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What to Expect When Breastfeeding a Newborn
The First Six Weeks
The Amazing Female Breast
The female breast has the ability to deliver exactly what your baby needs - the right type and amount of milk to meet your baby's health and developmental needs.
How? The type of milk your breast produces changes as your baby grows. That is why experts recommend that babies be fed only breast milk for the first six months and that breastfeeding continue once solids are introduced.
The breast also responds to cues from your baby. Suckling tells your body to make milk. More suckling tells your body to release the milk for your baby to drink.
Changes in Your Breasts
You probably noticed changes to your breasts throughout your pregnancy as your breasts started getting ready to feed your baby. Most mothers will notice some breast growth, change in colour of the areola, tenderness and the appearance of noticeable veins in the breast during pregnancy. Once your baby is born, you may notice more changes to your breasts, including:
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Increased fullness - once your baby drinks the first milk from your breast, the colostrum, the breast starts trying to figure out exactly how much milk your baby needs. At around 2-4 days after giving birth, you may notice that your breasts are fuller and heavier. This will subside if your baby is feeding often and removing enough milk. If the feeling of fullness becomes painful, your breasts may be engorged. Click HERE for suggestions on how to deal with engorgement.
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Nipple tenderness - your nipples may feel tender at the start of a feed. This tenderness should go away as your baby sucks and starts to drink. If the tenderness does not go away, try a different breastfeeding position and try to re-latch your baby. Do your best to help guide your nipple to the back of baby's mouth. If baby's mouth covers a good amount of areola and breast tissue, not just the nipple, it is less likely to lead to nipple tenderness. Click HERE for suggestions on how to deal with sore nipples.
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New sensations - some mothers may feel a new sensation when the milk ejection reflex releases, or delivers, the milk from the breast, also known as "let down". For most mothers, this improves or becomes more familiar with each breastfeed.
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Leaking - it is common for breasts to leak milk in the early days, as the breast is trying to determine how much milk the baby needs. Some women may notice leaking before a feed or from the breast not being suckled during a feed. As well, just hearing a baby cry may trigger the Milk Ejection Reflex and lead to leaking. As the lactation system matures, the breast learns how much milk to make for your baby and the leaking usually lessens or stops. Breast pads may help keep you comfortable if you are experiencing leaking.
To wake or not to wake?
When to wake your newborn baby to breastfeed.
Wake your baby to feed if:
In the first few days of life, wake your baby to feed if your baby does not wake on their own within 2-3 hours of breastfeeding.
Parents may also have to work to keep their newborn baby awake during feeds. Breast compressions during feeds can help keep your baby actively feeding at the breast.
Let baby sleep if:
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Baby is waking at least 8 times in 24 hours to feed.
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Baby stays awake at the breast.
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Baby shows signs of satisfaction after feeds.
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Baby is having the appropriate number of wet and dirty diapers for their age.
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Baby is gaining weight.
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Baby has a wet, pink mouth and bright eyes.
In these situations, follow baby's cues for feeding - called responsive cue-based feeding.
Click HERE to download or read the Sleep Well, Sleep Safe booklet provided by Best Start for tips and answers to frequently asked questions about sleep.
Breastfeeding a New Baby
Frequent Feedings
During the first few days, it might seem like your baby is feeding very frequently. That is natural. When the baby is first born, the breast is full of colostrum. Colostrum is very nutritious, it comes in smaller quantities and it takes longer to remove from the breast compared to more mature milk. Let your newborn baby feed as long as they want - colostrum will help with nutrition, immunity and stimulating bowel movements so it is important the baby gets as much as possible.
Frequent feeding, which can also occur when the baby gets older, may be referred to as cluster feeding. With cluster feeding, the frequent breast stimulation helps increase a mother's milk supply to meet the needs of your growing baby.
Early Arrivals
When your baby is premature
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Breast milk is very important for premature babies.
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The breast milk of a mother who has delivered early is different and specially designed to meet the needs of preterm babies. This breast milk is higher in proteins, fats, sodium, iron, chloride and other nutrients.
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Holding your premature baby skin-to-skin is very good for both you and your baby and it will help your body produce the hormones that impact your milk supply. This is sometimes called Kangaroo Mother Care.
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Preterm babies often have a weak suck, which will get stronger with age. For this reason, mothers of preterm babies may want to continue to use alternate methods of milk removal such as hand expression and pumping breast milk to build your milk supply and provide it to your growing baby. Work with your lactation professional to create a plan that works best for you.
Caesarean Birth
Many mothers who breastfeed have given birth by Caesarean Section. Here are some tips to help get breastfeeding off to a good start:
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Take the recommended pain medication in the early days; ask your doctor for a medication that is safe to take while breastfeeding.
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Breastfeed your baby early after the birth, in the recovery room if possible.
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Breastfeed your baby often, at least 8 times in 24 hours.
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Find breastfeeding positions that are comfortable for you.
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Hold your baby skin-to-skin often and between feeds.
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Get plenty of rest and spend time with your baby.
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Get up and walk around periodically, a little movement will help the recovery.
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Ask for help with meal preparation and housework from family and friends.
Siblings
If this is not your first baby, you may wonder about the best way to explain breastfeeding to your older children. You may also wonder how you will occupy them while you are breastfeeding your baby.
Many mothers find explaining what they are doing in plain language and inviting their older child to sit with them during breastfeeds helps their older child understand and be part of the breastfeeding experience. Since mothers are often sitting and relaxing during breastfeeds, older siblings may enjoy the opportunity to read, draw, or just visit with their mother at that time. Because mothers can breastfeed anywhere, anytime, they often find that breastfeeding is easy to do while also caring for their older children.
Tandem Feeding
Tandem feeding refers to breastfeeding two children at the same time. Some mothers may still be breastfeeding a child when they are pregnant and at the time of delivery. Many mothers want to continue to breastfeed their older child once their new baby is born. Here are three things to consider if you are tandem feeding:
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Prioritize your newborn.
If you decide to tandem feed, it is important to remember to feed your newborn first and prioritize the newborn’s feeds.
Even if you have been nursing through your pregnancy, your breasts will produce colostrum following delivery. It is important the newborn baby receive as much colostrum as possible.
Also, the older sibling will be able to eat and drink additional foods.
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Tell your health care provider.
You will want to let your health care provider know you are tandem feeding. Be sure to monitor your baby’s wet and dirty diapers and growth so you will know if baby is getting enough breast milk.
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Take care of yourself.
Make sure you are getting enough to eat and drink. Drink lots of water and add 2 - 3 servings of food from the Canada Food Guide to help restore your energy. Do your best to rest and sleep when you can.
If you can, ask friends and family to help out by assisting with household tasks so you have more time to breastfeed.
Is Your Baby Getting Enough Milk?
Three reliable ways to determine if your baby is getting enough milk:
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Does your baby have enough energy to actively feed at the breast by sucking, drinking and swallowing?
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Are the number of wet and dirty diapers appropriate for their age?
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After day four, is your baby gaining weight regularly?
This feeding chart can help you track the appropriate number of feeds and dirty diapers by age in the first few weeks.
What to Watch For
To make sure your baby is getting enough milk, keep track of the wet and dirty diapers in a 24-hr period.
A wet diaper is heavier than a dry diaper. Add 2 tablespoons of water to a dry diaper to see what it feels like. Your baby's urine should be clear or pale yellow and it should not smell.
A breastfed baby should have 3 or more large, soft, usually seedy poops per day after they are 2 days old. By 3 - 4 weeks of age, some babies will have only 1 - 2 poops per day. After the first 4 - 6 weeks, some babies will start to have one large poop. This is normal as long as your baby is feeding well, seems content and their poops are soft.
Get HELP if:
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Your baby reaches 4 days of age and is having fewer than 6 very wet diapers or 3 soiled (poopy) diapers in 24 hours.
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Your baby is having black poops after they are 4 days old.
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Your baby is very sleepy and always has to be woken up to eat.
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Your nipples or breasts hurt.
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You have a fever or feel sick.
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You are thinking about weaning.
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You are exclusively pumping.
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You are supplementing breastfeeding with formula.
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You are worried about yourself or your baby for any reason.
