Lactation Program Breastfeeding basics The first few weeks Is your baby getting enough milk? Latching How to hold your baby Pumping Breastfeeding challenges and solutions Returning to work   Tips for successful breast-feeding Try to minimize medication during labor, delivery and recovery. Breastfeed your baby as soon as possible after birth. Keep your baby in your room – many hospitals call this “rooming in.” You'll be more rested and able to respond quicker to his or her needs. Before you leave the hospital, perfect your latch-on and positioning techniques. Call on the hospital's lactation consultant for help. Try to avoid bottles or pacifiers for at least four weeks. Feed your baby as frequently and as long as he or she wants. This will help stimulate your milk supply and avoid engorgement. Get plenty of rest and eat a healthy diet. Be sure you have extra help at home.

BREASTFEEDING BASICS
The first few weeks

The first few weeks of breastfeeding can seem daunting. You and your baby are just getting to know each other, and you have so many questions: Is my baby getting enough breast milk? Am I doing it right? What should I expect?

Think of this time as a transitional learning period for both of you. It may take some time to begin to work together as a team. Try to be patient, get lots of rest and develop a schedule. And of course discuss any concerns with a lactation consultant or your health care provider.

It’s a good idea to keep a record of feeding times and diapers used on a chart or in a notebook for the first few weeks.

The first few days after your baby is born can be crucial to your future breastfeeding success.

Day one
If your baby is full-term and healthy, chances are he will be ready to begin breastfeeding within the first two hours after birth. After feeding, your baby may be sleepy or drowsy for up to 24 hours and not want to nurse. But you should breastfeed your baby several times on day one. During the first 24 hours, your baby will wet only a few diapers and have one or two black, tarry stools. These stools are also known as meconium.

Days two to four
By day two, your baby is beginning to get the hang of breastfeeding. While he will probably still need your help with latching on and sucking, he will wake and be interested in nursing every one-and-a-half to three hours, for 8 to 12 feedings in 24 hours.

Frequent feedings during the first few days may seem like a burden, but they give your baby colostrum (the first milk your breasts make), which is rich in infection-fighting antibodies. They also signal your breasts to increase milk production.

Each feeding your baby will probably nurse for at least 10 minutes. It’s OK to let him breastfeed for up to 30 minutes before gently removing your nipple from his mouth. After he finishes with one breast, you might want to change his diaper and burp him, then offer the other breast.

Your baby will continue to produce just a few wet and dirty diapers each day. You may notice your baby has lost a little weight. This is normal, and when your milk production increases, he will stop losing weight and begin to wet and dirty more diapers. Baby’s stools will still be very dark – black to greenish-black to brown.

While you are feeding your baby, your uterus (womb) may contract or cramp. This probably signals that your body is making one of the hormones that releases the milk from your breasts – also known as the “let down” or “milk ejection” reflex. Some women notice a tingling, hot or cool sensation on the breasts when the milk ejection occurs. Some women notice nothing different when it happens.

During these early days, your nipples may become sore or tender, especially during the first few minutes of a breastfeeding session. This will probably pass, but if it does not go away by the end of the week or if it becomes painful, consult a lactation consultant or other healthcare professional.

Days three to five
Around three to five days after birth, your milk will change from colostrum to breast milk. This event is sometimes referred to as your milk “coming in.” The amount of breast milk you produce will increase markedly, and within a day or so your baby will be producing many more wet diapers. The stools become more frequent and become softer and brown, then mustard-yellow, loose and seedy.

Soon after your milk comes in, your baby’s weight gain will probably increase, possibly to as much as a half ounce each day.

During this time, your breasts may feel heavy or full. They may become engorged because of increased milk production and swelling of breast tissues.

Your baby will continue to breastfeed for 10 to 30 minutes 8 to 12 times each day. View this chart to see if your baby is getting enough milk.

Days five to 28
Each day, you and your baby will get a little better and more comfortable at breastfeeding. He will continue to nurse 8 to 12 times each 24-hour period, for about 10 to 30 minutes on the first breast. Babies usually breastfeed for shorter periods on the second breast, and sometimes they refuse the second breast. If this happens, offer that breast first at the next session.

During this period, each day your baby will probably:

• Wet six diapers

• Have three or more mustard-yellow loose bowel movements

• Gain about half an ounce

Babies often have two- to four-day growth spurts around:

• Two to three weeks

• Four to six weeks

• Three months

During growth spurts, babies need extra nutrients and may want to breastfeed more often. Allow the baby to set the pace for feeding and do not try to withhold feedings if he is hungry. In a few days, your baby’s schedule should regulate.