Written by Robin Kaplan, M.Ed., IBCLC, Owner of the San Diego Breastfeeding Center
Welcome to our new series focused on Breastfeeding/Chestfeeding Stages. Today, in Part 1, we will cover frequently asked questions about what breastfeeding/chestfeeding looks like in the first two weeks after your baby is born.
Emotionally, breast/chestfeeding can often seem overwhelming and unfamiliar for the first few weeks (let’s be honest… first few months!) New parents often receive a *huge* amount of differing advice from many well-intentioned people, which can be incredibly confusing and discouraging. Below is a quick guideline to what “normal” breast/chestfeeding looks like, as well as some examples of when things aren’t going as they should and when you might want to seek help.
How often should my new baby be eating and how long should each feeding take?
A new baby should feed 8 or more times in 24 hours. It’s especially important in the early days to feed your baby “on demand”, or whenever the baby shows signs of hunger, regardless of when he/she ate last. If your baby is not asking to eat every 2-3 hours, it is important to wake the baby to feed him/her, until they have regained their birth weight. A feeding session typically takes about 30-45 minutes, and both breasts/chest should be offered during each feeding. It’s important to keep the baby stimulated and actively feeding during those 30-45 minutes.
How will I know if my baby is getting enough milk?
A great way to be sure your baby is getting enough milk is to keep a physical log of all feedings (start time and length), as well as all pees and poops. A baby who is taking enough milk will:
Feed 8 or more times in 24 hours, for about 30-45 minutes.
Have 1 pee diaper and 1 poop diaper per day of life, until day 5. For example, on day 1, baby should have 1 pee and 1 poop diaper; day 2, 2 of each, etc. After day 5, baby should be having 5 or so of each per day.
Be satisfied for approximately an hour or two after feeding. However, most babies will cluster feed for a 4-5 hour period during the day, when they may want to eat more frequently.
Stop losing weight by day 3-5 and start gaining an ounce a day (which continues until they are 4 months old!)
How much milk does my baby actually need?
A baby needs very little milk per feeding during their first few days of life. This is because they’re born full of meconium, which is that first poop, and their stomachs are super small. This is a perfect fit for you, as your first milk, colostrum, is low in volume. Most nursing parents see their milk change from colostrum to the fuller-volume mature milk somewhere between day 3 - day 5. Here are some normal amounts of milk that a baby would need in the first 2 weeks.
Day 1: 5-7ml/feeding
Day 3: 25-30ml/feeding
Day 7: 45-60ml/feeding
Day 14: 60-90ml/feeding
I need to supplement my baby, what are my options?
Sometimes, a baby may need to be supplemented with additional milk. There are many reasons for this - a baby has jaundice, is unable to latch well, there is a delay in milk “coming in”, etc. When supplementation is necessary, it’s important to remember that you can use your own pumped milk. If you aren’t able to pump the amount you need, you can use donor milk or formula instead. There are various methods to use when supplementing your baby, as well. You can supplement your baby at your chest using a supplemental nursing system, or by finger feeding, cup, or spoon. A slow flow bottle is always an option, as well.
My chest is enormous! They hurt and I can’t latch my baby…. what can I do?
As your milk transitions from colostrum to mature milk, it is common for a parent’s chest to feel full and sometimes engorged. Engorgement occurs when the breasts/chest fill up with so much milk that they become hard and uncomfortable. Some tricks to latch your baby on during this time are:
Pump or hand express for a few moments before latching your baby to soften your breasts/chest and get milk moving
Use warm compresses or take a shower just before feeding
Use cold compresses between feedings
If you still feel incredibly uncomfortable after your baby feeds, you can pump or hand express some additional milk - but it is important to only pump to comfort as you don’t want to send the message to your body to make even more milk.
Why do my nipples hurt and what can I do to heal them?
It’s normal for a nursing parent’s nipples to feel some initial tenderness in the first days and weeks of breast/chestfeeding. Anything beyond tenderness is a sign that maybe there is some room for improvement, especially if there is any tissue breakdown, damage, cracks or bleeding. Great healing items are your own expressed milk, organic coconut oil, hydrogels, Silverette cups, and calendula salve. And, the best prevention for sore nipples is a good latch - if you are having trouble achieving a great latch, get help from a lactation consultant!
My baby sleeps all day and parties all night. How long will this last?
Feels just cruel, right? All we want to do is to sleep at night after an exhausting day and our infant is wide awake and ready to hang out. This is because babies do not have a circadian rhythm until they are about 3-4 weeks old. This means, no matter what you do, your baby will want to wake frequently and will have a difficult time going back to sleep for the first few weeks. But, rest assured (pun intended!), once your baby is about 4 weeks old, she/he should fall back asleep much more easily after those middle of the night feeding sessions!
My 2 week-old baby is suddenly famished! He went from eating every 2-3 hours to wanting to eat *constantly*! He never seems satisfied and is fussy at the breast. Does this mean my milk supply is decreasing?
All babies go through a growth spurt around 2 weeks. It’s a natural occurrence to help build your milk supply to help keep up with the baby’s increasing needs. Growth spurts usually last 48-72 hours. As long as your baby is continuing to have plenty of wet and dirty diapers, there is no reason to think that your milk supply is faltering. And once the 3-day eating frenzy is over, your baby should go back to seeming calm and satisfied after eating… at least until the next growth spurt at 6 weeks.
Is my infant too young to babywear during the first two weeks?
You can wear a full-term baby from day one. In fact, many birthing parents will wear their baby in the hospital soon after birth. Wearing a newborn helps to get that oxytocin flowing and may help with milk production too. You can use any carrier that your baby fits in including our adjustable Free-to-Grow and Explore baby carriers.
When should I call a lactation consultant for help?
There may be times when things aren’t going the way they should or you feel like you need extra nursing assistance. At this time, please contact an International Board Certified Lactation Consultant to help you. Some signs that you might need some additional help include:
● Sore, cracked, bruised, or bleeding nipples
● Baby is still well under birth weight at 14 days old
● You suspect your baby may be tongue-tied
● Painful, recurrent engorgement
● Low supply or oversupply
● Overly gassy, fussy, or colicky baby.
● Breast infection - mastitis, abscess, or thrush