Breastfeeding Newborns – The First Hour
If you can, you should try to breastfeed your newborn within the first hour of birth. After this time, your baby can become sleepy for up to 24 hours and can be disinterested in feeding and hard to rouse for feeds. Place your baby skin to skin as soon as you can following your baby’s birth. There is no urgency to latch your baby immediately and if you just leave your baby on your chest you will see they will use some of their instinctive primitive reflexive behaviours to head towards the source of their milk.
Benefits of this first early feed include keeping baby warm by being skin to skin, calming the baby, giving baby colostrum as its very first milk and releasing oxytocin which makes your uterus contract and reduces your bleeding as well as making you feel very in love with your new tiny one.
The First Day: Breastfeeding Cues
In the first day of life, your baby may be sleepy and may not be too inclined to feed. Have your baby as close to you as possible so that you can feed your baby as soon as they are showing their early feeding cues. A baby’s breastfeeding cues include turning their head from side to side, sticking their tongue out, opening and closing or moving their mouth and taking their hands to their mouth. When you see these behaviours, you should offer your baby the breast. Crying is a late feeding cue, ideally you don’t want to wait for your baby to cry.
In the early days of newborn baby breastfeeding, your baby’s feed lengths will vary. Be responsive to your baby and wait for them to stop feeding or come off the breast on their own before removing them. Always offer the second breast. It is fine if your baby doesn’t want to drink from it.
The Second Day: Cluster Feeding
On the second day, your baby will likely be more awake and alert and many babies will cluster feed on their second night of life. Newborn clusterfeeding is another normal infant feeding behaviour and will reoccur frequently through the first 6 weeks of life. It typically starts in the evening and continues into the night. When your baby is cluster feeding, they will settle at the breast but when you attempt to unlatch them and put them down they will wake and begin to show feeding cues again. They may do this for hours and hours at a time until they eventually settle. Try to relax and be responsive at this crucial stage. Remember tomorrow is another day and will likely be very different.
Whilst babies do not cluster feed all the time, they do feed a lot!! A newborn infant should feed at least 8 times in 24 hours but more commonly they will feed 12 or more times. This can be normal. Babies have small stomachs and breastmilk is quickly digested meaning that your baby may want to feed every 2 hours or less sometimes.
Learning To Breastfeed:
Despite breastfeeding being natural, both mothers and babies still need to learn how to do it. Each baby and mother are unique, as is their anatomy, and over time they will learn to find the right fit for each other. For some lucky mums and babies, breastfeeding newborns will just happen, but for others it will require time and patience as you both learn what works. Knowing this will help to manage your expectations.
Positioning and attachment at the breast is key to getting things right. The CHIN acronym is useful to help with positioning:
- Close to the body
- Head free
- In line
- Nose to nipple
This video by Best Beginnings is an excellent resource for learning what good attachment looks like.
Getting It Right:
You know that your baby is feeding well if they are transferring milk during feeding.
Signs in the mother include…
- Milk Ejection reflex (MER)
- Increased lochia flow/uterinecontractions (NB first few days after delivery)
- Breast softening/emptying
- Milk dripping from other breast
Signs in the baby include…
- Signs of nutritive sucking
- Slow rhythmic jaw movement (seen in front of ear)
- Audible swallows
- Milk in the corner of the mouth
- Elongated and wet nipple after feed (not compressed)
Other signs that feeding is going well is that your baby is doing the right number of pees and poos for their day of life. You can check this here. The final sign is that your baby is regaining their birth weight and gaining weight as expected.
When Breastfeeding Your Newborn Isn’t Going Well:
Pain and nipple damage can be a sign that feeding isn’t going well. Beyond a slight discomfort when initially latching in the first few days, you should not experience any pain when breastfeeding. The earlier that you can access appropriate breastfeeding support, the better. Establishing breastfeeding for newborns is time sensitive and you want any issues resolved as soon as possible so that they don’t impact on your milk supply or cause you any pain or nipple trauma. If you are experiencing pain or any other difficulties with breastfeeding then seek an assessment from an IBCLC.
This blog was written by Stacey Zimmels, IBCLC Lactation Consultant, Feeding and Swallowing Specialist Speech and Language Therapist and Owner of Feed Eat Speak. She is also part of The Birth Collective, providing the breastfeeding portion of our antenatal course.