Coming home from the hospital is both exciting and a little daunting all at the same time. You’re now settling into life as a new family and adjusting to your little ones demanding, and often backwards, schedule. The best thing you can do is sit back, relax, let your baby set the pace and follow their schedule and feeding cues.
The First Week
Breastfeed, breastfeed, breastfeed! It’s going to feel like that’s all you do 24/7. It’s normal and it should be encouraged. Frequent feedings promotes a healthy milk supply and reduces engorgement. Your baby should nurse at least 10-12 times in 24hrs but that’s not the limit, if your baby wants to nurse more then go with it. Spend lots of time skin to skin and nurse at the first signs of hunger (stirring, rooting, hands in the mouth…), do not wait until baby is crying. Allow the baby to have unrestricted access to the breast and skin to skin cuddles makes it easier. When nursing, allow the baby to “finish” the first breast and then always offer the second breast. You may need to give baby a burp or a diaper change to wake them a little in between breasts. Use breast compression during the feed (see handout on breast compression) to allow maximum milk transfer to baby. Newborns are sometimes very sleepy and may not wake on their own to feed during the first week. It is important to offer the breast frequently and sticking to a “schedule” of every 2-3hrs during the day and no longer than every 4hrs at night is a good guideline.
It is normal and expected for babies to lose weight after birth. A weight loss of 5-7% is totally acceptable. It’s when the weight loss is 8% and higher that it is important to make sure that baby is doing well at the breast and that mom is feeling her milk come in. The milk usually “comes in” around day 3-4. There is always milk there, from pregnancy onwards, your body is making milk but around day 3-4 you will notice an increase in volume. Once the milk is in, baby’s usually gain 5-7oz a week.
What goes in, must come out! There is a lot of attention paid to baby’s diapers during the first week. As a lactation consultant I am more concerned with the wet pee diapers because it is an indication of baby’s hydration. Until day 5 baby should have one wet diaper for each day of life and then after day 5 they should consistently have 5-6 wet diapers a day. Initially baby’s will have several poopy diapers. Once mom’s milk starting coming in you will notice a change in color and texture. Breastmilk poops are yellow and seedy.
Weeks Two through Six
Your baby will continue to nurse 8-12 times in a 24hr period. Once your baby has established a good weight gain pattern and is consistently waking themselves to feed you can stop waking your baby to nurse and simply follow your baby’s cues.
NORMAL feeding behaviour:
Cluster feeding. Feedings can be so frequent that they sometimes feel constant. This usually happens in the evenings and extend into the wee hours of the morning. This is normal.
Feedings will vary throughout the day both in spacing and in length. If you think about the way that we eat during the day - we have a bigger meals and smaller snacks throughout the day - your baby will be the same. Some feeds will be long, some will be shorter, some will happen an hour after the last one and some will be 2-3hrs apart. This is normal.
By two weeks of age your baby should be back up to their birthweight. They will continue to gain 5-7oz/week.
Your baby will continue to have 5-6 wet diapers a day and they will begin to get heavier as your baby and their bladder grows. Your baby should have at least one poopy diaper a day the size of a quarter.
You may start to notice that your breasts feel softer. This is normal! Your body is adjusting to producing milk and as long as your baby is gaining weight, they will regulate your milk supply to match their needs. Softer breasts do not mean that your milk supply is decreasing, it means that your body is doing what it should.
When to call me:
Your baby has dark or rusty colored urine after day 3.
A sudden decrease in your baby’s diaper output.
Your baby does not have yellow, seedy breastmilk stools after day 4.
Your baby is not nursing the minimum of 8-10 feeds in a 24hr period.
Mom is having difficulty latching or has symptoms of mastitis (breast pain, fever, chills and body aches).
If you have any questions or concerns about how your baby is doing at the breast.