When lactation consultant Julie Hawksley and her colleagues get together, this is what they can’t talk enough about: That the all-too-common worries that get in the way of successful breastfeeding could easily be avoided—if only new moms knew what to expect.
Think about it. Most of us spend nine months devouring information telling us our baby-to-be is now the size of a kumquat and obsessing over every detail about labor and delivery. But what about getting ready for what happens after that? Not so much.
That’s crazy. By focusing on breastfeeding while you’re still pregnant—think of it as learning about the “fourth trimester”—you’ll be way less likely to view the very normal events of the early days of breastfeeding as problems that are your fault, a mindset that can get things off to a wobbly start.
“Successful breastfeeding has become like a badge of honor,” says Hawksley, a nurse and founder of Call the LC, which provides lactation consulting services to individuals and companies in the San Francisco Bay Area. “But if you’re not feeling very successful, you might feel it’s a reflection on your motherhood and your ability to parent. That’s so unfortunate, because it has nothing at all to do with that.”
Nothing. At. All!
Focusing on just these few key insights and simple adjustments can make a huge difference right from the start, she says:
Insight #1: Your baby won’t starve. Really—even though it’s probably the #1 thing you’ll worry about.
“Is my baby getting enough?” “How do I know?” “Why isn’t she nursing?”
Hawksley and other lactation consultants hear this A LOT in the beginning. First the reassuring bottom line: Your newborn is almost always getting more nutrition than you think she is. And in the pretty rare event she’s not, it will be caught quickly.
But there are good reasons moms wonder, which tend to stem from absolutely normal infant development. They only seem worrisome if you don’t know what to look for—namely:
On the first day or so, it’s normal for your baby to be pretty sleepy or uninterested in eating. That birthing business was tough! But your baby is born with sufficient stores of nutrition, so she doesn’t need a lot in the first 24 hours.
What helps: Hold your baby skin-to-skin (wearing just a diaper) against your bare chest. “This helps your baby conserve caloric energy and regulate vital signs,” Hawskley says. “It helps you produce the prolactin [a hormone that stimulates milk production] and provides an opportunity for latching.” Be patient, rest up, and enjoy each other—and don’t worry if your baby’s not yet chowing down with gusto.
On the second day or so, it’s normal for your baby to then “wake up” and want to eat—often. Like, 10 to 12 times in 24 hours. Like, every hour even. “Your baby will seem to nurse all the time, and you may worry there isn’t enough milk,” Hawksley says. It can feel like mental and emotional whiplash—the opposite of what you were worried about yesterday!
What helps: Go ahead and feed your baby as often as she seems to need it. These super-frequent feeds are called cluster feeding and don’t follow a schedule. But at this point— you’re just getting started!—this is ideal. There won’t be a lot of milk yet, but your newborn can only manage a tiny bit at a time right now anyway. That’s part of the reason she keeps at it so often. Use this phase to learn how to hold and position your baby (just as your baby is learning how to latch and suck) but don’t obsess yet about amount. Your bodies are doing the practice dance that’s needed to get production just right.
It’s normal for your newborn to lose weight. Yes, even if you’ve been breastfeeding just fine, your baby will lose up to 10 percent of birth weight. This happens to all babies (including those fed formula, although breastfed babies lose a little more). It’s thought they may be born with a little extra by design to see them through the transition to life outside the womb. They then regain it and get back to their birth weight by the time they’re 10 days to two weeks old.
What helps: Regular monitoring. That’s one of the reasons your health care providers weigh your baby often. Wet diapers are another reassuring sign that your baby is eating enough: “Output is an indicator of input,” Hawksley says.
Insight #2: Forget the idea that breast milk flows out as if from a spigot.
Many new moms also worry a lot about their milk production.
Milk from your breast doesn’t start flowing out like formula from a bottle. For one thing, the first “pre-milk” that comes out doesn’t even look like milk. It’s a thickish, yellowish liquid called colostrum—and there’s not much of it.
“We’re talking just drops,” Hawksley says. “But it’s very nutrient dense, so it’s perfect for the first days when your baby’s system can only tolerate a small amount.”
Rich in protein and immunities, colostrum gives your baby practice learning to coordinate sucking, breathing, and swallowing.
The more colostrum that comes out, the more milk your body is signaled to make, which sets it on the path of supply meeting demand. That’s why those first beginner suckles are important, even if it seems like “nothing’s happening.” A lactation consultant or nurse can show you how to hand express some through manual massage before and after feedings, a neat little trick that helps accelerate milk production.
Around three to five days after giving birth, whitish-bluish breast milk replaces colostrum.
Insight #3: Please don’t wait to hear crying to feed your baby. (Neither crying nor clock-watching are good ways to tell when it’s time to feed your baby.)
It’s a myth that crying is the way your baby says, “Okay, now I think I’d like to eat, please.” Crying is actually a late signal of hunger, Hawksley says. It’s more like your baby is screaming, “OMG I’m frantic here, can’t you tell I’m hungry, where is that food!?”
Long before the wailing starts, your newborn gives lots of other hunger signals, which are actually pretty interesting to pay attention to and watch for. The time to bring your baby to your breast is when you see:
Smacking the lips
Bringing fingers to the mouth
Rooting (turning the face or body toward you when you stroke your baby’s cheek)
“A lot of new moms watch the clock instead of the baby—waiting for two hours to pass between feedings or whatever,” Hawksley says. “A crying baby is ten times harder to latch, and you might wind up missing a feeding because your baby is too upset to settle down and nurse.”
Insight #4: The more laid back you can be about breastfeeding, the better. Literally.
You’ve just been through the physical stress of pregnancy and childbirth, and now you’re showing off your new baby and feeding her for what seems like 24/7 and your sleep is whacked out.
What if there were a way to ease pain, feel more relaxed, and rest a little while you get the hang of breastfeeding?
There is. It’s called “laid-back breastfeeding.” (That’s the actual name, by the way. It’s also known as biological nurturing or overlying.)
“Imagine holding your baby close and nursing in the traditional cradle hold, then lean back,” Hawksley says. “That’s it!”
In this semi- to fully-reclined position, with the baby on top of you, gravity helps sustain a deeper and more comfortable latch for babies. And it’s more comfortable for you because your baby’s weight is supported by your body instead of carried in your arms. “I tell moms to imagine themselves in bed or on the couch watching TV,” Hawksley says. Truly laid back!
“So when you breastfeed, relax your shoulders, lean back on some pillows, put your feet up,” Hawksley says. Laid-back nursing is especially helpful if you have sore nipples, and it’s a great position to help you get some rest while you breastfeed, she adds.
Insight #5: Most problems are pretty easily fixable…including the #1 problem (that doesn’t get talked about enough): sleep deprivation.
“Many moms believe that breastfeeding comes naturally because it’s a ‘natural’ thing, and are often surprised when they encounter problems,” Hawksley says. Most bumps crop up in the first few weeks, although it can take a good month or two for the breastfeeding dance to get established. Even then, things like growth spurts or going back to work can mean making adjustments to your feeding plan.
The thing is, any breastfeeding problem—from the miniscule to the bigger puzzlers—can seem way bigger when you’re stressed and tired. Which just about every new moms is, what with recovering from childbirth and showing off the new baby to functioning on little sleep and adjusting to all the new emotions of being a parent.
It’s a lot.
And the stress often creeps up before exhilarated, exhausted new moms realize how fried they’ve become. “You can’t have visitors all day and be up with a baby all night; feeding your baby is where your focus should be,” Hawksley says. “And if anyone visits, they need to bring you food!” Rest makes you more receptive to handling the inevitable snags in breastfeeding, most of which are easily fixable with a little hands-on guidance (like different latches or holds to try, how and when to pump). That’s why it also helps to have an experienced breastfeeding mom or a lactation consultant on speed dial.
Ultimately, though, you’ll notice way less of that stress right from the start when you’ve been prepped with the breastfeeding basics before your baby arrives. Hawksley sees this all the time in the new moms she helps in hospitals: Those who took prenatal breastfeeding classes are just plain calmer.
It makes sense. Just as with childbirth, breastfeeding is a “natural” experience that goes way better with a bit of preparation. But although all the know-how you pick up about delivery will be over within a day (thankfully!), the info that supports you and your breastfeeding baby sets you on a happy path that lasts much longer!