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What to feed baby before milk comes in


Breastfeeding your newborn | What to expect the first week

The first week with your baby is exciting but can also be daunting – particularly if you’ve never breastfed before. Read our breastfeeding advice to help you get off to the best possible start.

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How do I know when to feed my baby?

After giving birth life can seem pretty bewildering – you’re getting to know your newborn while recovering from the delivery. Your emotions might be all over the place (especially between days two and five when many women get the double whammy of their milk ‘coming in’1 and the ‘baby blues’.2 Plus, there’s often expectation – and pressure – to be up and about quickly and generally be a supermum. But one of the most super things you can do this week is just be with your baby and get breastfeeding on track.

When should I start breastfeeding my newborn?

It’s best to try to breastfeed your baby in the first hour after birth. By latching on and sucking rhythmically, he begins switching on the cells in your breasts to initiate your milk supply.1 It isn’t known as the ‘magic hour’ for nothing!

“Ideally, your baby will be put on your chest as soon as he’s born to give him access to the breast. He might feed, he might not; but give him the opportunity to do so,” says Cathy Garbin, an internationally renowned lactation consultant.

“Support his body and let him attempt to find his way to your breast and self-attach (you can watch videos of this process, called the ‘breast crawl’, online). However, if your baby doesn’t attach, healthcare professionals are usually very skilled at helping mums with positioning. Baby-led attachment, with mum in a semi-reclined breastfeeding position, is a good way to start.”

So forget about weighing and dressing your baby in that special first hour, or at least until after the first breastfeed. Enjoy relaxed cuddles and plenty of naked skin-to-skin contact with him. This will get oxytocin – ‘the love hormone’ – flowing in both of you, which is essential for the release of your first milk, colostrum.3

“As soon as they were sure our son was healthy, the midwives gave us time as a family – just me, my husband and our new baby – to get to know each other. It was messy, emotional and utterly blissful, and he fed twice in that special hour together,” remembers Ellie, mum of two, UK.

And did you know that as he breastfeeds, your baby is helping you recover from the birth? This is because oxytocin also makes your uterus contract. In the first hours after the birth this helps to expel your placenta naturally and reduces blood loss.4

What if the birth doesn’t go to plan?

If you have a c-section or there are other complications, you may still be able to have skin-to-skin time with your baby and breastfeed in the first few hours.

“If you aren’t able to hold your baby, the next best thing is for him to have skin-to-skin contact with your partner instead. This will help keep your baby feeling safe, loved and warm until you’re ready,” says Cathy.

If your baby is unable to breastfeed, then it’s a good idea to start expressing your milk early and frequently until he is able. “While breastfeeding directly as soon as possible gives mum and baby a good start, it’s not essential,” reassures Cathy. “What’s more important is to initiate your milk supply so you can work towards breastfeeding later if needed.”

You can hand express and use the hospital breast pump to help initiate your milk supply in the beginning.5 The precious colostrum you collect can then be given to your baby. This is especially important if he is premature or poorly, because your breast milk has so many wonderful health benefits.

Don’t feel like breastfeeding is unachievable if your baby arrives early or has medical complications that stop him feeding at the start, either. “I’ve worked with many, many mums where their baby hasn’t breastfed directly from the breast at all in the first six weeks due to a premature arrival or other difficulties, and they’ve gone on to breastfeed successfully,” says Cathy.

Is my baby latching on correctly?

Good attachment is crucial for getting breastfeeding off to a good start,6 as your baby’s latch affects how well he drinks the milk and consequently how he grows and develops. A poor latch can cause sore or damaged nipples, so never worry about asking a healthcare professional to check your attachment, even if you’ve been told the latch is fine and you don’t notice an obvious problem – especially while you’re still at your birth facility.

“Every time I fed in hospital, I buzzed a midwife to check the latch,” says Emma, mum of two, Australia. “There were a few times I thought I had it right but it was painful and the midwife helped take my baby off and do it properly. It meant I had the confidence to do that at home.”

When your baby is latching on, aim your nipple towards the roof of his mouth. This way he will latch on to the nipple, as well as some of the areola beneath it. This means he can draw both the nipple and some breast tissue into his mouth and feed well. 6

“The latch should feel pretty comfortable and like a tugging sensation rather than a pain,” says Cathy. “Your baby will have his mouth wide open. His bottom lip may be flanged outwards, but his top lip will rest comfortably on your breast. His body language will show he is comfortable. There’s not going to be a large volume of milk at this early stage, so you won’t see much swallowing, although your baby will be sucking a lot and feeding lots of times.”

How often should a newborn feed?

Breastfeeding frequency and duration can vary a lot in the first week. “The first 24 hours differ considerably from baby to baby. Some babies have a long sleep – birth is tiring! – and some feed frequently,” says Cathy. “This variability is one of the most confusing things for new mums. Everyone gives you different advice, so it’s important to remember each mother and baby are individuals.

“Colostrum is thicker than mature breast milk and produced in smaller amounts, but it’s packed with goodness. Drinking your colostrum gives your baby practice at sucking, swallowing and breathing before your milk comes in in greater quantities,” Cathy explains.

By the time your milk comes in, around days two to four, your baby will probably be nursing eight to 12 times every 24 hours (sometimes more!), including during the night.7 These early feeds can take anywhere from 10 to 15 minutes to 45 minutes to an hour, as your baby is still developing the muscles and coordination he needs to suck efficiently.

“It’s very intense at first – often more intense than you imagined it would be – and that’s what shocks most new mums,” says Cathy. “They can hardly have time to get to the loo, have a shower, get a bite to eat. It’s common to find that a surprise.”

This is something Camilla, mum of one, Australia, experienced: “That first week Frankie fed every two hours, day and night, for between half an hour to an hour at a time,” she says. “My partner and I were both permanently exhausted!”

Do I need a newborn feeding schedule?

The good news is that this frequent feeding helps initiate and build your milk supply. 7 So the more your baby feeds, the more milk you’ll make. Therefore you shouldn’t worry about planning a newborn feeding schedule as this may reduce his opportunities to feed. Just concentrate on breastfeeding when your baby gives you hunger cues,8 such as:

  • stirring from his sleep
  • opening his eyes
  • turning his head when he feels something on his cheek
  • poking his tongue out
  • making cooing noises
  • sucking his lips
  • trying to eat his hand
  • getting grizzly
  • starting to whine
  • crying

Crying is a late sign of hunger, so if in doubt offer your baby your breast. It can be harder to breastfeed your baby once he has started crying, especially at this early stage when you’re both still learning. As he gets older, he’s likely to feed faster and less often, so breastfeeding should start to feel more manageable.

Will breastfeeding hurt?

You might have been told breastfeeding shouldn’t hurt but, in reality, many mums find the first few days uncomfortable. It’s not surprising when you consider your nipples aren’t used to all that strong, frequent sucking your baby is doing.

“The first couple of days can be uncomfortable as your body and baby get used to breastfeeding. If your baby stays on the breast too long and isn’t attached well, the effect is like wearing a pair of stiff, new shoes,” says Cathy. “Just as you can damage your feet, you can damage your nipples. Preventing damage is better than having to treat it, so see a lactation consultant or breastfeeding specialist if pain continues after the first few days.”

Mariah, mum of one, Canada, agrees: “Though my son’s latch appeared good, he was doing damage while feeding and everything hurt. It turned out a tongue-tie was the culprit, and we received amazing support from our city breastfeeding clinic to diagnose and rectify this.”

You may also feel period-like cramps (known as afterpains) following feeding sessions in the first few days, especially if this isn’t your first baby. This is because the oxytocin released by breastfeeding will help your womb contract further, as it starts to return to its usual size.4

When your milk comes in, it’s usual for breasts to feel full, firm, and certainly bigger than they used to be. Some women find their breasts get very swollen, hard and tender – a condition called engorgement.10 Feeding your baby frequently should help relieve the pressure. Read What is breast engorgement? for more self-care tips.

How often will my newborn poo and wee?

What goes in must come out! Colostrum acts like a laxative that encourages your baby do his first poo, called meconium. This can be a bit startling as it’s black and sticky like tar.11 But don’t worry, his nappies won’t always be like this – in fact, breastfed babies’ poo usually has an inoffensive, slightly sweet smell.

Here’s how many dirty nappies you can expect and when, and what their contents should look like:

Day one

  • Number: one or more
  • Colour: greenish black
  • Texture: sticky and tar-like

Day two

  • Number: two or more
  • Colour: dark greenish brown
  • Texture: becoming less sticky

Day three

  • Number: two or more
  • Colour: greenish brown to brownish yellow
  • Texture: no longer sticky

Day four to one month

  • Number: two or more
  • Colour: yellow (they must be yellow by the end of day four at the latest)
  • Texture: seedy (like English or American mustard with a little wholegrain mixed in). Loose and watery.

When it comes to your baby’s wee, it should be pale yellow. An average newborn has one wee for each day of his life… until about day three, when he should have about three wet nappies daily, and from day five, five or more wet nappies daily. You should also notice these nappies getting heavier over the first few days.11

Is my baby getting enough breast milk?

Because you only produce small amounts of milk at first, you might worry it won’t satisfy your newborn. But if you’re feeding on demand, you should be producing what your baby needs. If you want to keep track, check the number of dirty and wet nappies he’s producing, as shown above. If he isn’t following this pattern, seek medical advice.

“In the first three or four weeks, most babies just feed and sleep. If your baby isn’t settled and wants to feed all the time, think about seeing a healthcare professional,” says Cathy.

Your baby might bring up milk-coloured vomit after a feed, and this isn’t a cause for concern. However, if his vomit has orange, red, green, brown or black in it, or he is projectile vomiting, see a healthcare professional. The same applies if your baby has a high temperature, blood in his poo, a sunken fontanelle (the soft spot on his head), or is not back to his birth weight by two weeks of age.11

But if he doesn’t have any of these signs and is meeting his growth targets, he’s getting enough milk. You’ll both soon get used to breastfeeding and settle down into a more regular pattern.

Read about the next step of your breastfeeding journey in Breastfeeding the first month: What to expect.

References

1 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J 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):S216–S221.

3 Moberg KU, Prime DK. Oxytocin effects in mothers and infants 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.

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.

6 Cadwell K. Latching‐On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery & Women’s Health. 2007;52(6):638-642.

7 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet, Gynecol, & Neonatal Nurs. 2012;41(1):114-121.

8 Australian Breastfeeding Association [Internet]. Feeding cues; 2017 Sep [cited 2018 Feb]. 

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.

10 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession; 2011. 1114 p.

Breastfeeding FAQs: Getting Started (for Parents)

Breastfeeding is natural, but it takes practice to get it right. Here's what you need to know about getting started.

When Will My Milk Come In?

For the first few days after your baby's birth, your body will make colostrum, a nutrient-rich "pre-milk." Colostrum (kuh-LOSS-trum) has many benefits, including nutrients that boost a baby's immune system and help fight infection.

For some women, colostrum is thick and yellowish. For others, it is thin and watery. The flow of colostrum is slow so that a baby can learn to nurse — a skill that requires a baby to suck, breathe, and swallow.

After 3–4 days of making colostrum, your breasts will start to feel firmer. This is a sign that your milk supply is increasing and changing from colostrum to mature milk. Your milk may become whiter and creamier, but this varies between women.

If your milk takes longer to come in, don't worry. This is normal and usually isn't a cause for concern, but let your doctor know. While babies don't need more than colostrum for the first few days, the doctor may need to make sure your baby's getting enough to eat. It can help to breastfeed often during this time to stimulate your milk production.

When Should I Begin Breastfeeding?

If possible, start nursing within an hour of your baby's birth. Babies tend to be alert in the first few hours of life, so breastfeeding right away takes advantage of this natural wakefulness. After this, newborns will sleep for most of the next 24 hours. At that point, it might be harder to get your baby to latch on.

When placed on your chest, your baby will naturally "root" (squirm toward the breast, turn the head toward it, and make sucking motions with the mouth). To breastfeed, babies latch onto the breast by forming a tight seal with the mouth around the nipple and areola (the dark part of skin around the nipple). Even if your baby doesn't latch on now and just "practices," it's still good for your baby (and you!) to get used to practicing breastfeeding.

In the first few days of life, your baby will want to feed on demand, usually about every 1–3 hours, day and night. As babies grow and their bellies can hold more milk, they may go longer between feedings.

How Can I Tell When My Baby's Ready to Nurse?

On-demand feeding means breastfeeding whenever your baby seems hungry. How can you tell? Hungry babies:

  • move their head from side to side
  • open their mouth
  • stick out their tongue
  • suck on their hands and fists
  • pucker their lips as if to suck
  • nuzzle against mom's breasts
  • show the rooting reflex (when a baby moves their mouth in the direction of something that's stroking or touching their cheek)

Crying is a late sign of hunger. So try to nurse before your baby gets upset and harder to calm down.

To calm a crying or fussy baby before a feeding, try soothing "skin-to-skin" time. Dress your baby in only a diaper and place your little one onto your bare chest.

How Do I Get My Baby to Latch?

When you your baby shows hunger signs, follow these steps:

  1. Make a "nipple sandwich." Hold your breast with your hand, and compress it to make a "nipple sandwich." An easy way to remember how to hold your hand: Keep your thumb by your baby's nose and your fingers by the chin. (The thumb and fingers should be back far enough so that your baby has enough of the nipple and areola — the darker circle of skin around the nipple — to latch onto.) Compressing your breast this way lets your baby get a deep latch. Your baby's head should lean back slightly, so their chin is touching your breast.
  2. Get your baby to open wide. Touch or rub your nipple on the skin between your baby's nose and lips. When this happens, your baby should open wide (like a yawn) with the tongue down.
  3. Bring your baby to your breast. When your baby's mouth is open wide, quickly bring your baby to your breast (not your breast to your baby). Your baby should take as much of the areola into the mouth as possible. Your baby's nose should almost touch your breast (not press against it) and their lips should be turned out ("flanged").

When your baby is properly latched on, you may have a few moments of discomfort in the beginning. After that, it should feel like a tug when your baby is sucking.

To make sure you're doing it right, it's best to be observed by a lactation consultant, or someone else who knows about breastfeeding.

How Do I Know My Baby Is Getting Enough to Eat?

Your baby's diapers can help you tell if your little one is eating enough. The more your baby nurses, the more dirty diapers you'll see.

Pee

Because colostrum is concentrated, your baby may have only one or two wet diapers in the first 24 hours. After 3–4 days, look for:

  • 6 or more wet diapers per day, with clear or very pale pee. Fewer wet diapers or darker pee may mean your baby's not getting enough to drink. If you see orange crystals in a wet diaper, call your baby's doctor. They're common in healthy, well-fed babies and usually not a cause for concern. But sometimes they're a sign that a baby isn't getting enough fluids.
Poop

A newborn's poop is thick and tarry at first, then more greenish-yellow as mom's milk comes in. After 3–4 days, look for:

  • 4 or more yellow, seedy poops per day, usually one after each feeding. After about a month, babies poop less often and many may go a few days without pooping.

Your baby probably is getting enough milk if he or she:

  • feeds 8–12 times a day
  • seems satisfied and content after eating
  • sleeps well
  • is alert when awake
  • is gaining weight

If you're worried that you baby isn't getting enough to eat, call your doctor.

I'm Having a Hard Time. What Can I Do?

Nursing takes time and practice. In fact, it can be one of the most challenging — and rewarding — things you do as a new mom.

While you're in the hospital, ask for help from a lactation consultant, the nursing staff, your baby's pediatrician, or your OB-GYN. When you get home, see if there's a lactation consultant in your area. You can search online at:

  • United States Lactation Consultant Association
  • International Lactation Consultant Association

The pediatrician will want to see your baby 24–48 hours after you leave the hospital. During this visit, the doctor will check your baby's weight and your feeding technique. If you have trouble or questions before then, call the doctor.

Whatever you do, don't let it get you down. With a little patience and some practice, breastfeeding is likely to get easier.

For more help or if you have questions, talk to a lactation consultant, your doctor, or someone who knows about breastfeeding.

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. nine0009 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. ” nine0003

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. nine0003

Did you know that breastfeeding helps to recover after childbirth? This is because oxytocin stimulates uterine contractions. In the first hours after childbirth, this promotes 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 caesarean section or other complications during childbirth,
You can still establish skin-to-skin contact with your baby and breastfeed him in the first hours after birth. nine0003

“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.” nine0003

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. nine0003

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. nine0003

“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. nine0009 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? nine0015

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. nine0003

Milk usually arrives on the second or fourth day after delivery. 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." nine0003

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. nine0003

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. ” nine0003

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. nine0009 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. nine0087
  • 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. nine0009 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. nine0003

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." nine0201 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." nine0201 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.

Breastfeeding / Breastfeeding / Useful Information / Children's Polyclinic / Departments of the CDMC

Breastfeeding Guide

Mommy, your milk is always the way I want, sometimes it is filled with the aroma of sweet herbs like honey, sometimes light, like dew, sometimes enveloping, like white clouds. How many times it healed me and I became strong again, or wrapped me in a sweet slumber when I was very tired. At your chest, I heard the singing of a lark high in the sky, and the whisper of leaves in a birch grove, and autumn rain outside the window, and the chime of waxwings on a winter day. nine0037 Even after many years I will remember it, we will remember it...

E. Ibragimova

Published in the special issue of the magazine "Liza.My child" special issue 01/2016

Many mothers, expecting their first baby, seriously think about how childbirth will take place, and less often they think about how they will feed the baby. Meanwhile, childbirth is a very short period of time, and the rest of the time of life with the baby will be devoted to building relationships with him through breastfeeding.

Some mothers-to-be are hesitant to breastfeed at all. nine0003

Let's look at their assumptions first:

  • Does breastfeeding ruin breast shape?

Breast shape changes during pregnancy. On the contrary, when feeding for more than a year and smooth weaning, the breast acquires an almost “pre-pregnant” shape. According to studies, smoking has a stronger effect on the shape of the breast than feeding.

  • Will it be impossible to leave the child?

For the first 3 months, short (1-1.5 hours) separations from the child are possible, from 3 months absence can be longer, after 9months, the mother can go to work full-time, leaving the baby with expressed milk.

  • If the mother is nervous or very tired, does the milk “burn out” or become bad for the baby?

There are no conditions in the mammary gland for "burning out" of milk. When breastfeeding, endorphins are released into the blood of a woman, and HB helps her to endure stress more easily and is the best prevention of depression. Yes, and the child himself calms down at the breast, even if before that he sees the unusual behavior of his mother. nine0003

  • Is formula practically the same as breast milk?

To give women such a doubt, manufacturers of infant formula have tried hard, investing millions of dollars in advertising and bribes.

Let's look at a few differences between breastfeeding and formula feeding:

nine0517

GV

Blend

nine0002 Economy

free

about 100 tr. in the first year of a child's life. If hypoallergenic mixtures are required, then about 240 tr.

Number of substances

over 700!

30- 50

Stem cells

yes

no

nine0002 Antibodies against diseases

yes

no

Growth factors for maturation of the intestines

enough

little

Effect of

normal maturation of the gastrointestinal tract, normal development of the immune system

constipation, diarrhea, increased risk of many diseases: allergies, gastrointestinal problems, various infections, diabetes, etc.

Proteins

easily absorbed whey

hard to digest casein clots

Change in composition

adapts to the needs of the baby (varies depending on the season, time of day, age of the baby, etc.)

composition is the same for all children

Vitamins and minerals

easily digestible

low absorption

Availability

no need to cook

it is necessary to go to shops, sterilize the bottle, dilute the formula with water, etc.

Excess substances

no

cases of salmonella infection, radioactive particles, etc. nine0003

Emotional connection between mother and child

strong

weak

And the list of differences goes on.

Imagine, can a baby bottle with formula replace the happy moments at the mother's breast?

With information and help, almost any woman can successfully breastfeed for a long time. And you can! nine0003

What information can help you?

First , immediately after birth (before measurements) skin-to-skin contact between the newborn and mother (a method that involves placing the naked child on the mother’s abdomen or chest), the child must be dried, covered with a dry diaper, contact duration - at least 40 minutes, optimally 2 hours or more. (This right of mother and child is also enshrined in the Methodological Letter of the Ministry of Health and Social Development of the Russian Federation dated July 13, 2011 N 15-4 / 10 / 2-6796 "On the organization of the work of the obstetric service in the context of the introduction of modern perinatal technologies").


Why is this important:

a) In this case, the baby's body is colonized by the same bacteria that live on the body of his mother. This, in combination with HB, is considered an important prevention of allergic diseases.

b) If a newborn is separated from his mother immediately after birth, he becomes vulnerable to aggressive hospital flora, the risk of nosocomial infections increases dramatically. nine0003

c) This calms the baby and mother, because they both experience great stress in childbirth.

d) The baby is more likely to be able to latch on correctly (especially if the birth was completed without medication).

Second , breastfeed within the first hour after birth. Don't panic if the baby doesn't take the breast right away. Children should eat when they show they are ready, and if the child is in close contact with the mother, she will notice this readiness. The recommended duration of application is at least 20 minutes from each breast. nine0003

The baby's first food should be colostrum. Colostrum is the secret of the mammary glands, which is produced during pregnancy and the first 3-5 days after childbirth (before milk arrives). It is a saturated thick liquid from light yellow to orange color. Do not be afraid that there is not enough colostrum. Colostrum is very concentrated, so the baby needs just drops.

Why it's important:

A) Colostrum contains several times more protein than mature milk, especially immunoglobulin A. Immunoglobulins are responsible for protecting the baby from infections and allergens, thanks to special mechanisms they are quickly absorbed in the baby's stomach and intestines. nine0003

B) It has laxative properties to help the baby quickly get rid of the original stool - meconium, and also reduces the risk of physiological jaundice in the baby.

C) The mother triggers the oxytocin reflex, which contributes to uterine contraction and faster recovery after childbirth.

Thirdly, the correct position of the baby at the breast and the correct attachment of to the breast. Let's dwell on the key points.

For example, you feed sitting. How to hold a baby:

a) The child's body and head are on the same line.

b) The baby's belly should be turned towards the mother's belly and touch it.

c) The WHOLE body of the child must be supported.

The baby is brought to the breast with the NOSE to the nipple so that it is necessary to reach for the breast. When he opens his mouth wide, we press the baby to ourselves.

If it is not possible to attach the baby well, gently insert the little finger into the corner of the mouth and open the gums, remove the breast.

What does proper attachment look like? The baby's mouth is open wide; lips turned out; his chin touches his mother's breasts; areola capture radius is 2-3 cm from the base of the nipple; except for swallowing, sniffing and even breathing, no other sounds are heard (smacking, etc. ); mom is not in pain. nine0003

There are many positions for feeding - sitting, lying down, close at hand, relaxed feeding, etc.

Nuance: Good breast sucking is affected by the frenulum under the tongue of the baby, ask the pediatrician at the maternity hospital to check it. If it turns out to be short, it is better to cut it immediately.

Fourth, frequent breastfeeding . The term “on demand” is commonly used, which confuses many moms. Many people think that a baby "demands" when it cries. At the same time, crying is the last thing a hungry child decides to do. nine0003

Signs of readiness to suckle in a newborn :
Muscles tense in the child, for example, he clenched his fists and flexed his arms at the elbows.
The child rolls, twists and arches his back.
The child makes different sounds.

The child draws his hands to his mouth (even if his eyes are closed, he can suck his own hand).
If the child's hand is next to the face, he turns towards the hand, pokes, opens his mouth.

A newborn in the first 3 months of life may want to kiss 15-25 times a day. After all, his stomach is very small (on the 1st day after birth - 5-7 ml, on the 3rd day - 22-27 ml, on the 7th day - 45-60 ml) and breast milk is quickly absorbed. In addition to receiving nourishment, the child also finds comfort in his mother's breast. Therefore, it is not recommended to feed the baby "according to the regime" - for example, once every 3 hours or to limit his time at the breast - for example, to feed no more than 15 minutes. Night feedings are crucial for successful lactation - thanks to them, the level of prolactin is maintained at the required level. nine0003

Why frequent breastfeeding is important:

a) The number of prolactin receptors in the breast increases, which contributes to sufficient milk production in the future.

b) Promotes a more relaxed flow of milk, without pronounced symptoms of engorgement.

c) When feeding “according to the regimen”, there is a high risk that the child will be offended by the mother (after all, they do not immediately respond to his needs) and will behave restlessly at the breast.

Fifth, it is not recommended to give pacifiers to the child. nine0136

Why it's important:

a) Soothers artificially delay feeding time, resulting in poor weight gain and decreased milk production.

b) The child finds solace not at the mother's breast, but in a silicone object and may refuse the breast.

c) It spoils the grip of the breast, which leads to cracks, lactostasis.

Sixth, if you need to supplement with expressed milk and/or formula, then avoid the use of bottles. nine0136

Why is this important:

A) The baby gets used to a strong and constant flow of milk from the bottle and begins to behave restlessly at the breast, “lazy” to suck.

B) When sucking a bottle and a breast, different muscle groups are used, so the grip on the breast often deteriorates, the child sucks milk poorly, gains weight worse.

Seventh, the joint sleep of mother and child.

It is perfectly normal to sleep with your baby. A child should not be spoiled with attention or held too much in his arms. The more children are held in their arms, the more attention is paid to them, the better they grow. The presence of the mother, her smell, constantly encourages him to suckle the breast more often, which means sucking out more milk. nine0003

Western parents are advised to leave their child to “shout out” before going to bed in order to raise an independent child who is used to loneliness and is able to calm himself. However, modern research shows that in this case, the child's brain is irreparably damaged.

Safe sleep:

  • The child should sleep on a clean and hard surface.
  • Avoid sleeping with your baby if you are overly tired.
  • Do not leave your baby unattended in an adult bed. nine0087
  • In cold weather, cover yourself with several layers of thin bed linen instead of one thick layer.
  • Pets should not be in bed
  • No one should smoke in the room where the baby sleeps.

Now let's look at some common cases:

  • Mother's Rh negative or blood type incompatibility is not a contraindication to breastfeeding. Rh-conflict, blood type conflict or hemolytic disease of the newborn is not a contraindication. Rh antibodies are destroyed in the gastric juice of the newborn. Studies also show that in children with hemolytic disease, HB does not increase the breakdown of erythrocytes, red blood cells. nine0087
  • The administration of anti-Rhesus immunoglobulin to prevent Rh conflicts in subsequent pregnancies in an Rh-negative mother is not a contraindication to breastfeeding. Anti-Rhesus immunoglobulin almost does not penetrate into breast milk. Most immunoglobulins are destroyed in the gastric juice of the newborn.
  • Is it possible to breastfeed with jaundice?

Even with severe physiological jaundice in children in the first days of life, it is impossible to refuse breastfeeding. Early attachment of the baby to the breast and frequent feedings are an important factor in the prevention of jaundice, since colostrum, having a laxative effect, leads to a faster discharge of meconium (original feces). With insufficient nutrition of a newborn baby, jaundice may be more intense and prolonged due to the thickening of bile. (source - NATIONAL PROGRAM OF OPTIMIZATION OF FEEDING OF CHILDREN OF THE FIRST YEAR OF LIFE IN THE RUSSIAN FEDERATION, p.17). nine0003

It is absolutely pointless to give the child water, glucose, activated charcoal, smectite, etc. in such a situation. - from this, the activity of liver enzymes, the function of which is reduced, will not increase. In some cases, it may be necessary to carry out phototherapy with special lamps, which can usually be rented from the hospital home.

  • What to do if you are separated from your child?

It is recommended to express at least eight times a day. Whether you can pump something or not, breast stimulation is important to maintain and increase your milk supply. nine0003

If there is no joint stay in the maternity hospital, or if the baby was taken to the children's department for some medical reasons - do not hesitate to visit him and feed him there! If your and his condition allows, try to feed the baby only colostrum and then breast milk.

Try not to give supplements from a bottle, but from a spoon, pipette or syringe without a needle.

"Arrival" of milk.

Milk comes on 3-4 days after childbirth, less often - on 5-7. Your chest becomes hot, heavy, tight. If the mother rarely put the baby to the breast before, then engorgement may occur. At the same time, remember that you can do without pain and rough straining. Act according to the scheme: heat - light massage - removal of swelling from the areola - decant a little - attach the child - cold compress. nine0003

"Hard" straining, which is often used in the hospital, leads to severe swelling and worsening of the situation. Alcohol compresses, Vishnevsky ointment, etc. are not recommended.

How to remove swelling from the areola? Use the Pressure Softening technique introduced by international consultant Jean Kotterman.

It is necessary to evenly and gently press on the areola towards the chest and hold the pressure for at least a full minute (up to 2-3 minutes). nine0003

How to express properly? Fingers are placed on the border of the areola and white skin. First, the fingers are pressed in the direction of the chest: you seem to grab the milk-filled ducts that lie under the areola, and only then roll over them with your fingers. Important: the fingers do not fidget over the skin, they stand in one place on it.

How do you know if your baby is getting enough milk?

Newborns lose up to 6-10% of their birth weight in the first two days of their lives. This is a physiological norm. Most children regain their weight or begin to put on weight by 5-7 days of life. nine0003

  • Wet Diaper Test .

Urination rate (per day) for a child under 10 days old = number of days + 1.

That is, for example, a 2-day-old baby who has enough milk pees 3 times a day.

Babies over 10 days of age should write 12 or more times a day.

These calculations are correct if there is no water addition and no drips.

  • Weight set . The rate of weight gain for babies in the first 6 months of life is from 500 to 2000 g per month. nine0087

The set is not calculated from birth weight, but from the minimum (usually this is discharge weight). If the weight gain is less than 150g per week, we advise you to contact the AKEV specialists and the pediatrician.

  • An infant should have at least 3-4 bowel movements per day (up to about 3-6 weeks). Then the chair is reduced - up to 1 time per day or less.

All other signs - baby crying, little pumping from the breast, no milk leakage, etc. - are not reliable signs of milk sufficiency / lack of milk .

Breastfeeding lifestyle: