The first 3 months postpartum were the most crucial and the most insane for me. Even though I had prepared myself for the breastfeeding part, I was not prepared for the lack of sleep part. It led to me getting cranky and doubting everything I was doing by the third day. I was actually at the point of requesting for formula in the middle of the night because I wanted my baby to sleep longer and thus let me sleep as well, but thankfully the nurses reminded me that it’s normal for breastfed babies to nurse so frequently because their tummies were still very small, like it can only hold about 1 to 1.4 teaspoon of milk. Imagine that! Once I was able to remember the things I’ve learned about breastfeeding, it was much easier to stay on this path even if getting more sleep was so tempting.
So what does one need to know about breastfeeding in the so-called fourth trimester?
- In the first 24 hours after delivering your baby, your breasts will produce only colostrum, which is a thick golden liquid full of antibodies. This is the reason why it is advised to have your baby latch on as soon as possible after birth, so that they can get the colostrum to increase their immunity.
- Baby’s tummy is going to be very small. They don’t need much milk yet to feel full, but that also means that once the milk is digested, they’ll be feeling hungry again soon.
- Babies breastfeed every 30 minutes to 2 hours. And sometimes, breastfeeding sessions can last for more than 30 minutes.
- Breastmilk is also digested much faster than formula, which is why your baby might feel hungry again even right after a breastfeeding session.
- Milk starts coming out around 2-3 days after baby’s birth. This is the time when the breasts start feeling full and hard, but milk will not necessarily be overflowing yet. At this point, most new mothers already expect a lot of milk to come out. That expectation, plus a baby crying for milk every 30 minutes, can make some new mothers very anxious and start thinking that they don’t have enough milk for their baby so they resort to formula. This was what I probably would have done if the nurses weren’t there to remind me of item number 1. Remember, less than 1 oz of milk is enough for your days old baby.
- Babies cry for many reasons, not just hunger. Again, some mothers think that they don’t have enough milk because their babies are always crying. Mine did too. And then I would cry because I wanted to sleep and didn’t know how to handle a lot of things. Babies cry because they also don’t know how to handle a lot of the new things in this strange new land. They might be feeling cold or gassy or itchy or just want to be held close and tight to feel the same comfort they had while they were in your tummy. Try some skin-to-skin contact with your little one everyday.
- There might be some nipple pain. While you are learning to breastfeed, your baby is also still learning how to latch. Sucking comes very naturally to the babies but proper latching is a learned art for many. Incorrect latching can lead to very painful and sore nipples so it’s important to teach your baby how to do this properly. It can also cause the baby to not get enough milk and so lower your milk supply. When in doubt, you can ask your breastfeeding-supportive pediatrician to check on latch, or find a lactation consultant or breastfeeding peer counselor to help you out in the first few days. If nipples do become sore, just apply some breastmilk to it and let it air dry. Once your baby gets the hang of latching, the pain should go away in a week or so.
- It won’t hurt to also check your baby for a lip tie or tongue tie. This limits their mouth’s movement and may result in an incorrect latch. I’ve always noticed that my daughter’s lips weren’t flanged wide enough and no matter what I did, she was limited to a certain angle. I checked and she didn’t have a tongue tie, but I wasn’t aware of a lip tie back then. I only read about it and noticed she had a lip tie when she was past her 6 month mark. No wonder she would latch so often just to get enough milk.
- The best way to tell if your baby is having enough milk in the first few days is to check the diapers. Babies should pass the meconium (a dark, tarry stool) within 24-48 hours, and have regular dirty or wet diapers after that. Your baby’s doctor will also require a wellness check around a week after birth to check if the baby is thriving. It’s expected for the babies to lose up to 10% of their weight within the first few days, but should be able to regain that weight and get back to their birth weight at around 2 weeks after birth. If your baby is gaining enough weight, then they are getting enough milk.
- It takes 6 weeks to stabilize supply. It’s recommended to have your baby do unli-latching in the first 6 weeks so that your body will know how much milk needs to be produced. Your body adjusts its milk supply depending on how much your baby is getting. This is why if a baby is getting some formula, it lessens his demand for the breast and the breast adjusts by producing less milk. It’s also not recommended to pump on top of doing unli-latching within this time frame because you might end up overproducing milk which can also lead to engorgement and mastitis. If you want to store extra milk at this point, you can use milk catchers such as breast shells or a Haakaa “breast pump”.
- Nipple confusion is when the baby starts preferring the bottle instead of the breast. This usually happens if bottles are introduced early and often because bottles have faster flow and doesn’t require much sucking effort for milk to come out. Personally, I would introduce the bottle to my baby right after the 6 week mark – 1 bottle per day just to get her used to it. I introduced the bottle to Amelie when she was already 3 months old and I think that was a bit too late. She refused the bottle for more than a week and I was concerned that she wouldn’t be able to take any milk when I returned to work. Thankfully, she did start taking the bottle just a few days before my first day back at work and would still latch on when I was back home.
- Even if your milk supply dips, you can still do something to increase it again. Your options are unli-latch, power pumping and galactagogues such as malunggay (capsules, tea, whatever), oatmeal or even lactation cookies.
Wow, I didn’t realize there are a lot of things to digest (forgive the pun) in the first few months alone. No wonder new parenthood can be so overwhelming, and to think these are only in relation to breastfeeding! Good luck new parents, and hang in there!
For my next post in this series, I’ll be writing about getting ready to go back to work and how you can continue your breastfeeding journey even when working full time.