Here are some questions that might come up for you while learning to breastfeed and our responses to these questions.
How often should I breastfeed?
The goal is eight or more in 24: at least eight breastfeeds in a 24-hour period of time. In the beginning, encourage your baby to feed at least every three hours, counting from the start of a feed to the next start. Growing babies are hungry babies, so your baby may feed as soon as one hour after finishing. Shorter, more frequent feeds are beneficial for mom and baby in the first several days. If your baby is over six pounds and peeing and pooping well, your baby may sleep for a six-hour stretch at night.
How long should I breastfeed?
First breast is appetizer and entrée and the second breast is dessert optional. Your baby may nurse five to 30 minutes per breast. Offer the second side as baby's choice, and then start the next feeding on that second side. For twins: one baby nurses on one breast per feeding, 10 to 40 minutes or longer. Switch breasts every 24 hours.
What is a correct latch?
You will feel pulling, suction, pressure, and at first it may be uncomfortable, but not painful, and should feel comfortable as baby begins to consistently suckle. Watch for your baby's cheeks to puff out, with both top and bottom lips flanged out like a fish, notice jaw joint movement (you should see baby's jaw open wide, pause slightly then close). Use one hand supporting your breast and one hand around the baby's neck while learning. Maintaining a constant and firm (but not painful) breast squeeze during suckling helps the milk flow. When the baby pauses, gently encourage baby to begin suckling again by pumping your breast with your hand.
Am I producing milk?
It takes most women 50 to 75 hours (up to three days) after childbirth for the breast milk to switch from teaspoons of wonderful colostrum to ounces of transitional breast milk. Within five to 12 days, you will be producing mature breast milk. When the baby feeds and the breast is stimulated, prolactin causes milk production and oxytocin causes the milk to eject from your breast and flow—you may feel sleepy, thirsty and relaxed as you breastfeed. During the first seven days or so, you will notice either a gush of vaginal bleeding and/or your uterus cramping as you colostrum/milk flows to your baby. After seven days, you may actually feel your breast milk flowing.
How much should I drink?
Drink enough fluids, particularly water, to satisfy thirst. Sip one to two large glasses of liquid with every breastfeeding or pumping unless fluids are restricted by your physician.
Is my baby getting enough?
In the first two weeks, keep a log and measure what is coming out. There are many apps you can download to your phone that can help you with this. Monitor baby's output by counting urine and stools. We recommend the following minimums: day one of life, baby should have at least one pee and at least one poop. Day two, two pees and two poops, day three, three pees and three poops, day four and beyond, at least four or more pees and four or more poops every day. Call your baby's pediatrician and contact a lactation consultant if below expected amounts. Our outpatient lactation list has lactation resources for you.
If you have a maternal history of:
- Breast reduction or breast surgery
- Previous poor milk supply
- Minimal breast changes during pregnancy
- Flat nipples – needing to use a nipple shield
- Large blood loss at birth
- Hormonal imbalances
- Polycystic Ovarian Syndrome
Or you have:
- A baby with weight concerns or inadequate output
Follow these suggestions:
- Pump both of your breasts after every feeding with electric breast pump, set up to pump both breasts together for 15 minutes until milk volume is well established (usually by two weeks).
- Feed pumped breast milk to baby AFTER nursing via baby cup or bottle with a slow flow nipple—mother's choice. We suggest any bottle with a wide base to the nipple and a slow flow.
Moms may use formula for supplement if you choose, but supplementing with your own pumped milk is the best recommendation to boost your milk supply.
If your baby:
- Has a weak suck
- Has tongue thrust
- Is unable to latch or stay latched
- Is a very sleepy baby
Then finger-suck training can help. While in the hospital, we use hospital bottled sugar water, pumped milk or formula for suck training. At home, use one pinch of sugar in one cup of very warm tap water or your own pumped milk.
- Interest – Stimulate your baby's interest by dabbing sugar water or milk on baby's lips and wait for the baby to actively lick his/her lips; re-dab as needed.
- Practice – Baby practices by sucking on parent's clean finger dipped in the sugar water. Be sure your fingernail is short with no nail polish, and is positioned down on baby's tongue.
- Transfer – After baby has a vigorous sucking pattern on the finger, dab the nipple with sugar water and gently transfer baby to the breast and breastfeed your baby.