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What to Expect: The First Two Weeks of Nursing

Post-delivery

What to Expect: The First Two Weeks of Nursing I've always thought that the first two weeks of nursing were the hardest to deal with, whether it was my first baby or my third. Once I was over that two-week hump, it seemed that nursing was, with a few exceptions, smooth sailing.

It takes about two weeks to establish a routine with baby, which changes often because of growth spurts, the first of which occurs between eight and twelve days. Subsequent surges in development that prompt baby to feed more frequently take place at about three to four weeks, and again at three months or so. After that, growth spurts are variable.

The more you know, the better you will be able to handle breastfeeding during this critical time when you are more likely to throw in the towel because you don't think you're doing it right. Here's what to expect from moments after delivery.

In the Delivery Room
Within the first two hours or so after birth, babies seek comfort in their mother's breast. Their instinct is to latch on and suck, so right after delivery is typically the best time to first nurse your baby. If you can't feed the baby soon after birth, make it clear to the delivery room staff and to the nursery personnel that you want to breastfeed as soon as possible, and that you don't want the baby to receive any supplemental feedings of formula or water if it's not medically necessary. Supplemental infant formula can confuse a baby just learning to nurse, because sucking on artificial nipples uses different tongue and jaw motions than does suckling at the breast. Have the baby stay with you if possible. This arrangement, called rooming in, encourages breastfeeding and reduces the odds that your baby will get supplemental feedings.

Sometimes women have a difficult delivery or their baby is born with certain problems that prevent breastfeeding right after birth. Does that mean breastfeeding becomes impossible? Not necessarily. My friend Hillary's situation beautifully illustrates that point.

Hillary delivered a son who was immediately whisked away to the Neonatal Intensive Care Unit. Because he required help breathing, her baby was placed on a respirator, ruling out breastfeeding for the time being. That didn't deter Hillary, however. While she waited for her baby to get well enough to breath on his own, she pumped her milk. Three days after delivery, Hillary first nursed her son, and it went without a hitch. Nine months later, he's a happy, robust boy who has clearly benefited from breastfeeding and the commitment his mother made to nursing.

Days one through fiveThe First Couple of Days
Baby may want to nurse, but the truth is, there's little for him to eat, largely because your milk hasn't "come in" yet. Don't despair, your newborn's belly is tiny and his nutrient needs are minimal for the first few days. And what you have to offer him—colostrum—is packed with exactly what he needs.

Colostrum is the highly nutritious liquid your breasts make right before they begin producing milk in earnest, which is about two to five days after delivery. Colostrum is rich in protective white blood cells and antibodies that ward off infection. Colostrum also coats baby's digestive tract to help prevent absorption of harmful substances by the body. As far as nutrition goes, colostrum contains concentrated amounts of protein, is relatively low in carbohydrate and fat, and is easy to digest.

Infants snooze a lot just after birth, but they should not be allowed to sleep through feedings. Newborns may be sluggish, but they must nurse at least eight to twelve times in a twenty-four-hour period and should take milk for about ten to twenty minutes from each breast. It's important to try to empty each breast so that baby can reap the benefits of hind milk, the fattiest, most calorie-dense milk, which comes later in the feeding. Wake sleepy babies every three hours or so by unwrapping their blanket, loosening their clothes, or gently wiping their face with a warm, wet cloth. Switching breasts can boost a tired baby's interest in feeding. It also promotes even milk production in each breast, which helps cut down on engorgement, best described as milk buildup.

Days Three Through Five
As your milk production picks up, chances are your breasts will feel rock hard, tender, and warm to the touch. Frequent nursing—as mentioned above—actually relieves the pressure and general discomfort from milk buildup. Eventually, this normal engorgement will pass, usually after the first few days or so of nursing. There is an irony in engorgement: the harder your breasts, the tougher it is for the baby to latch on properly. Pumping or expressing milk by hand makes breasts soft enough so that baby can latch on. Sometimes gently massaging the breast while baby is feeding provides relief, too. If engorgement doesn't resolve itself within two days, call your health care provider.

When it's time to feed baby again, start with the breast you ended with at the previous feeding. One good way of remembering which breast to begin with is by attaching a safety pin to the strap of your nursing bra on the side where you should start feeding the baby.

If your baby doesn't latch on correctly to the breast, it can be painful, never mind counterproductive. Chronic breast pain causes stress and may make you want to quit breastfeeding because you don't think you're doing it right.

To release milk from the breast, babies must suck on the areola, not the nipple. As baby latches on to the breast, she activates what's known as the let-down reflex. Suckling signals the body to release oxytocin, a hormone that prompts contractions of the breast tissue, allowing the milk to make it down to the nipple for baby to drink. Let-down is a great relief for moms and is characterized by tingling or warmth in breast as the milk begins to flow.

How will you know nursing is going well? Listen and watch for baby's swallowing while feeding. Don't fret if your baby sucks a few times and then rests, because it's perfectly normal. Clucking noises or dimples in her cheeks probably mean she isn't getting enough milk from the breast. Try repositioning. Use your pinkie to break the hold she has on your breast. When she goes to latch on again, make sure she opens wide, that her lower lip does not curl under, and that she's taking in the areola. Another positive sign of successful breastfeeding is in your baby's diapers. By her third day of life, your newborn will probably have had three to four wet diapers and one to two stools that are beginning to take on a yellow appearance. As long as your daughter is content after finishing a feeding and is gaining weight according to your pediatrician, then she is probably nursing just fine.

Many mothers worry that their babies are not getting enough nourishment from breast milk alone. Granted, there are times when this may be true, but in most cases, a lack of confidence in your milk supply is unjustified. Here's why. The more you feed your baby, the more milk you make. Giving baby supplemental formula without expressing your own milk serves to stymie milk production. There are cases when breastfed babies require water or infant formula, but they are few and far between. Before you feed your child anything but breast milk, or if you are experiencing any problems with your newborn, call your pediatrician.