Basic overview answers are provided here. Coming soon: At the end of each section there will be a link to a separate section of my website that will include more information and perhaps links to other sites to visit to gather more detailed information. Anytime you have more questions, you can use the 'contact me' section on the site and I can try to give you additional information! This site is NOT designed to take the place of in-person help and care with your and your baby's health care provider but to give a framework around which you can ascertain if breastfeeding is going well for you and your baby.
Does breastfeeding hurt?
While it can be uncomfortable at first (mainly due to sore nipples and engorgement), nursing should not be ongoingly painful. If you have been breastfeeding for several days and are still experiencing pain, your baby might not latching on correctly or there may be some anatomical issues to take a peek at. Calling and /or making an appointment to do a feed with your lactation consultant could be a good idea.
When will my milk come in?
Guess what? Milk for your baby has been 'in' your breasts for several months prior to your due date! That milk, in its rich concentrated form, is called colostrum and is ready in the perfect amounts for your newborn. People sometimes think that the volume of colostrum is insufficient for newborns, and will imply that more fluids are needed. Nature knows that the healthy full term baby only needs the teaspoons and tablespoons of colostrum in the first 2-3 days; when the GI tract is cleaned out of all the meconium, the gut is then primed for an increase in volume; in those low volume days, your baby has had lots of practice coordinating sucking and swallowing with breathing. The delivery of the placenta triggers a countdown for an increase in volume, which should happen any time from 24-96 hours after delivery, sometimes with a very dramatic va-va-va-voom! That new phase of milk production is often termed 'my milk came in' and should indeed happen by the 4th day. Evidence that this has occurred is by the baby's increasing urine output, transition to many yellow curdy stools each day and more evidence of swallowing. In mom, the breasts will feel firmer, heavier and sometimes warmer. If you do not see evidence of this by the end of day 4, it's time for a phone call to your lactation consultant, and possible supplementation for your baby.
How do I know if my baby is getting enough to eat?
Ah — the invisible food! It is a little difficult at first to know and trust that your body and your baby are working together in milk transfer. Right after birth, and continuing in those early days, your baby will be eating colostrum in very small amounts, and indeed, may suckle for only a few minutes many times a day, sometimes a couple times in an hour. If your baby is pooping the meconium, and is latching comfortably and frequently, there is probably adequate colostrum transfer.
After the milk surge, and especially in the first 2 weeks, evidence of milk transfer has to include the most if not all of the following feeding observations:
- Comfortable latch and suckling, feed lasts several minutes, usually 10-20 minutes (varies)
- Change in the suck swallow pattern from the fast choppy initial jaw action to a smooth compress and extend jaw drop action, then again faster suckling, followed by another swallowing phase
- At the jaw drop phase, a swallow should be heard-- sometimes a gulp sound, often a softer nn-kuh sound in the baby's throat.
- After the feed, the breast(s) should feel noticeably softer, indicating that let-down has occurred and milk has been removed.
- A weight check shows gain over time; in cases of concern, test weighing before a feed and after can gauge milk intake.
- Without a scale, on day 4 and beyond, milk transfer is evidenced by several heavy 'disposable's blue-line' urine filled diapers a day (cloth diapers-- they're damp to wet many times a day), with regular (some babies every feed, others a couple blowouts a day) stooling which should be yellow, mustard like consistency vs watery soaking into diaper, with evidence of adequate milk fat intake shown by the existence of curdy, 'scrapable-offable' poop in the diaper. There should be LOTS and LOTS of bird seed/sesame seed sized curds, or even soft cottage cheesy sized curds on the diaper. Greeny-yellow watery poop in the diapers may indicate that feeds are not long enough or the baby is not triggering several let- downs during the feed.