Breastfeeding basics for full-term healthy newborns
1. Most babies are sleepy during their first 24 hours of life. Babies become more alert and ready to nurse their second day. Holding your baby skin to skin in kangaroo care can help your baby to transition to life outside the womb.
2. Try to respond to your baby's early feeding cues: rooting, bringing hands/fists to mouth, suckling/smacking of lips, and awakening after a nap. If it has been two to three hours since your baby breastfed, you may need to awaken your newborn to attempt to nurse. Gently unwrap your baby, change his/her diaper and feed skin to skin whenever possible.
3. If in the first 24 hours your baby isn't feeding every two to three hours, hand express or pump to ensure your milk will come in. Once the baby is feeding eight to 12 times in a 24-hour period, discontinue hand expressing or pumping. Your breasts should be stimulated eight to 12 times per day either by breastfeeding or hand expressing/pumping to ensure a full milk supply.
4. After the first 24 hours, expect your baby to awaken more frequently and to nurse at least eight to 12 times each 24-hour day. Some babies "cluster" their feedings, nursing every 1½ to two hours with one long stretch of sleep of up to five hours. This is normal as long as your baby is feeding a minimum of eight times in 24 hours.
5. Feedings can range from five minutes per breast for a total of 10 minutes up to 30 minutes per breast for a total of one hour. These are normal ranges. Allow your baby to finish feeding on the first breast before attempting to feed on the other side. Always offer the second breast but some babies may nurse on only one breast at a feeding. This is OK if your baby is satisfied, gaining weight, has good urine output, and your other breast is not overly full.
6. Breastfed babies don't always burp. You may attempt for 15 to 30 seconds. If the baby doesn't burp, resume nursing.
7. Your baby should have one wet diaper for each day of age until your milk comes in, i.e., first day = one wet, second day = two wets, etc. After your milk is in, expect six to eight wet diapers every day.
8. Your baby should have two to 10 stools each day. They will go through several color changes: black, brown, green, yellow, and finally a seedy yellow.
9. Breastfeeding should not be painful although a small amount of tenderness or soreness is normal. It is not normal to have cracking, bleeding or blistering breasts. Please let your nurse know if this occurs. Length of feedings does not affect nipple soreness.
10. The most significant influence on nipple soreness is an incorrect latch. Ask your nurse for help if you're unable to latch your baby by yourself or would like her to check your baby's latch.
11. Often, before the mature milk comes in, babies will go through a marathon feeding frenzy. Nurse your baby through this. Most babies don't require supplementation of mom's breast milk except for medical reasons, as directed by your pediatrician. Your baby may lose seven to eight percent of the birth weight as extra fluid in his/her body is absorbed. Continue using your feeding log and follow your pediatrician's recommendations regarding your baby's weight loss.