After the baby is born, will I have any milk?
While you were pregnant, your body was preparing to make colostrum (first days of milk), this is the perfect starter food for your baby. This yellowish, creamy substance is found in the breasts during pregnancy and for a few days after delivery. Your colostrum comes in very small amounts that are just the right size for your newborn’s stomach size. Sometimes these small volumes make mom worry that she isn’t making enough milk for her newborn. Small but frequent feeds are perfect for a newborns stomach size, desire to cuddle and suck and to increase mom’s milk supply.
What is in breast milk?
Mother’s milk is made of fats, sugars, proteins, minerals, vitamins, and enzymes and is designed to promote brain and body growth. Antibodies are also present in your breast milk, which help boost your baby’s ability to resist infection. Early milk has lots of immune system support and specific nutrients made to help your baby’s body adapt to being part of the outside world. As your baby grows older, your milk changes to meet his/her nutritional needs. Mother’s milk is an always changing living fluid made specially for mother’s newborn(s) to help them grow and develop their body, organs and brain.
How often should I breastfeed?
Breastfeeding is all about supply and demand. Breastfeed or express your milk as soon as possible after delivery and often so your baby can get colostrum and stimulate your body to produce more milk.
Look at your newborns’ hand in a fist–this is roughly the size of a newborn’s stomach. They don’t need much to make them full, but they do need to feed frequently. Newborn babies want to feed on demand, which is usually every 1 to 3 hours per 24 hours (8-12 times or more in 24 hours) for the first two to four weeks. While breastfeeding, be cautious of well-meaning family and friends who encourage less frequent feedings. It is the frequency of nursing, not the duration of nursing sessions that dictates how much milk is made and how much your baby gets to eat!
The frequency of feeding or milk expression (not the duration of the feeding) is what stimulates your milk supply.
How does my baby tell me when it is time to eat?
Watch your baby for early cues he or she may be hungry (increased alertness or activity, mouthing, rooting, and sucking). Crying can also be a cue your baby is hungry, but it is a late sign of hunger – you will have an easier time breastfeeding if you learn to recognize your baby’s early cues and feed your baby before he or she starts crying (crying makes breastfeeding much more difficult).
If your baby does not show feeding cues in three hours during the day, attempt to wake him/her up.
When will my baby sleep through the night?
You should feed your baby throughout the day and night until they are around 4-6 months old. During the night, make sure no more than approximately four hours pass between feedings until your baby is old enough to “drop” one of the night-time feedings, usually around 4 months of age.
Well-meaning family members and even your doctor may ask “Is your baby sleeping through the night yet?” This can make mom and dad feel like their baby is not sleeping right if they aren’t sleeping all night long. The truth is sleep is very important for your baby’s brain but so is eating and in the first several months of life most newborns need to regularly eat every couple of hours whether it is day or night-time. Your baby really gets a lot of sleep whether it is daytime sleeping or night-time sleeping, but skipping feeds to get sleep can hurt growth and brain development.
For sleepy babies, your health care provider may request that you wake your baby every three hours for feedings until your baby has regained his/her birth weight.
Does my baby need a pacifier?
Pacifiers help reduce the risk of sudden infant death (SIDS) in infants between 1-6 months old. Pacifiers also satisfy your baby’s need to suck. Sometimes using a pacifier instead of feeding your baby can mean your baby misses a feeding opportunity, this can decrease the amount of food your baby eats and can limit or decrease your milk supply.
What if I need to use a bottle?
Using a bottle for feeding your baby may be necessary for mothers who need to be absent for periods of time. We recommend delaying introduction of the bottle if possible until you and your baby are doing well with breastfeeding. If a bottle is necessary earlier for feedings when mom is away or extra food (a supplement) using a slower flowing nipple and pacing (taking the bottle out of your baby’s mouth every 3-4 sucks) will help mimic the flow of milk during breastfeeding and will help you continue to work on successful breastfeeding.
Most babies do not need extra water even if they have a fever or the weather is hot, but they may want to feed more often.
How long should I feed?
• During the first week, bring in your full milk supply by offering both breasts at each feeding. Alternate which breast you start on. You may need to stimulate your baby to take the second breast.
• After you milk supply has come in, encourage your baby to nurse as long as she/he wants on the first breast. This is so your baby can get the high-fat, calorie rich hind milk. You can tell your baby has finished the first breast when suckling slows down and your breast becomes soft. Then offer the second breast if your baby is interested. Alternate which breast you start with.
• There is no set time or length of time a newborn eats at breast. Sometimes your baby will feed slowly and take 20-30 minutes at the breast, sometimes your baby will feed much more quickly. Both can be normal and feeding for a long time doesn’t mean your baby ate more milk, nor does feeding quickly mean your baby didn’t eat enough.
When will my milk “come in”?
Remember that colostrum is milk, and your milk is already “in” before your baby is even born. When people talk about your milk “coming in”, they are talking about the change in volume and appearance in your milk. For most women, this happens 2-4 days postpartum but sometimes can happen later if you were sick or needed a C-section. As the volume of milk you make increases, you may notice your breasts becoming larger, fuller, firmer, and heavier. This is called engorgement. Engorgement only happens once after the baby is born and typically doesn’t last long. The best treatment is to feed your baby more frequently. Once engorgement resolves, your body continues to make milk.
How do I know my baby is getting enough milk?
In the first couple weeks after birth, you know your baby is getting a good supply of milk if he/she is making at least six wet diapers and 3-4 bowel movements a day. In addition, most babies will act satisfied after completing a feeding. If breast feeding is going well, your baby will not lose too much weight after birth (though some weight loss is normal) and will be back to his/her birth weight by 14-18 days of age. This is why it is very important to go to your pediatric appointments for the checkups we recommend.
Does breastfeeding hurt?
Sometimes breastfeeding may cause sore nipples in the first few days, but it should not hurt for the whole feeding or over a period of a few days or longer. If pain persists, don’t ‘tough it out’ – seek help. To schedule an appointment with a Lactation Consultant, call our outpatient service for an appointment or questions: 501-526-3558.
What medications can I take when I am breastfeeding?
It is best to avoid taking medications that aren’t necessary. There are many common medications that are considered safe while breastfeeding (for example, Tylenol and Motrin or antibiotics). Check with your provider before you start taking any medications you have not already been told are safe.
You should also talk with your provider about vitamin, mineral, or other supplements you may wish to take while breastfeeding. Many providers recommend breastfeeding women continue to take a daily prenatal vitamin to ensure they are getting adequate amounts of the important vitamins and minerals they need (this is especially important if women are not eating a well-balanced diet or if their diet is deficient in calcium and vitamin D).
If you have any questions about medications and breastfeeding please consult with the INFANT RISK CENTER at Texas Tech University Health Science Center: 806-352-2519.
Some Commonly Used Medications that May Reduce Your Milk Production:
1. Pseudoephedrine (Sudafed) found in many over the counter cold and allergy medications (like Benadryl)
Do birth control medications affect my milk?
There is some research that indicates that milk production can be affected by birth control. This research is ongoing and probably doesn’t quite give us all the answers. There has also been a lot of research done that says that birth control does NOT hurt your milk supply. It is important to talk to your doctor about birth control after the birth of your baby. We recommend birth control at around 6 weeks after your delivery to allow you to recover from delivery and to really develop your milk supply. It is very important for mom’s to know that getting pregnant again within 12 months of a previous pregnancy can significantly increase the risk of having the next baby prematurely and it doesn’t allow mom’s body time to fully recover all the nutrients and get ready for growing another baby.
When should I call to schedule a breastfeeding support appointment?
• You would like a little extra help with your breastfeeding.
• You have any breastfeeding questions or concerns.
• By day four, if you do not feel your milk supply has increased.
• For treatment of sore nipples or sore breasts or any breast or nipple pain that isn’t going away.
• Concern about your baby’s output (urine and stools).
• If your baby is not feeding 8 to 12 times in 24 hours.
• If your baby is sleeping on the breast, not suckling well, and seems hungry each time you take him/ her off.
• Ineffective positioning, latch-on and engorgement.
• Breastfeeding challenges (twins, premature infants, babies with a slow weight gain, and women who have had breast surgery, thyroid problems, and fertility questions).
• Advice for the working mother regarding how to continue breastfeeding after returning to work and help with planning a daily routine.