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Breastfeeding: Getting Started

Breastfeeding: Getting Started

Breastfeeding your child

Breastmilk is the perfect food for your baby. It gives your baby many advantages compared with formula. Your milk contains just the right amount of nutrients. And it is gentle on your baby's developing stomach, intestines, and other body systems. 

The American Academy of Pediatrics (AAP) strongly recommends exclusive breastfeeding for at least 6 months. Exclusive breastfeeding means that your baby has only breastmilk for 6 months. That means giving your baby breastmilk from your breasts or from bottles. Don’t give your baby water, sugar water, or formula.

Pacifier use

The AAP recommends using pacifiers to decrease the risk of sudden infant death syndrome (SIDS). For breastfeeding mothers, the AAP recommends waiting until breastfeeding is well established. Then the pacifier isn't replacing the feedings babies need to grow. Well-established breastfeeding means that:

  • Your baby can easily put their mouth around the nipple and latches on

  • Breastfeeding is comfortable for you

  • Your baby weighs more than their original birth weight

These milestones are often reached after the first 3 or 4 weeks.

Getting started with breastfeeding

Your milk and how you breastfeed change as your baby grows and develops. A newborn's feeding routine is different than that of a breastfeeding 6-month-old. As your baby grows, the nutrients in your milk change to meet your growing baby's needs. The anti-infective properties also increase if you or your baby is exposed to some new bacteria or virus. Here's how to get started:

Early breastfeeding

The first few weeks of breastfeeding are a learning period for both you and your baby. It takes time for you both to work as a team. Be patient as you recover from your delivery, create a daily routine, and become comfortable with breastfeeding. Keep track of feedings and wet diapers. This can help your child's healthcare provider assess how your feedings are going.

Day 1

Most full-term, healthy babies are ready and eager to begin breastfeeding within the first half hour to 2 hours after birth. This first hour or 2 is an important time for babies to nurse and be with their mothers. The AAP recommends that babies be placed skin to skin with their mother right after birth (or when both you and your baby are able). Skin to skin means placing your naked baby stomach-down on your bare chest. This keeps the baby warm, helps keep the baby's blood sugar up, and helps the baby breastfeed for the first time. It is recommended that babies be kept skin to skin at least 1 hour. Or they can be kept this way longer if the baby hasn't breastfed yet.

After these first few hours of being awake, babies will often act sleepy or drowsy. Some babies are more interested in sleeping than eating on their birthdays. You can expect to change only a couple of diapers during the first 24 hours.

Days 2 to 4

Your baby may need practice with latching on and sucking. But by the second day, your baby should begin to wake and show readiness for feedings every 1 1/2 to 3 hours, for a total of 8 to 12 feedings over 24 hours. These frequent feedings provide your baby with antibody-rich first milk (colostrum). And they tell your breasts to make more milk. Let your baby nurse on one breast until finished. You can then change and burp your baby before you offer the other breast. If the baby is not interested in breastfeeding, start with the second breast at the next feeding.

As with day 1, you likely will change only a few wet and dirty diapers on baby's second and third days. Don't be surprised if your baby loses weight during the first few days. The number of diaper changes and your baby's weight will increase when your milk comes in. 

It's normal to have uterine cramping during the first few days of breastfeeding. This is a positive sign that the baby's sucking has triggered a milk let-down. It also means your uterus is contracting, which helps lessen bleeding. A nurse can give you medicine before feeding if needed for the discomfort. Some mothers briefly feel a tingling, pins and needles, or flushing of warmth or coolness through the breasts with milk let-down. Others don't notice anything different, except the rhythm of the baby's sucking.

Your baby is still learning how to latch on and breastfeed. So your nipples may be sore when your baby latches on or while you are breastfeeding. Other factors also may help lead to this soreness. But often it is mild and goes away by the end of the first week. Tell your nurse if soreness continues or gets worse. Or if your nipples are cracked. Your nurse or healthcare provider may recommend a lactation consultant. This is someone who specializes in breastfeeding.

Days 3 to 5

You will have a lot more milk 3 or 4 days after birth. When the amount of milk increases, the milk is said to have come in. Your baby is drinking more at each feeding. So he or she may drift off to sleep after a feeding and act more satisfied. Within 12 to 24 hours, you should be changing a lot more wet diapers. The number of dirty diapers also increases. And the stools should be changing. The baby's first bowel movements (meconium) are sticky and dark. They will become a mustard-yellow, loose, and seedy stool.

Weight gain should also pick up within 24 hours of this increase in milk production. So your baby will begin to gain at least 1/2 an ounce (15 g) a day. You may notice that your breasts feel fuller, heavier, or warmer when your milk comes in. The most important thing to do when your milk first comes in is to feed your baby frequently. This empties your breasts often and completely.

Breast engorgement

Your breasts may become overfilled with milk (engorged). This makes them swollen and painful. Your baby may have trouble latching on if your breasts are engorged. Feeding frequently and on demand will help prevent this. But if it happens:

  • Express some milk. This means squeezing a small amount out of your breasts. And then letting your baby latch on. A warm shower or warm compresses right before or during expressing may help.

  • Breastfeed or express milk by hand or breast pump often (every 1 to 2 hours). Your breasts should feel noticeably softer after breastfeeding or pumping.

  • If the pain is severe, you may put an ice pack on your breasts. Keep it on your breasts for 15 to 20 minutes after nursing or pumping. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice or an ice pack directly on your skin.

Days 5 to 28

Your baby will get better at breastfeeding as the first month progresses. Expect to feed your baby about 8 to 12 times in 24 hours. Let your baby tell you when he or she is finished eating. When the baby self-detaches from the nipple, you can offer the other breast. Some babies feed better between breasts if you change their diapers and burp them. Often a baby will breastfeed for a shorter period at the second breast. Sometimes he or she may not want to feed on the second breast at all. Simply offer the second breast first at the next feeding.

Your baby should continue to:

  • Soak 6 or more diapers a day with clear or pale yellow urine

  • Pass 3 or more loose, seedy, or curdlike yellow stools every day

  • Gain weight. Babies typically gain two-thirds of an ounce to 1 ounce each day, up to 3 months old.

Talk with your baby's healthcare provider if you think your baby is not eating enough.

General tips beyond the first few weeks

Every baby is different. Some will eat quickly and some will take longer to enjoy each drop. Others will take frequent breaks during each feeding. It's important to let your baby lead each feeding. This self-detachment will increase the amount of higher fat and higher calorie milk (hindmilk) that your baby will get. But once the breast is mostly empty, some babies will keep wanting to suck as a way of self-soothing. Over time you will be able to tell when your baby is switching to this self-soothing sucking. If your baby keeps sucking in this way and it’s painful, gently detach your baby. If breastfeeding is well established, you can offer a pacifier instead. If you aren't sure if your baby is full, try offering the other breast.

Your baby likely will go through a few 2-to-4-day growth spurt periods. During this time, he or she will seem to want to eat almost around the clock. Babies often have a growth spurt between 2 to 3 weeks, 4 to 6 weeks, and again at about 3 months. It’s important to let a baby feed more often during these spurts. Within a few days, your baby will go back to a more typical pattern.

Let your baby set the pace for breastfeeding. Watch his or her feeding cues. Here are some examples of feeding cues:

  • Turning the head toward the breast

  • Licking the lips

  • Smacking the lips

  • Being awake

  • Crying (this is a late sign of hunger)

The number of feedings each baby needs and the length of time each feeding lasts will vary from baby to baby. Also, every mother's milk production and storage capacity is different. Trying to force a breastfed baby to wait longer between feedings, or to fit a certain feeding schedule, can result in poor weight gain.

Reviewed Date: 11-01-2018

Breastfeeding: Getting Started

This content was reviewed by Mid-Atlantic Womens Care, PLC. Please visit their site to find an Mid-Atlantic Womens Care obstetrician.

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Mid-Atlantic Womens's Care
Health Tips
Babies Need "Tummy Time"
Help Your Babysitter Prepare for Anything
How to Bathe Your Baby
How to Use a Pacifier
Prevent Shaken Baby Syndrome
Taking Baby's Temperature
Breastfeeding Quiz
Can Surgery Solve Breastfeeding Woes?
Diseases & Conditions
Adding to Mother's Milk
Anatomy of the Newborn Skull
Assessments for Newborn Babies
Baby's Care After Birth
Bathing and Skin Care for the Newborn
Breast Milk Collection and Storage
Breast Milk Expression
Breastfeeding and Delayed Milk Production
Breastfeeding and Returning To Work
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Breastfeeding Difficulties - Baby
Breastfeeding Difficulties - Mother
Breastfeeding the High-Risk Newborn
Breastfeeding When Returning to Work
Breastfeeding Your Baby
Breastfeeding Your High-Risk Baby
Breastfeeding Your Premature Baby
Breastfeeding: Returning to Work
Breastmilk: Pumping, Collecting, Storing
Breathing Problems
Care of the Baby in the Delivery Room
Caring for Babies in the NICU
Chromosomal Abnormalities
Common Conditions and Complications
Common Procedures
Congenital Heart Disease Index
Difficulty with Latching On or Sucking
Digestive Disorders
Effective Sucking
Expressing Milk for Your High-Risk Baby
Expressing Your Milk - Helpful Equipment
Fever in A Newborn
Flat or Inverted Nipples
Hearing Loss in Babies
Hearing Screening Tests for Newborns
Heart Disorders
High-Risk Newborn Blood Disorders
How Breastmilk Is Made
Infant Feeding Guide
Infant of a Mother with Diabetes
Infant Play
Infant Sleep
Infection in Babies
Inguinal Hernia in Children
Keeping Your Baby Warm
Low Milk Production
Male Conditions
Managing Poor Weight Gain in Your Breastfed Baby
Maternal Nutrition and Breastfeeding
Maternity Leave
Megaureter in Children
Micropenis in Children
Milk Production and Your High-Risk Baby
Neurological Disorders in the Newborn
Newborn Appearance
Newborn Babies: Getting Ready at Home
Newborn Complications
Newborn Crying
Newborn Health Assessment
Newborn Measurements
Newborn Multiples
Newborn Reflexes
Newborn Screening Tests
Newborn Senses
Newborn Sleep Patterns
Newborn Warning Signs
Normal Newborn Behaviors and Activities
Overactive Let-Down
Physical Exam of the Newborn
Plugged Milk Ducts
Preparing for Your New Baby
Preparing the Family
Skin Color Changes
Sore Nipples
Storing Your Breastmilk
Substance Exposure
Surgery and the Breastfeeding Infant
Taking Care of Your Breast Pump and Collection Kit
Taking Your Baby Home
Thawing Breast Milk
The Benefits of Mother's Own Milk
The Growing Child: 1 to 3 Months
The Growing Child: 10 to 12 Months
The Growing Child: 1-Year-Olds
The Growing Child: 4 to 6 Months
The Growing Child: 7 to 9 Months
The Growing Child: Newborn
The Respiratory System in Babies
Thrush (Oral Candida Infection) in Children
Transient Tachypnea of the Newborn
Umbilical Cord Care
Using a Breast Pump
Vision and Hearing
When to Call Your Child's Healthcare Provider
Your Baby and Breastfeeding
Your High-Risk Baby and Expressing Milk

Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.