Breastfeeding: The First Week
/Who said breastfeeding would come naturally? I’d like to have a few words with that person. But seriously, just because breastfeeding is “natural,” doesn’t mean establishing it happens easily. In fact, the first week can be the toughest for some people.
I like to remind the families I work with that breastfeeding is more like learning to walk than like learning to breathe. When we’re born, we take that first breathe intuitively and that’s it - we’re breathing. But when we learn to walk, we have to try and try again. It takes time and patience. We’ll probably stumble and fall but if we keep at it, we’ll eventually figure that whole walking thing out. That’s what establishing breastfeeding can feel like. But with good education (and good support), many people eventually get the hang of it. So today, I’m sharing our top tips to help with that very first week.
Know Your Baby’s Stomach Size
For many first time parents, the size of their baby’s stomach at birth and through the first week can come as a big shock. Spoiler alert - it’s probably a lot smaller than you think! At birth, your baby’s stomach is about the size of a marble and holds only around 5-7ml (or about 1/2 a teaspoon of food). That’s it!
So even though your body is not producing large volumes of colostrum at this time, it is producing all that your baby needs to fill their tummy. Keep this in mind when it seems like your baby is hungry again and wants to come to the breast - it’s probably because they are. Those little bellies don’t hold much and need to be refilled often.
By around day 3-5, your baby’s stomach is now closer to the size of a cherry or ping pong ball and can hold closer to 1-1.5 ounces per feeding. That’s still not a lot! And around the same time, your body is probably starting to produce mature breast milk in higher volumes to meet your baby’s needs. So continue to put your baby to the breast frequently as you visualize that little ping pong ball tummy - it needs frequent feedings to stay full!
If for any reason you need to supplement or pump during this first week, remember those stomach sizes! Your baby does not need that much supplemental food. And your body is most likely not producing large amounts of milk or colostrum - it’s only producing what your baby needs. So if you pump or hand express and only get a small amount, that is NORMAL!
Work on a Good Latch from the Start
Establishing a nice, deep latch from the very beginning is so important. An improper, shallow latch can make it harder for your baby to transfer milk efficiently. And it also can be very painful and lead to nipple damage. This is something you want to avoid during this first week.
When your baby latches to the breast, you want them to take your nipple far enough back in their mouth that it reaches the soft palate. A shallow latch will result in your nipple getting smashed against the hard palate of their mouth, which will feel very painful and can lead to damage to the nipple.
To encourage that deep latch, bring your baby’s nose to your nipple, rather than their mouth to your nipple. Also look to see that their chin is “leading the latch” - meaning your baby’s chin should be the first part of their body to touch the breast tissue. We want to see chin touching, baby’s head angled back, and a nice, wide open mouth before pushing them onto the nipple to latch.
If your baby’s latch is causing a sharp, intense, “toe curling” pain at the nipple, take them off the breast and try again. You can break the seal of their latch, by inserting the tip of your pinky into their mouth, in between their lips and the breast, to break the suction. And then try again. And keep trying. Remember this takes a lot of practice and a lot of patience. If you are getting frustrated, take a break if needed and have your partner or support person soothe the baby for a bit before trying again. But it’s so much better for you in the long run to keep trying for that deep latch rather than allow your baby to nurse with a shallow latch and damage your nipples.
Watch the Clock, But Don’t Watch the Clock
This may sound confusing, but let me explain. You may have heard that a breastfed newborn will need to eat every 2-3 hours. This is because exclusively breastfed babies should eat anywhere between 8-12 times in a 24-hour period, so they get enough food and to help establish your milk supply.
But that’s the MINIMUM. Meaning, at a minimum we need the baby to eat every 2-3 hours. So keep an eye on the clock to make sure it hasn’t been MORE than 3 hours since your baby last ate. If that’s the case, it’s time to wake them up and feed them.
But DON’T watch the clock to try and hold off feeding times if your baby is showing hunger cues. That 2-3 hour time frame is to help you make sure you meet those minimum requirements, not to dictate when your baby can eat. So if it’s been less than 2 hours since the last feeding and your baby is showing you signs that they’re hungry and want to eat, definitely feed them. Exclusively breastfed babies should be fed on demand during this first week to make sure that they are gaining weight and that your milk supply is being stimulated frequently enough.
Watch Out for Sleepy Babies
One big challenge during this first week can be a super sleepy baby. We get it, this strange new world is a lot and I’d probably want to stay warm and sunggled up next to my parent, sleeping the days away as I adjust. But we need these little ones to wake up and eat - it’s pretty much their only job right now.
It can be frustrating to wake a baby when it’s time to eat, work hard to establish that nice, deep latch, and then notice that almost immediately your newborn is just hanging out at the breast, not actually eating anything because they are sound asleep. You’re going to have to wake them up!
Sometimes just stroking their cheeks, behind their ears, or the bottoms of their feet can get them sucking again. If that doesn’t work, my favorite tip is to try some breast compression and massage. You are probably already cupping your breast with one hand, so use your thumb and forefinger to gently press in and then massage downward toward the nipple. You can move your thumb and finger around your breast, massaging different parts, and working down to the nipple. This will encourage milk to flow through the milk ducts and into your baby’s mouth, without them having to do much work. That squirt of milk is usually enough to wake up a sleepy baby and remind them that they’re hungry, and get them to resume suckling.
You may have to rinse and repeat this a few times throughout your feeding session to make sure your baby actively eats from the breast.
Build Your Nest and Settle In
This last one is all about managing expectations. Establishing breastfeeding can take work - a LOT of work. Some days it might feel like all you’ve done is sit on the couch and feed your baby. And honestly, you feel that way because that’s what you probably did. Breastfeeding is time consuming. Breastfeeding is demanding. And if mentally you are not prepared for this, it can feel so overwhelming.
So let’s set some reasonable expectations about this first week with your newborn. You are BOTH learning a new skill, so please give yourself grace. Some feeding sessions are going to feel like you have no idea what you’re doing. And that’s okay! This takes practice, practice, and more practice. So some of my best advice is to build you nest, settle in, and get comfortable!
If you have accepted that you are going to spend a majority of your day feeding a brand new baby, let’s make that day as comfortable as possible. Pick your favorite, coziest spot in the house to be your “feeding station.” Surround yourself with all the things you will need - burp cloths, feeding pillows, nipple balm, a water bottle, your favorite snacks, charging station, iPad, TV remotes, etc. You get the hang of it. We want the time you spend nursing your baby to feel comfortable and relaxing. (And side note, the more relaxed you are, the more oxytocin is flowing, which means more breastmilk. Win win win!)