Colostrum: The First Milk
Once a baby is born, and for three to four days afterward, a mother’s breasts produce colostrum. It’s thicker than typical breast milk, but packed with nutrients newborns need. The flow of colostrum is slow, making it easier for a newborn to practice sucking, swallowing, and breathing at the same time.
By day five, a baby probably will have mastered the rhythm of feeding, and the mother’s milk supply will increase to match his increasing appetite.
How to Know When Baby Is Hungry
Crying can be a telltale sign of hunger, but there are other hunger signs, too. When a baby makes sucking movements or puts her fingers to her mouth—even if she is sleeping—baby may be telling you she’s ready to eat. It’s best to feed a baby when she is fully awake. You can help wake a baby by playing with her, changing her diaper, or talking to her before she eats.
Latching On (or Positioning Baby on the Breast)
A newborn may latch on as soon as the mother holds him to her breast. If not, don’t be disappointed. To latch on correctly, position the baby’s mouth over the pockets of milk located 1 to 1-1/2 inches behind the nipple. This way, he’ll get the most milk, and mothers will be less likely to have sore nipples.
The four steps to latching on are:
- Position baby’s face and body so he’s facing the mother, with his head at the level of the breast.
- Gently lift and support the breast with fingers below and a thumb on top of the breast, well away from the areola (the dark area around the nipple).
- Gently stroke baby’s lower lip with the nipple until he opens his mouth very wide.
- Quickly pull him onto the breast so his nose, cheeks, and chin are all slightly touching the breast. If his nostrils are blocked, pull his bottom upward and closer to you, so his head will move back slightly.
If you can imagine being able to draw a straight line from his ear to his shoulder to his hip, the baby will be latched on correctly. Since a baby sucks more efficiently on the first breast he uses, alternate the side he starts nursing on from feeding to feeding.
If the baby doesn’t open his mouth wide enough, gently stroke his bottom lip with a nipple in a downward motion. Repeat this stroking until he opens his mouth wide. Then quickly pull him onto your breast so his nose, cheeks, and chin all are touching the breast. He then should begin to suck.
To keep a steady milk supply in each breast, it’s important to switch breasts during feedings. Begin feeding on the breast that was not used last. After five or 10 minutes, try burping the baby, and then offer the second breast for as long as he wants. If he doesn’t seem interested in the second breast, offer that breast first at his next feeding.
When it’s time to remove baby from the breast, it is important to first break the suction. Gently slip one finger into the corner of his mouth before removing him from the breast.
Feeding Intervals
During the daytime, if three hours have passed since baby’s last feeding, or if the mother’s breasts are full, mothers may want to wake the baby to feed her. Talking, rubbing, patting, unwrapping, or undressing her will help. It may take five to 10 minutes to wake her completely, but it usually will result in a better feeding.
If she shows signs of hunger—even if she just ate an hour ago—it’s OK to feed her again. Sometimes infants “cluster feed” before taking a nap. It doesn’t mean the milk supply is low. Instead, this is normal breastfeeding behavior.
On the other hand, if one or both breasts become engorged between feedings, using a breast pump or hand expressing will help to relieve them.
How to Know if Baby Is Getting Enough Milk
In the beginning, you’ll know if the newborn is getting enough milk if he stops passing meconium (thick black or dark-green stools) after about four days, and begins to pass yellow, seedy, runny stools three or more times a day.
During the first month he’ll wet six to eight diapers and have two bowel movements a day. Once the milk supply is established, he should gain about 2/3 ounce a day during his first three months. Between three and six months, weight gain tapers off to about 1/2 ounce a day.
Other signs to look for:
- He’s sleeping for a couple of hours after feeding.
- He breastfeeds every two to three hours, at least eight times in a 24-hour period.
- He usually breastfeeds for ten or more minutes and no longer than an hour (but let the baby, not the clock, decide how long feeding lasts).
- You can hear a rhythm of suck/pause/suck during feedings.
- The baby usually breastfeeds at both breasts.
- The breasts feel full before a feeding and softer afterward.
- He appears settled and no longer hungry after feedings.
Charting the Course: Patterns Commonly Seen in Breastfed Infants
Indicator | Age | Description |
Urine Output | 3-4 days | Pale yellow to clear (NOT deep yellow or orange) |
5-7 days | 6 wet diapers or more |
Stools | 1-2 days | Thick, tarry and black color |
3-4 days | Greenish-yellow color |
5 days | Yellow color (NOT white or clay-colored) with watery, seedy or mustard-like texture |
By 5-7 days | 3-4 stools/day |
1 month & older | Number of stools may vary (can be several stools/day, one every 3-4 days or 1/week) |
Weight Gain | 0-6 months | 4-8 ounces/week |
7-12 months | 3-6 ounces/week |
Breastfeeding Pattern | 0-1 month | 8-12 feedings/24 hours |
1-2 months | 7-10 feedings/24 hours |
2-4 months | 6-9 feedings/24 hours |
4-6 months | 6-8 feedings/24 hours |
