A Parent's Guide to Breastfeeding: The First Week
By Ann Calandro, RNC, IBCLC
The first weeks of breastfeeding are important as you and your baby learn a new skill. After the first few weeks, breastfeeding is easier. Nursing frequently in the first weeks encourages a bountiful milk supply in weeks to come. Positioning your baby chest to chest is very important for easier, more comfortable attachment. Be sure your baby opens widely and takes in a lot of the areola behind the nipple. Breastfeeding should not hurt. Trust your instincts. If you feel you need help with positioning your baby, request it!
DAY 1- A sleepy day for most babies, keep him with you and feed whenever he cues (like rooting around or chewing at his hand) are shown, or at least every 3-4 hours. If he is sleepy you will need to wake him for feeds. Wake by removing his shirt and rubbing his back in a darkened room.
DAY 2- Your baby should nurse 8-12 times for 10-40 minutes each time. Most babies feed very frequently on the second day. That's great! Your baby knows what he is doing, so relax! You are not being used as a pacifier. (And remember that pacifiers may cause problems, so don't use them the first month.) Look for two or more wet diapers and two or more stools. Supplementing with formula is not a good idea unless medically indicated.
DAY 3- Your baby should nurse often. Your milk may be increasing today and you may notice your baby swallowing more. Your baby may have lost weight but should begin "catching up" on lost weight today. Watch for three or more wet diapers, three or more stools (getting lighter in color). You may need to hand express a little milk from your breast before feeding to make latching on easier. Nap whenever baby naps. Don't forget to eat to keep your energy up. Drink lots of liquids, too.
DAY 4- Nursing every 2-3 hours, your baby should seem more content after feeding. He may sometimes feed several times in a row. Wet diapers and stools increasing. Allow 20 minutes on first side, then as long as he needs on the second. His tummy is small. Breastmilk digests rapidly.
DAY 5- Today is an important day. Check the list below to see how things are going. If you answer yes, breastfeeding is going well. If you answer no, please contact your health care provider or IBCLC for further assistance. It is easier to fix a little problem than a big one!
- Do you feel breastfeeding is going well?
- Has your milk increased? (Breasts feel fuller, warmer, baby swallowing more)
- Can your baby latch comfortably and stay attached without difficulty?
- Does your baby feed well at least 10 minutes each feeding on one side?
- Does your baby seem alert and asking to eat every 2-3 hours? (8-12 feeds/24 hours)
- Do your breasts feel firmer before feeding and softer after?
- Has any nipple soreness decreased or gone away?
- Is your baby wetting 6+ diapers and having at least 3 large, soft, yellowish bowel movements every 24 hours? (Looks like cottage cheese mixed with mustard and water)
- Do you hear swallowing when your baby drinks?
- Does your baby seem more satisfied and content after feedings?
- If your baby's skin was yellow (jaundiced) is it getting less yellow now?
- Have you made arrangements for a follow-up weight check by the time your baby is a week old?
After day four, until 4 weeks of age, bowel movements are the most important indicator of how your baby is doing. At least three large bowel movements (size of baby's fist or larger) plus 6-8 clear wet diapers are good signs. By about 14 days, he should regain his birth weight. Remember, he will need lots of touching and holding in the early weeks for comfort and healthy development. Breastfeeding is a gift you give yourself--and your baby!
Baby's Name ______________________________________
Birth Date _______________________________
Baby's Birth Weight __________________
Baby's Weight on Discharge __________________
For Breastfeeding Assistance, please call ___________________________
For help anywhere in the USA, call 1-800-LA LECHE 24 hours a day.
For a Lactation Consultant near you, contact ILCA at 919/787-5181
Ann Calandro is a lactation specialist at Piedmont Medical Center, Rock Hill, SC.