Breastfeeding - Newborn Stage

Initiating breastfeeding is something that takes learning and can most certainly be overwhelming. I would certainly say nursing took learning (both times) for me but, overall, I was quite fortunate in how well things went. My second baby was actually more challenging for me than my first (but more on that another time). 

One of the biggest benefits I had was that I took a breastfeeding class and this allowed me to start nursing with some confidence. I would definitely recommend all pregnant women that plan to nurse take a breastfeeding class. I was also surrounded by mothers (mine and my husband's) that breastfed, as well as my best friend who was nursing baby #2 when I had my first and our pediatrician who nursed her own. It can be very helpful to surround yourself with a breastfeeding support group and be sure that you are comfortable asking your support group questions - because you will have many! You can also check out local groups in your area. Also, be sure to have the number of your local lactation consultant group available because chances are you will have a question for a LC at some point.

Here are my experiences and what I have learned about breastfeeding in the newborn stage with both of my daughters:

Milk supply is established in the first 4 - 6 weeks of life. This is the most important time and critical that the newborn has direct access to the breast around the clock. 

Breastfeeding should not be painful.  I've heard lots of women talk about soreness and even pain while nursing. I rarely experienced this. Pain is really a sign that there is a problem. I think I had no pain because of positioning and my children having downright fantastic latches. There are many reasons for pain or discomfort and you should always ask for help if you are experiencing pain. When I did experience discomfort it was always related to positioning.

Positioning:

Bring the baby to your breast, not your breast to the baby. 

Baby's mouth needs to be WIDE open to get a proper latch. 

Positioning my body any my baby's body was important to make sure there was no drag or pull on my nipples. While I was being evaluated by a lactation consultant, she noticed that I had a white line (compression of my nipple) and she was very concerned about my positioning. She informed me that I needed to make sure my baby's head was aligned well with my nipple. To do this I used a Boppy, several couch pillows and receiving blankets rolled in various manners to achieve the perfect position. My husband called this "Fort Breastfeed!" but it worked perfectly to get my baby in perfect alignment. I also had to use the ''C" hold of my breast. Both of these things were short-term and once I was a bit more skilled, I was able to let go of Fort Breastfeed. 

Once I was more comfortable with nursing, I also fell in love with nursing in the side lying position. With no effort at all, me and my baby were in perfect alignment and I was able to nap easily in this position. 

Hunger Cues and Timing:

I also learned crying is a late sign of hunger. Maybe many other mamas out there know this already but this was something that I learned during breastfeeding class. I tried my best to start feeding my baby before she began to cry --- but that's not to say that it didn't (or still doesn't) happen sometimes. I tried to learn all the non-crying signs of my baby's hunger but often still found myself asking regularly, Is she rooting? Is she hungry? Did something just brush her cheek so now she just thinks she's hungry? It could be really tough to tell. But as I got to know my baby better it became easier. It got to the point that all I had to do was hear my baby starting to shuffle in the co-sleeper beside my bed. Before she or I were even completely awake, I knew it was time for our middle-of-the-night nurse. 

Some of the best nursing advice I got was from my children's pediatrician. It was all about timing. Now, don't get me wrong -- I'm all about demand feeding and not putting a baby on a schedule --- but the basics of what the pediatrician taught me is this: Allow the baby to nurse about every 2 hours during the DAY. The reason for this is that breast fed infants initially need to eat on average 8 -12 times per day (usually this frequency is for the first 3 months but this varies for each baby). Basic math told me that, on average, that means every other hour. But the timing doesn't actually have to be every other hour around the clock. Of course, a baby can get hungry every hour on the hour for 3 or 4 hours straight (which is called cluster feeding and is quite common) or a baby can go 4 hours and not want to nurse. 

My pediatrician recommended that in the beginning I not let my baby go more than 2 hours without offering the breast during the DAY. If the baby isn't hungry, she won't eat. But if she is hungry, she simply will eat sooner than when I may have noticed her hunger cues. And the pediatrician said if I offer her more during the day, then I may not have to feed quite as much at night. I can tell you this worked beautifully for my oldest and she was sleeping 6 hours straight through the night by the time she was 6 weeks old. With my second it never went quite as perfectly. With both my girls, there were still wide fluctuations with their feeding schedules but this advice was just a nice guideline. Please keep in mind here that I am, again, not suggesting putting a baby on a feeding schedule. I believe strongly in the importance of learning your baby's hunger cues  and feeding on demand. The idea of feeding a minimum of every 2 hours is based on the theory that a new baby needs to eat this often anyway. By paying attention to this timing, it allowed me notice and learn hunger cues earlier.

Additionally, in the beginning it is absolutely recommended that babies eat around the clock. Most pediatricians teach that a sleeping baby should be awoken to feed at certain intervals - at least every 3 - 4 hours - until they have regained their birth weight, reached a certain age and/or the baby's doctor has given the okay to stop this.  

Length of each nursing session: A guideline my pediatrician suggested was a minimum of 5 minutes and a maximum of 30 minutes per side. This is only a guideline (like all other information in this post) and it is important to keep in mind that all babies and moms will not function within these guidelines, myself included, as I most certainly did not always follow these time suggestions.

If your baby nurses for less than 5 minutes: She may have just accidentally come unlatched and then was too sleepy to relatch herself. It is reasonable to attempt to wake baby and try to latch again.

If your baby nurses for more than 30 minutes: She may have a strong need to comfort nurse and be most content in this position. My first choice was to always allow my baby to unlatch herself, which most often did happen in under 30 minutes. If she did nurse longer than 30 minutes I typically chose to attempt to unlatch her at that point. If she cried, rooted or attempted to relatch I would most certainly allow her to continue nursing but I did choose to switch sides. Even if this meant, for example: 30 minutes on the right, 30 minutes on the left and 20 more on the right again. I also lost all track of time during our nap and night-time nursing when we both fell asleep and it was perfectly fine.  

Remember, to always continue to listen to your baby's hunger cues and nurse on demand. You cannot "over-nurse" your baby. If you are having any concern with pain or supply questions be sure to ask for help by a lactation consultant. 

Pumping:

Another big thing for me was learning about pumping. As a working mom this was just something that had to happen if I wanted to sustain breastfeeding for a year or longer. But I can't say enough how much I really, really do not like pumping. There's enough to say about pumping for a whole other post so all I will say now is that I didn't pump until the 4-6 week mark (which is also the earliest I introduced the bottle). This way, my baby was able to establish the exact amount of milk she needed during that first month or so which is the most critical time for establishing supply. Plus, I was exhausted enough without adding pumping and cleaning parts to the mix. [As with all recommendations, pumping this way only works if there are no feeding, latching or other medical concerns. Pumping initiation will also have to be determined based on the time that a mother has to return to work].

Nursing Moments:

In those early weeks, my body was healing after completing an amazing feat (growing a human for over 9 months and then giving birth to her) and was then learning how to continue to sustain her life through breastfeeding. It gave the term "sleep deprivation" a whole new meaning. One of my favorite things during that time though was nursing and snuggling with my baby afterwards. For me, all of the challenges and struggles are worth the wonderful nursing moments. One of my favorite memories of early nursing is when my first baby was finished she would unlatch and with her eyes closed she would smack her lips 3 times, then her head would lull back onto my chest. We would snuggle with each other afterwards and both of us were perfectly content. I carried this image with me often when I was away from my baby and it helped me so much when I sat down to pump at work.

Nursing Resources from other Moms:
 

Tenns from New Mama Diaries:

A really short and simple explanation regarding milk supply:

Breastfeeding: How to Know if Your Baby is Getting Enough Milk

And a little info on the quite challenging but inevitable cluster feeding: 

Recognizing and dealing with baby growth spurts


Julia from The Everyday Momma has  some fantastic tips listed on her: 

Top Breastfeeding DO's  and

Top Breastfeeding DONT's.

The only things I feel differently regarding Julia's DOs and DON'Ts list is that I absolutely love my nursing tanks and bras (especially my sleep bras) and I honestly can't imagine nursing a newborn without them. We also never kept formula in the house.

 I want to share this sign with you too. I first saw it on Julia's blog but I love it so much I wanted to add it to this post as well:

The Alpha Parent:The below link has day by day details and info for newborns and info goes up to age 2+. It is long but a fantastic reference to return to as baby grows.

Timeline of a Breastfed Baby by the Alpha Parent

Another fantastic nursing resource: 

Nursing Nurture 

As I'm sure you already know, there's an abundance of info available in books and on the web regarding breastfeeding. What worked well for me or another mom will not necessarily be what works well for you. It's just a matter of finding what's best for you and your baby and knowing there's a lot of trial and error. And that's not just regarding breastfeeding - it's finding what works best for you regarding parenting, and life in general. You will make a million choices as a mom. Your choices may be different from mine or your best friends or your sisters. But as long as it works well for you and your baby - that is all that matters!

Updated: 12/29/13, 12/30/13, 5/4/14, 5/5/14
Updates made for: clarification purposes, easier readability, additional resources linked

Please remember that this post if my tips and advice from my personal experience.The internet is never a proper source of medical information and this is not intended for medical advice or treatment. You should always seek care from you and your child's care providers.

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The above information is not intended to be used for medical advice and you should always consult your own healthcare team when making health decisions for yourself or your family.