First Breast Feeding

By Michael K. Davis, MD
August  5, 2009

Some new mothers may be surprised that the newborn is prepared to eat within minutes of delivery.  The early breast milk (i.e., colostrum) is ready immediately after birth.  Once the placenta is expelled, progesterone levels in the mother drop, leading to increased breast milk production.  This so called, “let down” of the milk may take up to 5 days.

When should breastfeeding start?

Breastfeeding should begin within the first few hours after birth.  Some experts have shown that there is a benefit to allowing the infant to breast feed moments after birth.  Some potential benefits of breastfeeding in the first hour of life are:

Suckling stimulates release of the hormone oxytocin in the mother.  Oxytocin stimulates breast milk “let down” and also increases uterine contraction.  Contraction of the uterus helps with removal of the placenta and reduces bleeding from the uterus after birth.

• Infants have an intense suckling reflex after birth and this helps initiate the mother-infant bond.
• The early breastmilk (i.e., colostrum) contains important immune protection factors.
• Early breastfeeding stimulates the infants gut to move, which helps the infant pass any swallowed blood.  Digested blood can contribute to jaundice in the infant.
• The risk of breast engorgement is reduced.
• Early stimulation of the breasts encourages breastmilk production more quickly.
• The infant is more alert in the first 2 hours after delivery than later in the first day of life.

Will my baby get enough milk in the first few days before my milk “comes in?”

Newborn infants may lose up to 10% of their body weight in the first week of life.  This mostly occurs due to body water loss.  Newborns are born with extra fluid that helps prevent dehydration during this time.  While this is “natures expected path,” it is important to provide newborn infants with fluids and nutrition as early as possible to prevent excessive weight loss and dehydration.  It is important for newborn infants (especially breastfed infants) to see a pediatrician by 1 or 2 weeks of age to make sure feeding is adequate.

Some tips for breastfeeding in the first week of life.

• Breastfeeding should occur at least every 3 hours (day and night) in the first few weeks of life.
• Allow the infant to completely empty the breast on one side before switching to the other side.
• Avoiding the use of pacifiers in the first few weeks may encourage more effective breastfeeding.
• Do not supplement with baby milk formulas in the first few weeks unless directed by your doctor.
• The baby should urinate within about 8 hours of birth (babies often urinate during delivery or during the first bath).
• The baby should have a wet diaper at least every 4 hours.
• The baby should pass the first stool (i.e., meconium) within the first 24 hours of life.
• The baby should pass stool at least 4 times per day (about every 6 hours or less) in the first few weeks of life.  However, there is a lot of normal variation in the number of stools per day in breastfed infants.
• The baby should wake up and feed vigorously every 3 hours.
• Stools should turn yellow and “seedy” by about day 4 or 5 of life.
• The mother should be able to feel and hear her feeding infant swallow.
• Milk should be visible around the baby’s mouth and often leaks from the opposite breast when milk production is adequate.
• <>A feeding infant should latch onto the breast well without a lot of loud noise from air sucked into the baby’s mouth.

What are some clues that breastfeeding is not adequate?

• The baby should urinate within about 8 hours of birth (babies often urinate during delivery or during the first bath).
• The baby should have a wet diaper at least every 4 hours.
• The baby should pass the first stool (i.e., meconium) within the first 24 hours of life.
• The baby should pass stool at least 4 times per day (about every 6 hours or less) in the first few weeks of life.  However, there is a lot of normal variation in the number of stools per day in breastfed infants.
• The baby should wake up and feed vigorously every 3 hours.
• Stools should turn yellow and “seedy” by about day 4 or 5 of life.
• The mother should be able to feel and hear her feeding infant swallow.
• Milk should be visible around the baby’s mouth and often leaks from the opposite breast when milk production is adequate.
• A feeding infant should latch onto the breast well without a lot of loud noise from air sucked into the baby’s mouth.

Source: Dr Tummy

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