Today’s Podcast

Episode 125 Faq 8 Day 1-4  What to expect the first week

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We have done a lot of work here on FAQ day.

So far, we have talked about what an IBCLC is.  I shared how I decided to become an IBCLC ad all the steps I took to get here.  On the third FAQ day, I talked about one of my most favorite topics = Just how do the breasts make milk? It really is all so mysterious because you can’t really see this work in progress, you just know it is all happening behind the scenes.  I love talking about it because so many people tell me that they literally have a greater appreciate for the breasts as this life giving organ as well as something gives one sexual pleasure.  I know that learning that this mammary gland actual serves the purpose of sustaining life for our babies, literally opens the minds of people who have just, quite frankly, never thought about the breasts in such a way.  I have no problem with sexualizing the breasts and for it to be a pleasurable organ, as long as we respect and value this amazing organ for it’s main purpose and that is to provide food for our human babies.

Okay, see how I can easily go off on a  mini tangent about the beauty of the breast.  Just wait though, until you hear me talk about the amazing placenta,, you haven’t heard anything yet!  Pity the poor families who take my childbirth education classes.  Just think how they must feel!   Nahhhh,, actually couples often gave me feedback about how I manage to turn something kind of mundane that they never really thought too much about before, into a subject they go home and have an interest in researching even more.  Yup, when I taught childbirth classes, I did a whole hour on the amazing placenta!

Okay, getting back to breasts…  On the 4th FAQ, we talked about your hormones and what they have to do with breastfeeding.  WE got into the gold, liquid gold that is.  That must be the 5th FAQ where we talked about your baby’s first food colostrum. FAQ 6 was all about the latch and laast weeks show I taught you ow you can tell if you need to ge thelp with breastfeeding.  We talked about how you know that BF is going well?

I always find it so interesting that when I talk to parents pp, very few tell me that they learned how to tell when things were going well and how do they determine that they are not going well.  Since feeding your baby and ensuring they are getting the right amount of calories, nutrients and hydration is like one of the most important things you need to know as new parents, it is kind of crazy that these skills are not being talked about enough.

This all leads us to todays who, FAQ #8 –  You just gave birth, you have begun breastfeeding your baby.  Now you need to know, beyond the latch, what should you expect from you, from your baby, in the first 4 days, as far as breastfeeding goes.

The first 24 hours:

If all went well with your birth and you and your baby do not need any special care, it is best if you do what you can to spend the first 24 hours just being with your baby.  We like to call it your “babymoon” time.  Your physical body and emotional mind has been through a lot of changes from pregnancy to birth to postpartum.  You have gone through a lot in the last 9 months.  Here is what you can expect the first 24 hours:

Babies usually eat 3-4 times the first day. Sometimes taking one side and sometimes both sides. Pain is not normal, ever!  Baby wants to eat  more frequently, go for it!
2.  They should have good quality nutritive sucking the majority of the time they are at breast and should not be spending much of their time sleeping at breast before they have had a good feed.

3.   Babies usually pee and poop the first 24 hours whatever was inside them. Keep good records for the next 7 days to help evaluate their feedings.

4.   From day 2 on, babies should be hungry enough to wake up on their own for about 7-9 feeds a  day.

5.   These feedings should be comfortable for mom and productive for baby…no sleeping at breast. Pain is not normal, ever!  Most of the time your baby should be satisfied for 1 1/2 – 3 hours after feelings.

  1.  Day 3:  Should be similar to the 2nd day.  Lots of good breastfeeding, about 8 times. Output should be changing from dark black and sticky meconium the first day to a lighter brown on the third day.  lack of normal output is a sign of poor milk transfer.  painful breastfeeding is a sign of poor milk transfer. Poor milk transfer means your baby is not getting enough food.
  2. At this point, your breasts are beginning to fill with milk.  Your baby enjoys a good breastfeeding and your breasts should soften up quite a bit when the feeding is over. Engorgement, firm lumps and clogged ducts are not normal and if it has been more then 24 hours see your lactation consultant. Pain is not normal, ever!
  1. By day 4, you should have a noticeable increase in the volume of milk, breastfeeding should be comfortable, your breasts should be much fuller before a feeding and quite a bit softer when done. Your baby should have transitioned to yellowish mustardy color stools, that look chunky or like  sesame seeds. Four heavy wet diapers a day is normal from this point on.

 

Here are signs that tell you there is reason to be concerned that breastfeeding is not going so well and you could use some help.:

  1. If your baby is sleeping at the breast most of the time, OR spending lots of time at breast and  usually still hungry after feeds, does not have the normal output stated here. and is either  extremely fussy or extremely sleepy, you should  have breastfeeding evaluated.10.   If you are pumping because of poor feedings, low milk supply, painful feedings, baby lost too  much weight, this is a sign that breastfeeding is not going well and you will want to schedule an  appointment with an IBCLC
    .

11   If you are pumping, a hospital grade pump is highly recommended. When to pump? Every time  your baby takes milk from a bottle.

At some point between birth and 4 days old, it is likely that you have taken your baby to be seen by a physician.  A complete examination will be done.  This should include a weight check.  A 4-5 oz weight loss is normal in the first 4 days.  By Day 5, it is normal for your baby to begin gradually gaining back the normal weight loss and be back to birthweight by the time your baby is 14 days.

Being a new mommy is quite tiring.  My hope is that you have at least one full time support person helping you with almost everything.  Your main job is to rest and recover from the birth, take care of your personal needs, eat well and hydrate to thirst, take care of your baby and nap when your baby naps.  If you don’t take advantage of the time your baby sleeps, you will be a zombie in a few days. You just cannot go 24/7 without sleep.  There are no chores or work that you should be doing while your baby is sleeping.  Let others calm a fussy baby, change diapers, walk, rock and soothe while you get sleep in between feedings.  I know I sound like a broken record on this two items, however, it definitely bears repeating:

Breastfeeding should not be painful, your nipples should not be sore. You need to put your baby’s feedings and your sleep as the two top priorities.

 

Lori J. Isenstadt, IBCLC
Lori j Isenstadt, IBCLCLori Jill Isenstadt, IBCLC is a huge breastfeeding supporter.  She has spent much  of her adult life working in the maternal health field. Once she became turned on to birth and became a childbirth educator, there was no stopping her love of working with families during their childbearing years.  Lori became a Birth doula and a Postpartum doula and soon became a lactation consultant.  She has been helping moms and babies with breastfeeding for over 25 years.  Lori founded her private practice, All About Breastfeeding where she meets with moms one on one to help solve their breastfeeding challenges.  She is an international speaker, book author and the host of the  popular itunes podcast, All About Breastfeeding, the place where the girls hang out.  You can reach Lori by email at: [email protected] or contact her via her website:  allaboutbreastfeeding.biz/contact

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