November, 2022 | Spectra Baby USA

By: Chrisie Rosenthal, IBCLC
The Lactation Network

Breastfeeding: The First Week

Your little one is here! The first week of your baby’s life is sure to bring big emotions, special memories and a few challenging moments as well. When it comes to breastfeeding, knowing what to expect can make the tough times much easier.

Day 1: When your baby is born, they will be looking to eat right away! Take advantage of their instincts in this “golden hour” by bringing your baby to your chest and latching immediately after birth. Studies tell us that latching in the first hour helps ensure long-term breastfeeding success! However, if you aren’t able to breastfeed in the “golden hour”, don’t worry – breastfeed your baby as soon as you’re together and if you’re separated for more than four hours, it’s important to start pumping to let your body know that you are breastfeeding. If you delivered your baby in the hospital, ask the nurses to assist you. You may also see an in-patient IBCLC during your stay. You are surrounded by a team of people who are there to support you!

It’s a myth that breastfeeding should “just come naturally”! Breastfeeding is a learned skill, for the parent and for the baby. It takes time and practice. Babies need to eat a minimum of 8-12 times every 24 hours, and in the early weeks, it’s common for babies to eat 10-12 times every 24 hours. In fact, in the first few days, Pediatricians generally recommend that you feed your baby every 2-3 hours around the clock, measured from the start of one feed to the start of the next.

Output is also important. On day 1, your baby should have at least one wet diaper and one stool. After that, the number of wet diapers should increase by one for the first 4 days i.e. a minimum of 2 wet diapers on day 2, a minimum of 3 wet on day 3, and 4+ wet diapers on day 4. Stool frequency varies greatly, but you’ll notice that your baby first passes meconium, a thick, dark, sticky stool. Over the next couple of days, it will transition to a light brown or green, and by day 3-5 you’ll finally see “breastmilk stools” which are loose and a yellow/mustard color.

Day 2: If your support team at the hospital has been helping you latch, today is a great day to start latching your baby yourself, and asking them to observe and give you tips. If you have a partner with you, they can help by making note of the tips and techniques you’re learning.

Night 2 may bring baby’s first growth spurt! Growth spurts are marked by frequent feeding, gassiness, a cranky baby, and lots of wet diapers. Baby may feed more veraciously, your nipples may become more sore. Expect this growth spurt to last a couple of days.

It’s a myth that breastfeeding is “just painful, and you have to push through it.” Although you may feel tugging when your baby is latched deeply at the breast, it shouldn’t hurt. If it hurts, an IBCLC (an expert Lactation Consultant) can work with you to create a plan to feed the baby and make it more comfortable for you. Studies support that applying breastmilk to your nipples is one of the most effective healing measures.

Day 3-5: You may already be or may be heading home soon and if you’re feeling overwhelmed by this transition, know that those feelings are very common. Now is the perfect time to request a consultant with your Lactation Consultant, create a plan for breastfeeding at home and troubleshoot any concerns you’re having.

Sometime during days 3-5, you will also experience your milk transitioning from colostrum and increasing in volume. If you become uncomfortably full, cold compresses applied to your breast tissue (in addition to feeding your baby) can help to provide relief.

This is also when most parents have their first outpatient Pediatrician appointment. Your Pediatrician will ask about feeding, diaper output and take your baby’s weight and measurements. They may also tell you that at this point, your baby is allowed one longer stretch between feeds once a day.

It’s a myth that by “doing the right things, you can coach a newborn baby to sleep long stretches at night.” Babies tend to be nocturnal for the first few weeks of their life. Sleep deprivation can be a real challenge! If you have a partner, work together so you both have a chance to rest every day. If you don’t have a partner, lean on your support network at this time and ask for help. The good news is that baby’s sleep generally improves around six weeks.

Day 6-7: You’re nearing the end of baby’s first week, and you’re probably feeling like you’ve found a little bit of a rhythm by now. If your nipples were tender from the first few days of breastfeeding, you should be feeling some relief at this point. You should also be gaining more confidence in latching. If you’ve been using one breastfeeding position (most likely cross-cradle), this is a great time to switch it up and experiment with other positions (consider football or side-lying).

It’s also not uncommon to be feeling big swings in emotions. (Hormones!) Although “baby blues” are common, familiarize yourself with the signs of postpartum depression and postpartum anxiety. Your OB, MD and Lactation Consultant can provide resources if you need them!

It’s a myth that breastfeeding “is all or nothing”. Or that there’s only “one way” to breastfeed. Some parents choose to feed their baby exclusively at breast, or exclusively pump and bottle feed. Most introduce the bottle in the early weeks and feed both at breast and with a bottle. Your feeding journey is unique to you and your baby, but you’re not alone. If you need support, Lactation Consultants can help you reach your goals. You’ve got this!

Did you know that your breast pump and lactation consultations are often covered under your insurance? The Lactation Network is a great resource and can help connect you to an IBCLC in your area.

Source:

How often to breastfeed. HealthyChildren.org. (n.d.). Retrieved November 28, 2022, from https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/How-Often-to-Breastfeed.aspx?_ga=2.190306667.199690818.1668731164-1827075293.1652815044&_gl=1%2A1xjwh9v%2A_ga%2AMTgyNzA3NTI5My4xNjUyODE1MDQ0%2A_ga_FD9D3XZVQQ%2AMTY2ODczMTE2NC40MC4wLjE2Njg3MzExNjQuMC4wLjA

GOODLIN-JONES, B. E. T. H. L., BURNHAM, M. E. L. I. S. S. A. M., GAYLOR, E. R. I. K. A. E., & ANDERS, T. H. O. M. A. S. F. (2001). Night waking, sleep-wake organization, and self-soothing in the first year of life. Journal of Developmental & Behavioral Pediatrics, 22(4), 226–233. https://doi.org/10.1097/00004703-200108000-00003

AAP schedule of well-child care visits. HealthyChildren.org. (n.d.). Retrieved November 28, 2022, from https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx

By: Melissa Portunato, IBCLC

Breast Gymnastics is a gentle massage technique that can bring pain relief and easier milk flow for mothers experiencing engorgement, clogged ducts, and other common breastfeeding conditions. Maya Bolman, IBCLC and leading researcher in Therapeutic Breast Massage coined the phrase “breast gymnastics” to teach breastfeeding families and lactation health care professionals the benefits of gentle stretching and movement of the breast. Breast gymnastics triggers drainage of the lymphatic system creating milk to flow freely improving the quality of breast milk and decreasing swelling. Used in combination with hand expression, breast gymnastics effectively alleviate breast pain making nursing and pumping a more enjoyable experience.

THE BENEFITS OF BREAST GYMNASTICS

Breast pain is a leading cause of premature weaning and breast gymnastics can help resolve common ailments associated with early breastfeeding. Often relief is immediate, and breastfeeding can continue with no interruptions.

Chronic Breastfeeding Pain
If you are experiencing chronic breast pain, practicing breast gymnastics can bring relief. Chronic pain in the breast can sometimes be caused by a bacterial infection. It’s important to monitor your symptoms and check with your doctor if your symptoms are not improving.

Engorgement
Also known as “milk stasis”, engorgement comes from built-up milk in the ducts which can cause painful swelling, firmness, and sensitivity of the nipples and breast. Engorgement is most common among first-time mothers but can also happen when weaning from breastfeeding.

Clogged Ducts
A “plugged” or “clogged duct” occurs when a milk duct that leads to the nipple gets blocked. The onset is often fast and can be associated with a hard, often painful lump. Some causes of a blocked duct are prolonged time without milk removal, shallow latch, restrictive clothing, or even stress. With proper care, most clogged ducts subside within 2-3 days.

Mastitis
Mastitis can be infectious or non-infectious, and symptoms of both include fever, pain, swelling, redness of the breast, hard lumps, hot to the touch, and feeling flu-like symptoms. If you suspect you may have mastitis, make an appointment with your doctor. Breast Gymnastics can aid recovery, but you may also need medications to clear up the infection.

Latching Baby To Breast
Breast Gymnastics can soften the breast to allow your baby to latch on to your breast. The gentle movement and circulation with hand expression can protrude the nipple and your baby will be able to latch deeper for more nutritive feedings at the breast. You can move and stretch your breasts while simultaneously feeding your baby for more productive nursing sessions.

HOW TO DO BREAST GYMNASTICS

Step 1
Cup both hands under one breast

Step 2
Lift breast up and down

Step 3
Move your breast softly to the left and then right

Step 4
Move your breast gently all the way around in a circular motion – clockwise and then counterclockwise

Step 5
Repeat on the other breast

If your baby cannot nurse, protect your milk supply by breast pumping every 2-3 hours with a hospital-strength breast pump. If you are experiencing breast pain, connect with an International Board Certified Lactation Consultant, IBCLC for evidence-based information, counseling, and support to continue to meet your breastfeeding goals.

Source:

Mothers Value and Utilize Early Outpatient Education on Breast Massage and Hand Expression in Their Self-Management of Engorgement. Witt AM, Bolman M, Kredit S, Breastfeed Medicine 2016 Nov; 11:433-439.

Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts and Mastitis. Witt AM, Bolman M, Vanic A, Kredit S, J Hum Lact 0890334415619439, first published on December 7, 2015.

Recapturing the Art of Therapeutic Breast Massage During Breastfeeding. Bolman M, Saju L, Oganesyan K, Kondrashova T, Witt AM. J Hum Lact. 2013 Aug;29(3):328-31.