Planning for breastfeeding – what you can do during pregnancy

Your breasts have been preparing for breastfeeding during your pregnancy. Your areola and nipples get darker, like a target for a new baby and your breasts are changing from non-lactating to lactating. An entire system is developing in your breasts for lactation. Your nipples are preparing for stretching so that your baby can extend your nipple into the back part of his/her mouth to properly suckle. Please do these two tests to check and see if your nipples are graspable and will be able to be extended deep into your baby's mouth:

  1. Stimulate your nipple with cold water, cold air, or your fingers and watch your nipple's response. Does your nipple extend and stay protruding or have no response to your stimulation? Does your nipple or part of your nipple retract and fold into your breast?
  2. Then try the pinch test. Place your fingers about ½ to one inch behind your nipple and gently "pinch" your fingers together. Your fingers are the "jaws" of your baby. Does your nipple continue to protrude or does your nipple flatten or invert-retract into your breast?

Prenatally, we then suggest you contact a board-certified lactation consultant if your nipple does not protrude and continue to remain protruding in response to the two tests. A lactation consult to evaluate your nipples for grasp ability may be beneficial. If there is a concern, do a Google search for breast shells and nipple shields as these may be used after delivery to help your baby latch.

Breastfeeding the first days and weeks after delivery

Your breasts have been making colostrum, the name of the first kind of milk you produce, from your second trimester of pregnancy. Colostrum resembles melted butterscotch candy and is sticky and thick. Colostrum is loaded with protective antibodies and antivirals for your baby. Colostrum is very sweet and highly laxative and helps your baby excrete the first bowel movements of thick black meconium. Your baby will receive colostrum in the exact amount he/she needs at each nursing on the day you deliver and for following three to five days of age. Supplemental feedings are usually not needed.

Sometimes a baby will need supplemental feedings if a problem exists, such as low blood sugar, elevated bilirubin, refusal to latch and breastfeed, early gestation, or low birth weight. The baby's physician, your staff nurse, or the lactation consultant will discuss this need with you.

Note: Your baby may not be fed formula without your consent; you will be involved in the decision. If formula is temporarily needed, the baby may be fed cup, bottle or other alternate feeding device. If your baby needs supplemental feedings, ask your staff nurse for help with pumping your breasts to gain expressed milk and to stimulate your milk supply even if your baby is nursing at each feeding.

Transition from teaspoons of colostrum to mature breast milk

Between day three and five after delivery, your breasts will be in transition, changing from the production of colostrum to the production of breast milk. You will notice a gradual change in the fullness of your breasts. Initially you will notice that your breasts feel warmer to the touch and that the breast tissue will feel denser or thicker, if gently squeezed. As your baby requires more milk and demands more frequent nursings, your breasts will respond and produce more breast milk. Your breasts work on the principle of demand and supply, the more breast milk that your baby demands, the more breast milk your breasts will supply for feedings.

The initial breast milk you will produce has a slightly golden/whitish color. This is transitional milk and is a mixture of colostrum and breast milk. Mature breast milk is produced at about one to two weeks after delivery and the color changes to milky white as the fat content rises throughout the feeding. The color and taste of your breast milk could be affected by your diet, medications and vitamins. Babies like the variety of breast milk flavors that your diet provides. After all, “variety is the spice of life!"