Welcome to the place where you can easily access TONS of FREE Breastfeeding information and GAIN valuable insight on best tips, how-to’s and “ need to know” about all things breastfeeding related.Please enjoy this All About Breastfeeding podcast with Lori Isenstadt, IBCLC

Listen now to our breastfeeding podcasts to hear mothers share their breastfeeding stories. Hear interviews with well known authors pediatricians, midwives, doulas and others who eagerly share their knowledge.

 Episode 81     Day 5 to Day 14

On your babies 5th day of life, you should be continuing to breastfeed with comfort. The whole act of breastfeeding may very well still feel awkward to you. You will likely still be figuring out which positions seem to work the best for you and for your baby. Getting the right set up with pillows and what chair you are sitting in and if using a stool is helpful or not, are all things that you may spend the next several weeks working on, until you find what seems to work the best for you.

It is important that you have patience with yourself, your baby and the process of learning how to breastfeed. It is common for most new mothers to feel like you don’t know what you are doing and to feel some degree of a lack of confidence. More than likely, you are not giving yourself enough credit as you are in the learning phase of some pretty important new skills that you have never had the opportunity to practice before. Looking at pictures, watching videos and practicing with dolls can only take you so far. The real learning comes when you have your real live breastfeeding partner, your baby with you. Now you can learn together.

You may be experimenting with positions that you don’t have to sit up for, like side-lying and laid back nursing. I am not suggesting that you keep changing positions all the time, I am just saying that if you have not found something that you are very comfortable with, it is helpful to experiment. Ultimately, a lot of work goes into finding a position and a place that work well for you and when you find it, my suggestion is to stick with it. If the position you have found that works best for you, is one you realize will not be conducive to long term breastfeeding, breastfeeding on the outside, stick with this one until it is easy, then begin to experiment with one that you know will work best when you are on the outside, perhaps without your pillows and stool.

From Day 5 to Day 14, it would be fairly normal for your baby to be interested in both sides per feeding. You always want to let your baby finish feeding from one side and when done, always offer the second side. If your baby falls asleep after the first side, I would suggest a diaper change, either real or fake, to see if you can rouse your baby and then offer the second side. If after 15 minutes of trying, with a very sleepy baby, then I would say just leave your baby be, until he or she shows hunger cues again.

It would be fairly common for your baby to have feedings that are inconsistent as far as frequency goes and as far as time spent breastfeeding each feeding. Some babies literally do follow what some books say: Feeds for 15 minutes on each side, every 3 hours and sleeps the whole time in between. If this is what your baby is doing and he is full and has normal output, then this is his normal. If your baby breastfeeds every 2 hours for 3 feedings in a row and then sleeps for 4 hours before waking up to feed again, is full from feedings and has normal output, this is his normal.

The reason we don’t get too hung up on specific times and frequencies is because mothers are individuals, with different milk supplies and you all have different babies with different degrees of effectiveness at breastfeeding.

Some mothers have an abundant supply, enough to feed several other babies. If this is the case, you will usually hear your babies gulping at the breast and they literally can be done after 15 minutes on one side only and happily sleep for 3 hours. While this does happen, it is not the norm, particularly in the first 2 weeks of life. It would be more common for your baby to be interested in both sides per feeding and more likely that they are breastfeeding for 20-30 minutes on each side per feeding.

I find that mothers tend to focus on the wrong things when assessing how breastfeeding is going. They focus on how often their baby is feeding, if they take both sides or not, how long a feeding lasts, how long in between feedings. Rather than focus on the time or which breast and for how long, I need for you to focus on: Is the latch good? Is it comfortable? Is your baby spending quality time at the breast sucking nutritively and transferring an average volume in an average time frame?

In other words, you can chart that your baby came to the breast 9 times in one day, you can document hw long your baby stayed on each side and if you get in the right amount of feedings the books say and your baby spends the right amount of time the books say, you will feel breastfeeding is going well.

However, your baby spending 15 minutes at breast sleeping, is not the same as your baby spending 10 minutes of good quality sucking. Your baby spending 15 minutes at breast and you are crying in pain is not the same as 15 minutes at breast in total comfort. Your baby spending 15 minutes at the breast feeding and you having a much softer breast when they are done is not the same as your baby spending 15 minutes at the breast, with your breast being just as firm as when they began.

My hope is that you are beginning to learn what it is that you should be focused on when assessing how breastfeeding is going.

Ultimately, what we are looking for is this:

Is your baby having good nutritive sucking quality at the breast.

Can your baby get enough milk with each breastfeeding to keep him satiated for 2-3 hours. Is breastfeeding comfortable for you and does your baby seem to be comfortable at breast during the feeding? Is your baby having the normal amount of output and having about 8 feedings a day?

If the answer is yes to all this, breastfeeding is going well for you and this will probably be confirmed at your next pediatric visit when your baby is weighed.

There is a normal rhythm to his feeding and he should not be sleeping at the breast, you should not need to be nudging your baby to stay awake to feed. You should not need to use tickling or blowing on their face or wet wash cloths to keep them wake to feed. Sleepy babies at breast means poor feedings and this is a huge red flag for you to get expert help.

Lack of output is a huge red flag. By Day 5, you should be able to feel the weight of their pee diaper and the coloring should be clear to light yellow. If there is not much pee or it is a dark color or has a strong odor this is a sign of not getting enough and possible dehydration, so another red flag. By Day 5, your baby should have already gone through 4 days of frequent stooling with the colors and consistency changing from the early dark black and sticky meconium to a lighter brown and less sticky to a very definite 2-3 quarter size stools on Day 5 that are yellowish in color and cottage cheese or seedy in consistency. Lack of stools and dark stools are all a red flag.

Remember we talked about the fact that your baby should not lose more than 7 oz in the first 4-5 days? And 7 oz is on the higher end of weight loss. Well, now your baby should be gaining from the 5th day on. He should be gaining enough so that he is back to birthweight or within an ounce or 2 at 14 days.

One more, very common breastfeeding behavior that we often see develop in the first few weeks is cluster feeding. If you don’t know about or understand cluster feeding, this can really throw you off.

Cluster feeding: is when babies bunch feeds close together at certain times of the day. You may begin to worry that you don’t have enough milk because they literally give you hardly any break between one feed to the next. This cluster feeding session usually happens for 3-4 hours, usually happens in the evening and usually follows a longer sleep period. While there are many theories as to why cluster feeding happens, the truth is, we really don’t know why. We just know that if your baby typically spaces out all other feedings, is happy most of the other times, has normal output, weight gain and is otherwise breastfeeding well, then cluster feeding is nothing to be concerned about. Once you are sure everything else with breastfeeding is going well and you have these consistent cluster feeding sessions once a day, It is more about how to respond to the cluster feeding times, rather than thinking something is wrong that you have to fix.

Whether the reasons for this such as possible, the supply is lower during this time, or whether the flow is slower during these times, or whether it is just a time period that you baby wants to be held and cuddled or rocked and swayed, does not matter so much. What matters is that you understand that this is very normal newborn breastfeeding behavior and that you understand that it may last a few days, a week or a few months.

Now you know that it is normal, you are saying to yourself, how can I possible deal with this, particular at the end of a very tiring day? Well, knowing that it is normal, that alone, usually takes a huge weight off mothers shoulders as they typically feel they are doing something wrong or they don’t have enough milk. Knowing this is normal, can help to reduce your stress a few notches.

Now that you know you can anticipate this behavior, you need to come up with a game plan on how to deal with it, rather than thinking you need to fix it. It becomes pretty clear to you that for a few hours, you probably can’t count on being able to do much of anything, except feed your baby. What helps:

1. Babywearing – with your baby in a wrap or sling, he may be happier for a little longer. With your baby in a wrap, you may be able to eat dinner as your hands will be free.

2. Speaking of dinner, if this always seems to happen around dinner time, try eating dinner a half hour earlier than you might have done. This way you are not getting hungrier and hungrier as your baby wants to nurse more frequently.

3. Speaking of food, plan for cluster feeding by having quick and easy snacks that you can grab. Have all the makings for a protein shake in one spot so you can put it together in 5 minutes or less.

4. Of course having someone in your household help you during this time period can be a huge help. They can make something for you to eat, bring you drinks, snacks. They can hold our baby, take your baby out for a walk for a short period of time to free you up to eat your dinner or take a shower in between quick feedings. If you have other children, it will be incredibly helpful if you have someone else who can take care of the other kids during this time each day.

5. If your baby is not incredibly fussy and does not need to be rocked and sang to and just wants to feed frequently, what better time to plan on Binge watching one of your favorite shows.

As long as you are sure these are normal cluster feeding sessions with a baby that is otherwise breastfeeding well, you definitely do not want to offer your baby milk in a bottle. Moms tend to do this because of their own internal pressure or pressure from outside sources – when the thinking is that you do not have enough milk, there is a strong tendency to want to give milk in a bottle. Offering your baby milk in a bottle, means that he will get full from a large volume in a short period of time. This means that he will not be interested in coming to the breast so frequently. Sure this gives you a break, but at the same time, it will likely cause your supply to drop. Less breast stimulation, less milk. This will also undermine your confidence as you watch your baby gulp down a lot of milk. You and others will say see… he was hungry. Yes, he was hungry…. and your frequent feedings will ultimately satisfy his hunger and signal your body to make more milk.

Your take home points for Day 5 – 15 are:

1. Knowing how to tell the difference between really good sucking behavior and good milk transfer and babies who are just hanging out at the breast, are one of the MOST important things for you to learn about breastfeeding. Without good milk transfer, your baby will not gain the proper weight and you will struggle with your supply.

2. Understanding that breastfeeding should not hurt or cause sore nipples, cracked or bleeding nipples and ongoing engorgement. Painful breastfeeding, usually leads to poor milk transfer, and lack of weight gain and you will likely struggle with your supply. Painful breastfeeding frequently leads to chronic clogged ducts and breast infections.

3. Understanding normal weight loss and weight gain and the time frame for this. Understanding normal output and color and volume and consistency of output is important information for you to have.

4. And last but not least, the wonderful subject of cluster feeding. I will be honest and just put it out there that cluster feeding can be very difficult for some. Knowing that it is normal and having a game plan on how to respond to this behavior can make all the difference. Do educate your family members about cluster feeding and elicit their help during these few hours each day. By educating them of the normalcy of cluster feeding will help well meaning family members to continue to support you with breastfeeding, rather than suggest you offer supplements because your baby is so hungry.

Episode # 79 and this one #81 are specifically geared towards knowing what is normal breastfeeding newborn behavior the first 2 weeks of your babies life. I find that once you get through these first 2 weeks and all is going well, it may take you a few more weeks of practice and getting use to breastfeeding and pretty soon, you will begin to enjoy the comfort that it brings to both you and your baby. You will really begin to enjoy the convenience that breastfeeding brings to a new mother. I mean, we all have to feed our babies, one way or another. And to have the goods, readily available, anytime anyplace, always in the right container and at the right temperature – have baby and breasts and will travel. What could be more convenient! I hope you have enjoyed these 2 shows and learned a lot. Please go right ahead and share this show with other pregnant and new moms. there is a wealth of knowledge here that I am sure they will appreciate.

I will leave you with today’s quote:

The natural state of motherhood is unselfishness. When you become a mother, you are no longer the center of your own universe. You relinquish that position to your children. Jessica Lange

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