Most women can make plenty of milk.
Milk supply is usually determined by the frequency and efficiency of milk removal by the baby. The more frequently and the more completely the baby empties the breasts through active suckling, the more milk is made. In most cases, milk supply is a supply-and-demand operation. Therefore, the best approach to breastfeeding is to feed the baby as often as the baby will feed, or about 8 to 12 times each day. Keeping the baby actively nursing will help produce the most milk, which will help you to make the most in future feedings.
Sometime problems such as poor latch, jaundice, engorgement or passive feedings interfere with milk removal from the breast. In these cases you should seek help from a lactation consultant as soon as possible. Failing to do so may impact the baby’s growth and development, and can reduce your milk supply.
Breastfeeding should be comfortable.
Any soreness that lasts longer than a couple of seconds and any persistent or severe breast pain should be considered abnormal. Persistent nipple pain or any visible damage to the nipple tissue needs immediate assessment by a lactation consultant to determine the cause. This helps to identify the best remedy to alleviate it. Milk onset causes full, heavy breasts, but they should not be overly painful. Any severe breast pain, or any episodes where it appears that the breasts have become too hard to let milk pass through freely need immediate attention from your lactation consultant. Severe engorgement can cause a drastic reduction in later milk supply.
A baby’s feedings may not be predictable.
Babies follow their own unique patterns of waking, sleeping, and eating. It is important during the first weeks after birth to allow the baby to determine its own feeding schedule. Don’t try to fit the baby into a specific schedule. Some babies feed about 2 hours apart, around the clock, with only occasional longer sleep stretches. Some babies want to “cluster feed” with some feedings being nearly one after the other, followed by a stretch of sleep.
Parents who are uncertain about the adequacy of their baby’s feeding can have the milk intakes assessed by the lactation consultant through test weights. The lactation consultant will take the baby’s weight before and after the feeding is done, using a very accurate gram-weight scale. The amount of milk taken can be calculated by the amount of grams gained by the baby during the feeding. Just call Laurel to schedule test weights if there is any concern about the efficiency of baby’s feedings.
The first week.
How often? Aim for 10-12 feedings per 24 hours for the first two weeks of life. Even though you can nurse too little, you can’t nurse too much.
WHEN? At first signs of hunger (stirring, rooting, sucking, etc). Crying is too late, easier to nurse before crying. You can change baby before switching to next breast for a more peaceful changing.
HOW LONG? Watch the baby, not the clock. Keep the baby actively sucking/swallowing by cuing if he stops (breast compression- squeezing breast when baby slows down). When the baby comes off, burp and/or change and then offer the second breast. Baby should be feeding every 2-3 hours during the day with possibly a longer stretch at night.
WEIGHT GAIN? Normal weight loss= 7-8% in first few days. Once mature milk is in, normal weight gain is 6 or more ounces weekly.
PEES and POOPS? 1 on day 1, 2 on day 2, 3 on day 3, from day 4 on – 4 or more seedy, yellow poops and 6-8 pees every 24 hours.
BREAST CHANGES? Mature milk typically “comes in” between day 2 & 5. Minimize engorgement with frequent feedings, finishing one breast before switching to the next, ensuring good latch. You can use cold compresses, cabbage leaves, or hand expression to relieve the discomfort of engorgement.
Breastfeeding gets much easier with support and time!
The first days to weeks of breastfeeding take some real energy and can be frustrating. It can take some practice, for both mother and baby. It is usually a very good idea to have some assistance the basics of breastfeeding is learned. It can also be helpful to have baby’s weight closely monitored for awhile. Calling your lactation consultant can make a difference!
Insurance reimbursement claim forms are provided at the time of service for potential reimbursement to the client.
(*Breast compression)To keep baby actively sucking/swallowing at breast, squeeze breast when he slows down.
CALL YOUR DOCTOR OR LACTATION CONSULTANT if insufficient pees or poops, dark colored urine after day 3, dark colored stools after day 4, or mom has mastitis symptoms (chills, fever, inflamed breast, flu feeling).
- Laid back breastfeeding – Leaning back, baby on chest, the baby will seek out your breast
- You can support the neck and shoulders/back, but try not to push on head. Chin hits breast first, nose free, head is slightly tilted back, throat is open.
- Aiming nipple to nose can be helpful. Baby takes in more breast near his lower lip. It is not usually possible to get entire areola in baby’s mouth. You will still see top of areola and little or none of bottom. Baby comes UP onto breast.
- If baby is struggling to latch due to tongue tie, prematurity, flat or inverted nipples, then, a nipple shield may help him stay on and help supply issues.
- New baby has a lot to learn at once. Allow mother and baby to “master” breastfeeding before introducing other things (unless medically indicated) such as pacifiers or bottles.
- Pacifiers: Routine use linked to early weaning, confusion, lower milk intake, increased thrush, oral development problems, lower weight gain, & fewer smiles! No calories going in, but burning calories. Newborns should be fed when they want to suck, rather than offered a pacifier.
- Even though your nipples may feel tender, they should not be cracked or bleeding. If they are, seek assistance from a lactation consultant who can usually resolve these issues, typically, improper latch or oral anomaly.
- Try varying position, remembering you are BREASTfeeding, not NIPPLE feeding.
- Start on least sore side first.
- If you need to remove baby from breast, release the suction first.