Health Education

Breastfeeding the First Week

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How often can I expect my baby to nurse?

8 to 12 times per day. Your milk supply is dependent on how frequently your breasts are stimulated and how well they are drained. Allowing your baby to feed frequently helps your breast tissue to develop and helps tell your body to make the amount of milk needed for your baby.

How do I know my baby is getting enough?

Watch for wet and/or dirty diapers. Listen for swallowing. In the first week, a baby will typically have one wet diaper for every day old he or she is (for example, 5 wet diapers when he or she is 5 days old). Initially, your baby may have one stool every other day. However, after a few days, expect multiple dirty diapers. Your baby’s stool will start out black and tar-like but will turn yellow and seedy as your milk comes in. Eventually, your baby may have as many as a yellow seedy diaper with each feeding.

While your baby is at the breast, listen for swallowing and look for wide jaw motions as the baby sucks. These are signs showing that your baby is transferring milk.

How can I encourage my baby to eat more?

Keep your baby close to your breast! By keeping your baby close, you are learning your baby’s feeding cues (like rooting and putting hands in the mouth). Hold your baby skin-to-skin because this stimulates her other senses (like smell and feel) and encourages her to feed. Your baby will even search for your breast on her own if kept skin-to-skin.

How do I wake a sleepy baby?

Undress the baby, unwrap any swaddling blankets and/or change his diaper. If your baby is sleepy in the first few days, unwrap him and change his diaper. While he is eating, you can rub the palms of his hands or the soles of his feet. Before nursing, you may need to hold him away from your body while he is unwrapped to encourage him to wake up. Your baby may be especially sleepy if he is very jaundiced (mild jaundice is found in almost every child) but as the jaundice goes away, he will become a more efficient eater and will not be as sleepy.

What do I do if I get engorged?

Feed your baby more frequently. Use breast massage and breast compressions during feeding to drain the breast and any plugged ducts. To reduce pain and swelling, you may want to use cold compresses after feeding and take ibuprofen or acetaminophen. Sometimes women have difficulty with their milk letting down while they are engorged. If this happens to you, try a warm compress on the breast during a feeding or while pumping. If you need to pump to help relieve your engorgement, just pump to comfort, not to drain your breasts.

What if my baby has trouble latching on when I’m engorged?

Hand express prior to feed or pump 1-2 minutes prior to the feed to soften the breast. This makes the nipple and areola easier for the baby to grasp and so easier to feed.

How do I hand express?

There are many different methods to hand expression.  Often more milk is expressed if the breasts are gently massaged prior to hand expressing. Check out the Breastfeeding Medicine of Northeast Ohio video online for our hand expression demonstration.

Is it normal for my nipples to hurt?

No, it shouldn’t hurt if your baby has a good latch.  A good latch means your nipple is far back in the baby’s mouth by the soft palate.  Allow your baby’s head to tilt back so that her chin comes to the breast first. This helps signal your baby to open her mouth wide. As she opens up and over your nipple, she is latched deeper onto your breast. With your nipple further back in the baby’s mouth it will not be pinched as your baby feeds and it will not hurt. Remember to support your baby’s back and bottom while they are latching. If you are unable to get a pain free latch then make an appointment to be seen. Our lactation consultants are happy to work with you to make sure you have a good latch.