Hello readers! It’s National Breastfeeding Month 2021, and lactation is my passion! If you have been around and read my posts, you know I love chatting all things birth by nature of my career, but I also love nerding out about all things lactation! My interest in lactation began during my first breastfeeding journey with my son.
I had left the hospital with dry, cracked, scabbed, bleeding nipples, and everyone just kept saying, “well, it shouldn’t hurt. The latch looks great.” They seemed to care more that he was latched and appeared to be eating rather than what was actually happening. Finally, my journey was saved by the in-home nurse’s visit when she said something that changed my ability to latch my baby effectively: “listen for the ka, ka, sound.” I don’t know why that made things click, but it did. To be clear, I still spent countless hours wondering if my baby was getting enough and trying to grow my freezer stash before returning to work, BUT I was never prepared for how the journey unfolded. I breastfed my son, as a working mom, for 33 months!
What I have found in my work is that we prepare, prepare, prepare for birth only to gloss over the postpartum period, which includes feeding your baby. You should have a plan and education on breastfeeding just like you have for delivery. Many of us go into the golden hour thinking that nursing our babies is easy, but the majority of us are met with some difficulties. How we handle those difficulties varies, but having support is the biggest factor in continuing your journey.
Here is my crash course on what to expect in the fourth trimester:
First 24 Hours: baby is usually very sleepy. You will still want to get a good latch started in the golden hour (or two), but chances are baby will be recovering from birth and will spend a lot of time resting. This means you will be waking baby up to feed them.
Second 24 hours: If your baby was born at 11 PM Monday, they will be sleepy until 11 PM Tuesday, but on Wednesday night, be ready for your presumably chill baby to turn into a normal baby. Your baby will likely want to eat every 1-2 hours and only want to be held or latched on for the entire night. This is them waking up to the world and soaking in all of the new stimuli. These days should be spent skin-to-skin.
Week 1-2: Unfortunately, pain is common, but that doesn’t mean it’s normal. There will usually be pain on the initial latch as the tissues expand, but the pain should not last an entire feeding session. Spend the first 5 days getting acquainted with baby and focusing on latch and positioning. Any discomfort you are feeling should subside by 2 weeks; however, if you are still experiencing pain, it’s a good time to schedule a visit with a lactation professional. Your baby should also be back up to birth weight by 2 weeks after birth.
Week 3: You likely just felt like you got everything figured out, and then BAM, growth spurt! Baby will likely wake frequently every hour or two to feed, and you will experience cluster feeding. It’s normal; your baby is stimulating your milk supply by demanding more! If you plan on returning to work, you will want to consider introducing a bottle now; it will help avoid bottle refusal in the future. Start with once a day.
Week 4-6: Your supply should be established around this timeframe which should mean less leaking (if you have experienced this as part of your journey, but please note that leaking is not an indicator that you have milk or an indicator of your supply).
Feed on demand: Your baby will not show any indication of a feeding schedule for quite some time. The only thing you can count on is baby waking to feed every 1-3 hours for the next 3 months…or longer because every baby is different!
Rule of 10: You should be removing milk 10 times in a 24 hour period, at a minimum, from your body. That means baby should be eating a least 10 times in 24 hours at the breast (or more, it’s usually more) OR you are pumping 10 times a day.
NO CLOCKS!: Let your baby initiate the end of a feed by popping off the breast. This will only help to establish your supply. Do not just pop your baby off after 10-15 minutes because that’s what the pediatrician said. Let your baby suckle as long as they need; it becomes less stressful when you aren’t obsessed with the clock. Your baby may only want to be latched for 10-15 minutes, but don’t bank on that until they are older. It’s not abnormal for some babies to suckle for 30-45 minutes.
Nighttime: Night feedings are normal and necessary for your baby and your supply. Milk replenishes at night, so there is usually a lot for baby to enjoy. This is why you will notice that a morning pump session is usually quite lucrative. Your baby should be waking at night frequently. You can expect that their days and nights will be flipped in the first month, but they usually get redirected by your daily activity, and, of course, with time, they begin to figure it out. Even if you have chosen to exclusively pump, you still need to wake to pump at night to maintain your supply.
Your baby being at the breast is for more than just nourishment; it’s comfort and security. So let your baby lead the way and try to stay relaxed and focus on your perfecting your new skill in these early days so as the days, weeks, months, and possibly even years go on, it’s just an easy part of your life. You can appreciate where it all started by celebrating with a wedding cake-sized breastfeeding celebration cake when it’s all said and done…or to celebrate at any stop along the journey. Reach your goal? BUY THE CAKE!