Help & Advice – Establishing Breastfeeding and Lactation
Congratulations on your new arrival…
Now let’s get those breasts working! Here is my step-by-step guide from birth to establishing breastfeeding…
Offer short bursts of 10-15 minutes of active feeding on each breast every 1-2 hours during the day for the first 24-48 hours and 3-4 hours at night. (Between 9-10pm to 6-7am).
Wind/burp when inactive or every 5 minutes. Until your milk has come in you won’t get much in the way of burping but the breaking helps to refocus and wake up. Make sure you wake your baby before the feed by way of a nappy change or stripping to a vest to cool your newborn’s body down. Shorter bursts of active stimulation will create more milk-boosting stimulation for your breasts rather than leaving a baby to suckle or comfort suck on an empty breast for extended periods.
Nipples can be easily damaged at this stage and leaving your newborn to comfort suck could leave you in great pain and with damaged nipples once your milk comes.
Extend the length of feeds to 15-20 minutes on day three, every 2-3 hours during the day and 3-4 hours at night. Break to wake up and wind every 5 minutes. Leaving longer between feeds at night means that you get much-needed rest for recovery and to make milk. Some women start lactating at day one, but it can take up to ten days for your milk to come in, especially if you’ve had a C-section.
Some babies are born sleepy and not so hungry, others ravenous. If the latter, giving a little formula to satisfy until milk comes in will stop your baby crying all night and save your nipples from being damaged. But only give 30ml/1oz at a time from 6-9pm. Too much milk and your baby will not be interested in latching on to the breast at the next feed. Giving a little formula through a bottle, in my experience, will not discourage a baby from the breast if given in very small quantities. This gives you and your breasts a chance to rest at night and do their job in producing milk after a long day of frequent stimulation.
Before offering a bottle in the evening, give both breasts first to stimulate and then top up with 1oz/30mls of formula (making sure you wind/burp after the bottle). I would only do this when a baby is unsettled and not satisfied enough to sleep.
On day four to five, extend the length of your breastfeeds to 20 minutes on each side every 3 hours in the day and 4 hours during the night. Once your milk has come in, extend the time on each breast to 20-30 minutes during your day feeds only. At week 2 -3 move on to the 7pm -7am feeding plan of 3.5-4 hour day feeds, allowing 30 minutes each side and self waking by night.
With all feeds, ensure burping every 3-5 minutes or when baby slows or starts falling asleep. Allow an hour for the whole process, which includes time for waking and winding. This should be enough time to fill and satisfy your baby, if this isn’t happening and your baby is still hungry, check and work on your milk supply. In some cases, it can take 30 minutes for a breast to drain and it’s important that baby reaches the hind milk. If your baby is over 6lbs/2.7kg and feeding well during the day, then leaving longer than 4 hours between feeds at night is fine as long as baby is gaining weight. Limit night feeds to 30-40 minutes in total making night feeds shorter and with a lower milk intake than your day feeds, thus teaching the difference between night and day.
Think active feeding and focusing on digestion = fuller tummy and peaceful sleep!
Drink plenty of water or fennel tea. Eating properly between each feed and resting during the day will make all the difference to how quickly your milk comes and increasing your milk supply. When recovering from giving birth your body uses energy firstly to heal, then to support your body and lastly lactation. Often with supply and demand, the demand comes first and the supply can be lagging behind. It can take weeks to build a supply, with some women unable to lactate successfully or produce enough milk for their fast-growing baby. In this case, the bottle is your friend for mixed feeding and getting partially breastfed is better than nothing.
Formulas are so high-tech nutritionally these days that it is an okay substitute if breastfeeding is not meant to be, for whatever reason.
For more information, please grab a copy of my book 7pm to 7am Sleeping Baby Routine or for help and support do book in for a consultation.
Hi I’m Charmian Mead, author of the best selling parenting book 7pm to 7am Sleeping Baby Routine, parent coach and lactation consultant. I offer lactation and breastfeeding support to new Mums. As a breastfeeding councillor / Consultant I can help you achieve a breastfeeding routine.