How To Get The Best Start With Breastfeeding Part 2
The Golden rule: FEED EARLY AND OFTEN
More is Better
In the early days of breastfeeding, you are laying down the framework for future breastfeeding and milk supply. More nursing sessions = more milk producing glands = more milk production. Research shows that frequency has more effect on overall milk supply than length of feedings or pumps.
Feeding On Demand
After the first 24 hours, you will want to continue to feed your baby “on demand,” offering at least every 2-3 hours. Skin-to-skin will remain an important part of feeding and bonding, and it is recommend to continue this well beyond your hospital stay. You will want to continue offering on demand and every 2-3hrs at least until baby is gaining well over birth weight.
Babies will cluster feed after the first 24 hours once they wake up. Cluster feeding is feeding back to back, on average every 1-1.5 hours, sometimes more frequently. This method of feeding is crucial for increasing milk supply and does not mean anything is wrong or that the baby isn’t getting nourished from the breast. It is their way of placing an order for future milk supply. Cluster feeding will happen during growth spurts in the first week, week three, week six, month three and month six (give or take).
Length of Feeding
The length of each feeding will vary from hour to hour and day to day. It’s best not to time or schedule feedings. Infants will remove themselves from the breast or stop actively nursing once full. It’s much more important to pay attention to what the baby does while nursing. You should hear swallows and see long jaw movements. If they aren’t nursing despite tactile stimulation and breast compressions, you can slide them off and see if they are content, but really they know best. Both sides should be offered (like dinner and dessert), but it is not mandatory that they take both sides.
STEER CLEAR OF BOOBY TRAPS AND BREASTFEEDING MYTHS
Arm yourself with knowledge, and don’t be afraid to advocate for yourself and your baby. Try to see through the fear mongering that sometimes may occur, and steer clear of these pitfalls:
Avoid nipple shields if possible (they are not without risks or need for observation) until you have seen an IBCLC who can determine if you really need one.
Avoid all artificial nipples including pacifiers and bottles for the first 4 weeks.
Don’t let someone test your supply by pumping; it’s not as efficient as a baby and is not an accurate assessment of milk supply.
Avoid supplementation, unnecessary procedures, blood sugar checks and suctioning unless absolutely medically necessary.
Try to avoid sending baby to the nursery for long periods of time, if at all.
Delay bathing and circumcision (if you opt for it) until after breastfeeding is going well.
Don’t attempt to schedule feedings. Watch the baby, not the clock. He/she will tell you what they need and when. Scheduling feedings can be bad news for your supply and breastfeeding in general.
Don’t assume crying means that baby is not getting enough (pees, poops, and weight okay? You’re good!).
A healthy-term baby does not “tire” or “burn too many calories” after 15-30 minutes of feeding, and the breasts are never empty.
You cannot overfeed a breastfed infant.
Weight loss is normal. Typically, as long as your baby does not lose more than 10-12% of their birth weight, all is well. Take into account all the IV fluids given before birth, cesarean delivery and scale discrepancies.
Minimal pees and poops are expected early on (usually, more poops than pees the first few days). Only one of each on day one, two of each on day two, and three of each on day three. From day four to one month, 4-6 heavy wets per day and 3-8 stools per day are typical.
Limit visitors. I know it can be hard, but you will be glad you did.
Say “No thanks” to the formula gift bag if offered.
Take advice given from the myriad of professionals and loved ones around you, and pick and choose what works for you. It can be overwhelming trying to sift through all the differing advice. Get help from an IBCLC, and above all else, trust your body and your baby.
REACH OUT FOR HELP EARLY ON
If you are having trouble after the first 24 hours with nipple damage/pain, if baby arrived early, if you are separated from baby, if baby is struggling with jaundice, struggling with feeding, if output is low, weight loss is high or you’re feeling concerned, then don’t hesitate to ask for help. It may be necessary to start pumping early if there is a medical indication. There is a lot of support out there for you! Find a breastfeeding support group, surround yourself with positive people, don’t compare your experience to others’, take it one day at a time, and reach out to an IBCLC for breastfeeding help early on if needed.
Breanna Duncan BSN, RN, IBCLC, RLC
Breanna Duncan is the owner of The Mama Mantra, which opened in April 2016 after she moved to Austin from Atlanta with her husband and two pups. Breanna is a Registered Nurse and International Board Certified Lactation Consultant (IBCLC) working in both the hospital and private practice setting. The Mama Mantra provides comprehensive breastfeeding guidance for families in the greater Austin area and is dedicated to providing the highest quality of service with the goal of supporting, promoting and protecting breastfeeding in its many forms. Breanna is passionate about holistic and integrative healing and prides herself in applying this approach to breastfeeding, as well as collaborating with like-minded professionals who assist in making breastfeeding successful.