Breastfeeding: The First 72 Hours

Breastfeeding is natural, but that doesn’t mean it comes naturally. Many breastfeeding mothers will tell you that the first days are the hardest: You and your baby are both learning, and your body is adapting to its new demands. Establishing beneficial habits and developing a schedule early on will encourage triumphant nursing in the months to come.

Successful breastfeeding begins in the delivery room. Some mothers choose to have their infants placed directly on their chests at birth, beginning the bonding process and the skin-to-skin contact that can lead to better breastfeeding. Others prefer to wait a few minutes while the umbilical cord is cut and the placenta is passed. Either way, early contact is important, so get close as soon as you can during the first hour to encourage your breast milk to start flowing.

The best time to begin breastfeeding is the very first time you hold your newborn. The initial challenge is forming a good latch—the key to less painful, more efficient suckling. To achieve this, gently guide your baby’s chin down so that his mouth is wide open, and bring him to your breast. His mouth should cover as much of the areola (the dark part of the nipple) as possible so that the nipple is farther back in baby’s mouth. If the latch is too shallow or uncomfortable for you, break the suction by inserting your pinkie finger between baby’s lower lip and your skin. Try again until you both have it right.

In the beginning, it will seem as if baby isn’t getting enough milk, but if he’s producing wet diapers, you’re doing something right! Your milk supply won’t fully come in for two to four days (in most cases), but from the time of baby’s birth, your body is producing colostrum, a form of human milk that’s biologically ideal to meet baby needs. This crucial first milk is high in protein and antibodies—you’re passing on strength and immunity boosters that will protect your newborn.

Establishing a Breastfeeding Schedule

Introduce a consistent breastfeeding schedule from day one. It’s recommended that babies feed 10 to 15 minutes on each breast, and feedings should be about two hours apart in the first week, even during the night. (Note: Time feedings from start to start, not end to start. If one feeding goes from noon to 12:45 p.m., start the next at 2 p.m.) However, don’t be a slave to the clock. Watch for hunger cues—rooting, sucking and eventually crying— and offer your breast every time he looks for it. You may want to keep your baby in the hospital room with you, even through the night, to become accustomed to his signals and further synchronize your schedules. If baby stays in the nursery overnight, make sure the nurses know you want to breastfeed at least every two hours.

While your baby is getting used to nursing, avoid giving him glucose water, infant formula or other liquids, and ask your baby’s nurses to do the same. Leaving off the pacifier during the first days of breastfeeding may also help baby form effective habits more quickly. Ensuring that your little one has frequent, fulfilling feedings will help your breast milk supply come in sooner and stronger.

Even before your milk comes in, however, you may begin to experience nipple discomfort, pain or other common breastfeeding problems. This doesn’t necessarily mean that you’re doing something wrong, but speak with a lactation consultant or a nurse trained in breastfeeding before you leave the hospital. They can provide valuable breastfeeding support to ensure baby latches well and is positioned correctly. This will help minimize pain and boost your confidence that baby is getting enough breastmilk to encourage healthy weight gain in those first few days of life.

Coming Home with Baby

When you arrive home from the hospital, continue your feeding pattern and consider sharing a room with your baby during the night. Keeping his bassinet or co-sleeping device near your bed will make feedings easier, and you’ll be more in tune with his needs. Because you may be pretty exhausted by the physical demands and grueling schedule of breastfeeding your baby, don’t depend on your memory. Record each feeding session’s time and duration and document every wet and dirty diaper so you can track baby’s progress and have a full report for the pediatrician (the first visit should be three to five days postpartum). Also keep track of which breast you started with during each session, and try to alternate each time.

If it seems like you don’t have much time between feedings in the beginning, it’s because you really don’t! Hang in there and learn to multitask: Take up knitting, catch up on the last season of your favorite show, read a good book, and nourish your baby at the same time. You might actually enjoy taking life at a slower pace for a little while, even if you’re not accomplishing as much as usual.

And Then the Breast Milk Deluge

Expect your milk to come in between days two and four. At this time, your breasts may become unusually large, swollen and hard. This breast engorgement period is somewhat uncomfortable at best, but for many women, it can be downright painful.

As your body regulates the amount of milk you’ll produce, breastfeed frequently and only use a breast pump to express milk if the areola is just too firm for baby to latch onto. While nursing, massage the breast to encourage letdown and keep the flow going. If the pain is still too much, try applying cold packs or cabbage leaves between feedings, or ask your healthcare provider if it’s OK to take a mild pain reliever. Bear in mind that (1) all this milk production is really a good thing, and (2) true engorgement usually lasts just a couple days—you can do it!