Breastfeeding – Getting Started

Of all of the gifts that you can ever give your child as a mother, breastfeeding in the first 6 months of life may be the most important. So to avoid unnecessary worry, it’s worth knowing what to expect in the first few days.

What must I do to “bring my milk in”?

Just be there. Childbirth triggers the process of milk production, so in fact you’ll make milk even if you don’t breastfeed. Having said that, regular suckling will make it all happen quicker. Latch the baby immediately after birth if possible.

Is it true that you don’t have milk for the first 2 days?

Not really. The colostrum or foremilk that you make in the first 2 days may be low volume but its very potent and provides for the baby’s needs until your milk “comes in”. So the baby takes little bits at a time, and gets by quite happily on 30 – 40 ml per day until day 3 to 4 when the milk arrives. Try to feed every 2-3 hours during this time.

How do I know if baby is getting enough?

If you have a problem free birth and your baby is well, latches nicely on a regular basis and settles between feeds, all is good. Remember the weight will always drop in the first 3 days.

If baby never settles between feeds, or is very drowsy and doesn’t latch for a long time (5 or 6 hours makes most nurses a bit anxious), you’ll get help with breastfeeding, which may sort it out. If there’s still concern we may check the baby’s blood glucose with a heel prick, and if this is low, we will give the baby a cup or syringe feed with expressed breastmilk or formula.

When does the milk “come in”?    

I keep putting this in inverted commas because you do have milk in the first few days, it’s just different. But between 48 and 72 hours after birth your breasts get obviously fuller, the milk volume gets much more, and you can actually hear it going down as baby swallows. Baby will drink for longer,  go for longer between feeds and start to settle in to a routine. The weight will start to go up. At this is the time feeding on the baby’s cues (demand feeding) will allow baby to sleep for longer periods between feeds, hopefully at night!

Should I express milk to be sure how much baby is getting?

Not necessary. Firstly, baby is much better than you are at getting milk out of your breasts, so expressing is not a true reflection. Secondly, neither you nor the baby is a machine, so the milk volume will vary from day to day and feed to feed. Feed on demand and check baby’s weight once a week, and if baby seems content and gains weight well (150-210 grams per week), you have nothing to worry about.

What foods must I avoid while I’m breastfeeding?

There is no one list that applies to everyone. Remember that a mother in India eats completely different food to a mother in Japan or England, and generally the babies are all fine. In the womb the babies gets used to the tastes of the foods that you eat because they flavour the amniotic fluid, and baby swallows this continuously, so if you continue with this healthy, balanced diet during breastfeeding if should be fine. Obviously if you notice that baby becomes fussy and uncomfortable when you raid the chocolate cupboard or eat a tomato, you’d want to make a note of this and avoid that food while you’re breastfeeding. You may in particular try to cut out cow’s milk products if baby develops allergy symptoms (cramps, eczema or a stuffy nose).

What about medications and breastfeeding?

There are 2 important questions: 1. Is the medication bad for the baby? and 2. Is the medication bad for breastfeeding?

• Most medications come through in the breast milk in small amounts, so if you have to take medicines whilst you’re breastfeeding, get advice from your doctor about whether they’re safe for the baby or not.
• Some medications reduce milk supply. Once again, don’t take anything without checking with your doctor.

So the message is try to avoid taking medicines while your breastfeeding, but if you have no choice and have to take something for an important condition, check that it’s safe to continue feeding your baby.