breastfeeding in the first few days

Establishing breast feeding can be really challenging. Your baby may want to feed very frequently and this can feel really hard especially when you are very tired, during the night and if your nipples are sore. We are here to help support you during this time to establish breastfeeding, both on the post natal wards and at home. This leaflet offers some useful tips and practical advice about breastfeeding in the first few days that we hope you will find useful.

Babies vary in the frequency of their feeding in the first 48 hours. Many feed frequently for short periods, whilst others may not feed very much in the first 24 hours and then want to feed a lot. A baby’s stomach at birth is tiny (about the size of a hazelnut) and it does not need much to fill it. Even though you may think that you are producing only small amounts it matches the size of the baby’s stomach.

Night time feeds are particularly valuable because the milk-producing hormone Prolactin is present in larger quantities at night. So night feeds are really important for building up your milk supply. Surprisingly, night feeds also have a relaxing effect; the quality of sleep improves due to the breastfeeding hormones produced. It has been proven that women who breastfeed have a better quality of sleep and get back to sleep quicker than mothers who bottle feed. If it is your first baby, and the baby has fed a lot at night, have a lie in the following morning.

Sore nipples are caused by the baby being incorrectly attached to the breast, rather than suckling itself. When positioning and latch are corrected, feeding will immediately become more comfortable, and even very tender nipples will heal quickly.

Babies have many ways of letting you know they need food. They only begin to cry to be fed once the other signals they have given have not been recognised. Some newborn babies will not have the energy to cry and may just go back to sleep if the feeding cues are not responded to.

Infant feeding cues

• Rapid eye movements seen under closed eyelids.
• Flexing of arms while still asleep.
• Making sighing noises.
• Lip sucking.
• Mouth gaping.
• Rooting and putting hand to mouth.
• Following their hand with gaping mouth.
• Waking and making quiet eye contact.

This sequence of non-verbal cues lasts for approximately fifteen minutes. If the above body language is not responded to, most babies will cry. Some, however, will simply go back to sleep to conserve energy.

It is recommended that you respond to the early cues. Babies that are learning to breastfeed, often feed better when they are coming out of a sleep, rather than very hungry and upset. This is called responsive feeding and allows for babies to find comfort as well as food at the breast.

We now know that keeping our babies close and responding to their cues for food, comfort and love is important for their brain growth and this closeness helps to foster close family relationships, which are good for long term health and wellbeing.

• Breastfeeding works on a supply or demand basis. The more the baby feeds the more milk is produced. If a baby is given an artificial feed it will take longer to digest and she or he will not want to suckle for some time. This affects this natural balance of supply or demand and thus less milk is produced.

• If the baby does not breastfeed often enough, your breasts may become full. This can be painful and may make it difficult for the baby to attach correctly.

• Artificial feeds alter the bacteria in the baby’s gut. This may increase the risk of your baby developing infections.

• Artificial feeds may potentially increase the risk of asthma, diabetes obesity and allergies, particularly if there is a family history.

• A baby uses the tongue, jaws and mouth differently when sucking on a bottle. If a baby is given a bottle at this early stage, she/he may find it more difficult to learn to suckle at the breast as a very different technique is practised when bottle feeding.

Your baby’s tummy is tiny at birth, with a stomach capacity of around 5 to 7 millilitres. It is about the size of a hazelnut. This increases over the first few days to 22 to 27 millilitres at 3  to 5 days. By 10 to 12 days the capacity expands to 60 to 85 millilitres (about the size of a walnut!).

Don’t worry about your milk production, providing that the baby is feeding regularly at the breast or you are expressing 8 to 12 times a day our milk supply will increase to match your baby’s growing appetite.

Count the number of wet nappies: baby should be producing at least two on day two, three on day three, four on day four and at least six wet nappies a day thereafter. The volume of urine in the nappy should increase along with the increase in number of wet nappies. Note the colour of dirty nappies. The stool should be changing from the sticky, dark meconium by day three, be brown by day four and become a yellow colour by the fifth day.

If your baby does not have a dirty nappy for more than 24 hours or the stools are not changing colour in the first five days, you should seek advice from a midwife.

The following is a guide for mothers who need to express milk for their babies.

Breastmilk:  Average volume produced