Breastfeeding in the early weeks: breastfeeding problems and tips
We all know how important it is to breastfeed your baby! But the truth is that sometimes it can be difficult getting started and sometimes it can be equally difficult maintaining breastfeeding through the different ages and stages.
By Adrienne Wheatley
Remember, the majority of breastfeeding problems can be solved. It is vital that you and your baby get the right advice at the right time.
The First few weeks after your baby’s birth
In the early weeks, babies spend a lot of time at the breast and mostly feed eight to twelve times in 24 hours! As they grow up, they become more efficient and will spend less time breastfeeding.
- How often should my baby be breastfeeding?
Frequent breastfeeding encourages good milk supply and reduces engorgement. Aim for feeding at least 10 – 12 times per day (24 hours). You CAN’T breastfeed too often– you CAN breastfeed too little.
Feed at the first signs of hunger (stirring, rooting, hands in mouth) – don’t wait until your baby is crying. Allow your baby unlimited time at the breast when sucking actively and then, offer the second breast. Some newborns are excessively sleepy at first – only wake your baby to breastfeed if 2-3 hours (during the day) or 4 hours (at night) have passed without feeding.
- Is your baby getting enough milk?
Weight gain: Normal newborns may lose up to 7 – 10% of birth weight in the first few days. After your milk comes in, the average breastfed baby gains 150 – 200g/week). Take baby for a weight check at the end of the first week or beginning of the second week. Consult with baby’s doctor and your lactation consultant if your baby is not gaining weight as expected.
Dirty nappies: In the early days, baby typically has one dirty nappy for each day of life (1 on day one, 2 on day two, and so on). After day 4, stools should be yellow and your baby should have at least 3-4 bowel movements daily that are the size of a 20 cent coin or larger. Some babies stool every time they feed, or even more often – this is normal, too. The normal excrement of a breastfed baby is soft to runny and may be seedy or curdy.
Wet nappies: In the early days, baby typically has one wet nappy for each day of life (1 on day one, 2 on day two, and so on). Once your milk comes in, expect 5-6+ wet nappies every 24 hours.
Your milk should start to “come in” (increase in quantity and change from colostrum to mature milk) between days 2 and 5. To minimise engorgement, it is recommended to breastfeed often and don’t skip feedings (not even at night), ensure good latch/attachment and let your baby finish the first breast before offering the other side. To decrease discomfort from engorgement, use cold and/or cabbage leaf compresses between feedings. If your baby is having trouble latching due to engorgement, express milk until the nipple is soft, and then try latching again.
Potential issues may include:
- Sore or cracked nipples
- Difficulty achieving comfortable positioning and attachment
- Low milk supply or oversupply
- Breast augmentation (implants) or breast reduction surgery
- Mastitis, blocked ducts or nipple thrush
- Maternal dietary factors which may affect your baby
- Combining breast and bottle and/or returning to work
- Baby with poor suck due to type of delivery or tongue tie
- History of low milk supply with first baby
Remember that most breastfeeding problems can be easily solved if you get the right advice at the right time! If you are having any challenges with breastfeeding or your baby is very ‘fussy’ or has sleep issues, make sure you contact me or your nearest Lactation Consultant. Together we can work out a solution that is best for you and your baby.
Adrienne Wheatley (Lactation Consultant, Midwife, Child Health Nurse)
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