Breastfeeding

The first 24 hours

How many wet nappies should I expect my baby to have today, and how long does the black poo last?

Newborns only wee once or twice in the first day, as they only drink small amounts of milk. The black poo (called meconium) usually takes about two days before it changes to a greenish colour.

My baby seems to have a lot of mucous in his/her tummy. He keeps bringing this up and is very sleepy and not interested in feeding, what should I do?

Frequently babies are sleepy in the first 24 hours after birth. After a good first breastfeed, it is normal for babies to be sleepy for up to eight hours. If your baby won’t attach after eight hours, it is important to express some colostrum (first breast milk) and give this to the baby. Your baby will only need about half a teaspoon of breast milk with each feed at this time.

I can’t seem to get this attachment right! Why can’t I do it?

Remember that breastfeeding is a learned skill for you and your baby. It takes plenty of practice and patience. When trying to breastfeed ask the midwife caring for you for some guidance. You may be shown many different ways to breastfeed, choose the one most comfortable for you and stick with it – persistence will pay off.

Whenever I feed I get contraction type pains, why is this happening?

These are known as after birth pains, and though not common with your first baby, they are very common with your second, third, etc. After birth pains are due to a hormone called oxytocin which stimulates the let down or release of your milk and also causes your uterus to contract. Ask for a hot pack or pain relief if you require it. The pains should settle in two to three days.

Which breast should I offer each feed?

Always offer both breasts at each feed. The first breast is known as the main meal. A nappy change after the first breast will help to wake a sleepy baby for the second breast (dessert). At times your baby may not feel like the second side especially when your milk first comes in. Start with the opposite breast you started the last feed with. This way each breast will get a turn of being the main meal. As your baby gets older they will empty your breasts faster. Leave the change to the end of the feed when your baby is sure to fill their nappy.

24 to 48 hours

My nipples are very tender, especially when the baby first attaches to the breast. Am I doing something wrong?

If the discomfort persists beyond the first minute of the feed, detach your baby by breaking the seal of their mouth with your finger and ask for guidance. It is important to check your nipple shape as soon as the baby lets go of the breast. If the nipple is a normal shape, then what you are feeling is normal tenderness. This will settle in a day or two. Your
baby has not been well attached if your nipple is an odd shape or in any way discoloured, grazed or cracked.

Yesterday my baby slept most of the time. Today he/she has hardly slept at all and seems to be constantly hungry, am I doing something wrong?

In their second to third day of life babies do become very frequent feeders. This is normal behaviour to increase the milk supply. Feed whenever your baby displays hunger signs, and rest when they sleep. Some mothers find it helpful to feed lying down at this time, so they can get some much-needed rest.

My baby doesn’t seem to burp very much. How important is it to burp him/her? Are hiccups normal?  

In the first few days when your baby isn’t drinking large amounts of milk, they may not burp after a feed. During this time babies are only taking about one teaspoon of colostrum each feed. Give your baby the opportunity to burp by holding them upright with their back straight for a few minutes. It is not necessary to try to burp them for a long period of time. Hiccups are common to most newborns, and don’t seem to bother them. They may be relieved by re-offering the breast.

How many wet and dirty nappies are normal on the second day?

Most babies will have at least two wet nappies today. The meconium (black) poo will continue and may start to change to a dark green colour.
.

48 hours +

My breasts are very full. They feel tight and sore. How long does this last?

When your milk comes in (usually between 48 and 72 hours), your breasts often produce too much milk. The tight, full feeling starts to settle after 24 hours and feeding your baby often will help. The use of cold packs on your breasts after feeds may also help these symptoms.

We just seemed to have got the feeding right and now my baby is having trouble attaching to the breast. What has happened?

The fullness of your breasts has made the areola (brown area) very firm, so your baby is now trying to latch onto what is more like an inflated balloon. It can help to express a small amount of milk until this area becomes much softer and easy to shape. You will probably need to do this for the next day or two until your supply starts to settle. Keep this in mind if your baby sleeps for longer than usual and your breasts have become overfull again.

How do I know if I have got the attachment right?

Your baby will take plenty of the areola (brown area) into their mouth. Once attached and sucking there should be no pain. You will be able to hear your baby swallowing milk regularly. When your baby releases the breast from their mouth the nipple will be the same shape as when it went in. Your breast will also feel much softer.

What should I expect now when changing nappies?

Over these two days expect your baby’s wet nappies to increase as your milk supply increases. Your baby’s poo should be green and once your milk supply has increased, will become a mustard colour.

Days 4 to 7

What is the ‘let down’?

The ‘let down’ is a hormonal response to nipple stimulation (either from your baby or when expressing). It involves the tiny muscles in your breast contracting and pushing milk down the ducts toward the nipple. Some women may feel a tingling sensation in their breast, milk leaking from the other breast, thirst or nothing at all. All are perfectly normal. The only way to really know you have had a let down is the change in your baby’s suck from short shallow sucks to longer drawing sucks and swallowing can be heard. You can have more than one let down each feed time.

How do I know if my baby is getting enough to drink?

• Your baby should be having at least six breastfeeds in 24 hours.
• Expect at least six heavy, pale wet nappies (by day five).
• Poos should be mustard in colour, quite liquid with some ‘seedy’ parts (by day five); at least two each 24 hours; most newborns will have more than this for the first five to six weeks.
• Your baby should be content after most feeds.
• Expect your baby to be bright eyed and alert, demanding feeds.
• Babies usually have an initial weight loss in the first three days, then regain their birth weight by two to three weeks. Usual growth is 150 to 210 grams

How often and how long should I expect my baby to breastfeed?

Every baby has its own feeding pattern. How often a baby feeds depends on how much milk your breasts can store, and your baby’s size and appetite. It is important to allow the breast and baby to work it out between them. Not limiting their time at the breast will give your breasts the best message about how much milk they need to produce. This is how supply equals demand. This is an important time when establishing a long-term milk supply. Most babies will breastfeed between six and 12 times over a 24 hour period. The spacing between feeds will also vary greatly. From long breaks, to feeds with very little space between them (cluster feeds). If you are concerned about the frequency of feeds or length of time it takes to feed your baby, seek guidance from your midwife.