses and parasites.
Alpha-lactalbumin supports the bifidoflora in the baby's intestines, and also forms bioactive lipids that contribute to the destruction of cancer and other foreign cells.
Linoleic and alpha-linoleic acids form the brain and neuroretina of the eye.
All these and many other substances are not artificially reproducible.
It is known that getting even a few drops on the oral mucosa of a premature baby helps to increase the body's defenses and prevent many complications in care.
Early receipt of colostrum, among other things, contributes to the timely and soft removal of meconium - the original dark-colored stool.
Feeding on Demand
WHO and UNICEF recommend that breastfeeding is best done "on demand" - that is, every time the baby begins to show signs of anxiety and search for the mother's breast.
This approach, unlike feeding according to the regimen, allows the mother and baby to feel more comfortable, relaxed, and receive all the benefits of breast milk in the amount that the child individually requires.
In the first 24 hours, there may be up to 20 or more such requests. It is believed that the number of feedings that is necessary in the first day of a baby's life should be at least 8.
Frequent feedings are also necessary because very little colostrum is produced at this stage. But the baby's stomach is still so small that this small volume is just what you need. On the first day of life, the baby's stomach can hold only 6 ml of food!
So frequent feeding from birth is a sure way to give your baby the best protection that colostrum provides.
Feeding on demand in the first 24 hours of life and beyond is the right and most harmonious start to breastfeeding imaginable.
Frequent breastfeeding also helps to initiate lactation and prepare the breasts for transitional and then mature milk. Then the volume of breast milk will always meet the growing needs of the baby, he will begin to gain weight well, and you, most likely, will not have a reason to worry about a lack of milk in the future.
There are times when feeding on demand is not possible - for example, the baby is in the intensive care unit or, for one reason or another, is not able to suckle.
Then it is necessary to take measures for the timely development of lactation and providing the child with precious breast milk, organizing pumping with a breast pump. The best way to do this is to use the dedicated INITIATE program on the Symphony* Clinical Breast Pump. In this case, pumping is carried out as often as you would put a baby on - every 2 to 2.5 hours at least.
Correct breastfeeding
One of the first and most important skills that mother and baby must master is the correct breastfeeding.
Incorrect latch is one of the most common causes of sore and subsequently cracked nipples.
One or two sessions of feeding with an incorrect latch can be enough to form painful cracks that cause great concern to the mother and are the "entrance gate" for breast infection.
Not only that, improper latch-on leads to the fact that the baby is simply not able to get enough milk from the breast, he is malnourished, and weak stimulation does not allow lactation to develop as actively as it should.
Cracks, pain, restlessness and malnutrition of the child, sluggish development of lactation, which soon leads to a lack of milk - these are the negative consequences of improper latch that should be tried to prevent.
Therefore, it is very important from the very first day to pay special attention to the correct latch of the baby, and this is another of the main tasks of the first 24 hours of a child's life.
A nurse practitioner, a midwife at the maternity hospital or a lactation consultant can help check if the baby is latching correctly and advise on how to correct the situation if necessary.
Often just stretching the nipples before feeding with a breast pump or Nipple Shaper Pads** can help, as an unshaped, flat or even inverted nipple makes latch on difficult.
For particularly difficult cases, Contact** silicone breast pads are available to help your baby ease in and out of the breast.
Sometimes a lingual frenulum is the cause of a poor grip - then it is important to identify the problem as soon as possible and resolve it quickly. After a small and almost bloodless operation to cut the frenulum, the baby can be immediately applied to the chest.
Also often the problem of grip is explained by the lack of habit, uncomfortable position - all this is quite easily corrected, postures and positions can be mastered under the guidance of experienced mentors, but it is necessary to correct mistakes as soon as possible, in the first 24 hours.
So, here are three important conditions for the key 24 hours after childbirth:
- early attachment;
- feeding on demand;
- correct chest grip.
They help start breastfeeding successfully and harmoniously, ensure the favorable development and protection of the baby's body, and start lactation in a timely manner.
If something went wrong, the main thing is not to despair and not give up. Medela comes to the rescue in every situation with modern and fast solutions.
Literature
Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia. 2007;12(4):211-221. - Pang, W.W., Hartmann, P.I., "Lactation initiation in the lactating mother: secretory differentiation and secretory activation." G Mammary Gland Biol Neoplasia. 2007;12(4):211-221.
Klaus M. Mother and infant: early emotional ties. Pediatrics. 1998;102( Supplement E 1):1244-1246. — Klaus M., "Mother and Child: The First Emotional Ties". Pediatrix (Pediatrics). 1998; 102 (Appendix E1).
Sobhy SI, Mohame NA. The effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. J Egypt Public Health Assoc . 2004;79(1-2):1-2.- Sobhi SI, Moham NA, "Early initiation of breastfeeding and its effect on vaginal bleeding in the fourth stage of labour.