If breastfeeding a newborn is natural, why is it so hard?
You would think that feeding your newborn the natural way would be easy right? But very rarely have I met a woman that has said that the first few weeks was easy.
Newborns are tiny, they have little mouths, and post-natal boobs tend to be engorged, sensitive and sore.
Breastfeeding can be difficult. It can take weeks, or months to come right. But it is worth sticking at, breast milk has so many advantages, and the breastfeeding relationship is worth persevering with.
Breastfeeding Newborns: The Ultimate Guide
There are many advantages to breastfeeding, both for the mother and the baby. The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists, strongly recommend breastfeeding. But you, your baby, and your situation are unique, and the ultimate decision is up to you.
The benefits to breastfeeding are:
1. A healthier baby
The incidences of pneumonia, colds and viruses are reduced among breastfed babies. Gastrointestinal infections like diarrhea are also less common (1).
Breastfed babies are less at risk of developing chronic conditions, such as type I diabetes, celiac disease and Crohn’s disease.
Breastfeeding can decrease your baby’s risk of some childhood cancers, and they are less likely to become obese during their lifetime (3).
Breastfeeding also reduces the risk of death from Sudden Infant Death Syndrome (SIDS) by 50%.
Formula isn’t able to change its constitution, but your breast milk morphs to meet your baby’s changing needs, over time and also at different times in the day. If your baby is sick, your body makes the right anti-bodies and gives them to your baby. It is like magic.
2. A Healthier Mama
Women who breastfeed have a lower risk of post menopausal osteoporosis. When a woman is pregnant and lactating, her body absorbs calcium much more efficiently. So while some bones, particularly those in the spine and hips, may be a bit less dense at weaning, six months later, they are more dense than they were before pregnancy! (2)
The oxytocin (happy hormone) released when your baby nurses helps your uterus contract, reducing your post-delivery blood loss. Plus, breastfeeding will help your uterus return to its normal size about 4 weeks faster than if you do not breastfeed.
Women that have breastfed also have a lower risk of pre-menopausal breast cancer and ovarian cancer.
Ovulation is delayed in women that exclusively breastfeed, so you can enjoy a period-holiday for a while (yay!!)(3).
3. A Healthier Wallet
Breastfeeding is significantly cheaper than buying formula, and it saves all the effort and pollution involved in making commercial formula.
4. It is Convenient (except when it isn’t)
Simply pull up your shirt and nurse. Breast milk is always available and always at the right temperature. Sadly Dad or Granny cannot help, so you are the one and only food supply.
Women with PCOS sometimes struggle with genuine low supply issues, breastfeeding can be very stressful in this circumstance.
Breastfeeding and Pumping
Generally speaking, unless you are needing to build a bank of milk for returning to work, you should not need to routinely pump milk.
However, if you are struggling with a low milk supply, pumping, combined with a high nutrient diet can help build your supply.
There are many other reasons to pump breast milk.
- You may want to store milk for when you’re away from your baby. Maybe you’re going back to work, leaving your baby with family, friends, or a babysitter, or running errands (and grabbing a coffee and sitting for a while!)
- Your baby is unable to latch or feed directly from the breast.
- You want to give your baby breastmilk but don’t want to feed directly from the breast.
- You’re interested in donating milk to a milk bank or milk exchange program.
- You’re trying to increase your milk supply, are weaning and need to alleviate pressure, or are suffering from mastitis or need to drain your breast to help healing
The Best Times to Pump While Continuing to Breastfeed
- Pump in the morning. Many moms get the most milk first thing in the morning. Try latching baby on one side and pump off of the other – saves time, and it is usually more effective!
- Pump between breastfeeds, either 30-60 minutes after nursing or at least one hour before breastfeeding. This should leave plenty of milk for your baby at your next feed.
- If your baby wants to breastfeed right after breast pumping, let them. Some babies are patient and will just feed longer to get the milk they need.
The Best Times to Pump When Baby is Exclusively NOT Latching On
This covers babies being tube fed, pumping for other moms, bottle feeding breast milk, and donations to milk banks.
- Plan to pump 8-10 times in a 24 hour period. Full milk production is typically 25-35 oz. (750-1,035 mL) per 24 hours.
- Once you have reached full milk production (you sound like a factory..), maintain a schedule that continues producing about 25-35oz of breastmilk in a 24 hour period.
- Each mom and baby are different, plan your pumping sessions around what works best for the two of you.
REMEMBER you will need an efficient electric pump to make this work.
How long should I pump each session?
If you are needing to pump for a baby that cannot latch for any reason this is the pumping schedule you should follow.
Days 1-3: Pump at least 10-15 minutes each pumping session. Then tilt the flange back and hand express any remaining colostrum in your breasts into the flange and collection container.
You may only get a few drops to a few cc’s of colostrum with each pumping session these first few days.
After day 4: Once your milk is in, pump 15-30 minutes per session. Always pump 1-2 minutes after the last drop of milk to get those rich, high-fat drops of milk to help your baby grow.
Remember to use your hands to help drain your breasts of milk–massage your breasts before and during pumping.
Double pumping is when you express both sides at once. Double pumping is better than single pumping. It is also less time consuming than pumping one breast at a time. Research has shown that most mothers who double pump the recommended number of times daily get their milk in sooner and develop a better supply overall.
If you are also latching your baby and feeding them, you can latch baby on one side and pump off of the other, it has the same effect as double pumping.
Supply and Demand
Breasts are amazingly efficient, making milk on a supply/demand basis. That means the more milk that is removed from the breast, the more milk your breasts will produce. Amazing eh!
A few tips: It’s always a good idea to pump after morning breastfeeding sessions when your breasts typically have more milk. And, if you’re planning to pump while you’re away at work or school, be sure you’re using a double-electric pump.
Keep a container in the refrigerator for your pumped milk, then each time you pump within a 24-hour period, add your milk to the container.
The milk will separate and the cream will rise to the top. Don’t worry – it hasn’t gone bad! Some separation is completely normal. You can gently swirl the container to re-blend the milk.
At the end of each day pour your milk into storage containers like breast milk bottles or bags . Be sure to date the containers and always use the oldest milk first. Store the containers on the lowest level and at the back of your freezer (never in the door).
Pumping When You are Away From Baby
If you are returning to work or have to go away from your baby for long periods of time, make sure you continue to pump during your time away!
I know it can be hard to fit pumping in, but you need to keep doing it as regularly as you would feed your baby if he was with you.
Or, even better, try adding an additional pumping session. Your freshly-pumped milk can be taken home and added to your stored milk supply.
Baby Won’t Latch
The best way to help when your baby won’t latch is to spend plenty of time “skin to skin”. Get naked from the waist up, strip baby down to just a diaper, and get yourself comfortable in a semi-reclining position with baby on your chest.
The worst thing you can do about breast refusal is to get uptight and anxious. Relax and go with it. While your baby is not latching, you can give baby milk from a syringe, a cup, finger feed or ever *gasp, horror* a bottle. You won’t break your baby, and a fed baby is a happy baby. Don’t make this parenting thing harder than it already is!!
I know people will tell you if the latch hurts then it is wrong. But I am here to tell you that in the first few weeks, sometimes it just hurts. It should settle down once they settle in to sucking, but that initial latch on can make you wanna cry sometimes.
Pain as the baby latches on usually means the baby is not getting a big enough mouthful of breast at the start. The problem is that tiny babies have tiny mouths!!
To make it a little better, you want the baby’s mouth to be open wide as she latches on, with her chin pressed into your breast and her head tipped back so that her nose is away from the breast. Make sure your hand is not behind her head, as that can prevent a good latch.
Shooting or Stabbing Pains in the Breast
You need to see your doctor or midwife as soon as possible, as this is a classic symptom of a thrush infection. Both your boobs and baby’s mouth will need to be treated.
A non-prescription remedy that is often helpful is gentian violet, which is swabbed on the mother’s nipples right before feeding the baby (so that the baby gets some too) once or twice a day for three or four days.
Gentian violet is available in pharmacies; ask for a one-percent solution and remember that it will turn any clothes or fabric it touches permanently purple. Don’t be alarmed — baby’s lips and mouth will turn purple too!
Baby Wants Fed ALL the Time
Don’t listen to Great Aunt Maude, a breastfed baby should feed often, a 4 hourly schedule for a little baby is asking for trouble with both weight gains and your overall milk supply.
If the baby is otherwise well, having at least two or three poopy diapers each day and your nipples are not sore, frequent feedings may just be the norm for your baby. If baby is not gaining weight well, speak to your paediatrician or family doctor.
My Baby is Drowning and Choking on the Milk
These babies often have frothy green poops as well. Some women have phenomenal letdown pressure, imaging trying to drink from a fire hose. The best way to combat this is to find a way to feed baby where you are lying down, or reclining very far backwards.
A couple of strategies that can work: try switching sides every two or three minutes, to equalize the flow. If this isn’t helping, try what’s called “block feeding:”
Pick a block of time —say, four hours —and every time the baby wants to nurse during that time, give him the left breast. The right breast will become quite full, but that’s the idea —the fullness signals the breast to make less milk. Then switch and use the other breast for the next four hours.
This is not normal, it means baby is not latching far enough back on your breast. In the first few weeks apply lanolin to your nipples after every feed to help protect and prevent cracks and grazes from developing. Lanolin also helps heal cracks faster, and it is perfectly safe for you and baby.
If you are very fair and / or have sensitive skin, you will be more prone to skin breakdown/cracking on your nipples. Be hyper vigilant about applying lanolin.
Newborn Breastfeeding Schedule
The First Week
How often should baby be nursing?
Frequent nursing encourages good milk supply and reduces engorgement. Aim for nursing at least 10 – 12 times per day (24 hours). You CAN’T nurse too often–you CAN nurse too little.
During the day feed every 2 hours, at night aim for at least every 4 hours. You can feed more often than these times, but try not to let it go any longer than them.
Weeks two through six
How often should baby be nursing?
Frequent nursing in the early weeks is important for establishing a good milk supply. Most newborns need to nurse 8 – 10 times per day (24 hours).
To be expected:
- Frequent and/or long feeds, often with little naps in between
- Varying nursing pattern from day to day.
- Cluster nursing (very frequent to constant nursing) for several hours—usually evenings—each day. This may coincide with the normal “fussy time” that most babies have in the early months.
- Growth spurts, where baby nurses more often than usual for several days and may act very fussy. Common growth spurt times in the early weeks are the first few days at home, 7 – 10 days, 2 – 3 weeks and 4 – 6 weeks.
As long as your baby is gaining weight (breastfed babies do gain slower than bottle babies), and you are getting plenty of poopy and wet diapers, and baby is settled (mostly) between feeds then you have enough.
You fullness of your breasts will reduce as you settle in to this feeding thing, and your baby will often feed a lot, especially in the evening. This is all normal and has no reflection on the quality or quantity of your breast milk.
I recommend that you follow a high nutrient, good quality diet while you are breastfeeding, you baby needs top quality fats to grow her brain and nerves (they are 60% fat!). The same fertility diet that got you pregnant, will help grow your new bundle as well.
If you have PCOS, there is a real chance that you are struggling with an actual milk supply deficiency. About 1/3 of women with PCOS will have an oversupply of milk (yay you!), 1/3 will have a “normal” supply, and 1/3 struggle with a low milk supply.
This was me, and my baby ended up severely jaundice and very dehydrated before anyone would listen to me. If you do not think your baby is swallowing anything, they are not saturating their diapers, or they become listless, get help.
There are some prescriptions you can try – I went on domperidone, and there are herbal solutions as well. Blessed thistle and fenergreek are the two better known ones. Dr Jack Newman has some fantastic resources for increasing milk supply here. He is a genuine specialist who is very kind (he even replied when I asked him what I should do!) and he knows what he is talking about.