Getting Breastfeeding Started
What the first week looks like and how to get a good latch
The First Feedings
In the first hours after birth, most babies are alert and ready to feed. Take advantage of this window. The baby should be placed skin-to-skin on the birthing person's chest immediately after birth. Many babies will crawl toward the breast on their own in the first hour. The first milk is colostrum, a thick yellowish fluid produced in small amounts. It is concentrated with antibodies, white blood cells, and protein. You only produce about one ounce in the first 24 hours, and that is exactly what the baby needs. Think of colostrum as the baby's first immunization, it coats the digestive tract, establishes healthy gut bacteria, and helps the baby pass the first dark stool called meconium.
Positioning: Tummy to Tummy
No matter which position you use, the same principles apply: the baby's tummy should be pressed against yours, the baby's head should be higher than their bottom, and the baby's ears, shoulders, and hips should be in a straight line. Use pillows to bring the baby up to breast height so you do not have to lean down. Common positions to try: cradle hold (classic, best once feeding is established), football hold (baby tucked under your arm like a football, excellent after cesarean or for large breasts), side-lying (both lie facing each other, good for night feedings), and laid-back nursing (mother reclines, baby lies on top and self-attaches using instinct). Try different positions to find what works for you and your baby.
What a Good Latch Looks Like
The most common cause of breastfeeding pain is a shallow latch. The baby needs to take in a large mouthful of breast tissue, not just the nipple. Aim the nipple toward the roof of the baby's mouth and pull the baby in quickly when their mouth is wide open. Signs of a good latch: the baby's mouth covers about an inch of the areola, the lips are flanged outward like fish lips, the chin is pressed into the breast, and you hear swallowing after the initial suckling. If the latch hurts beyond the first 30 seconds, break the suction with your finger and try again. A common fix: after latching, press down on the chin to flip the lower lip outward, which often resolves pinching immediately.
Feed on Cue, Not on a Schedule
Newborns need to feed 8 to 12 times in 24 hours in the early weeks. Feeding on a fixed schedule does not work for newborns. Watch for early hunger cues: rooting (turning the head and opening the mouth), hand-to-mouth movements, lip smacking, and stirring or squirming. Crying is a late hunger cue. Feeding before the crying starts makes for a calmer, more effective session. In the early weeks, wake the baby to feed if they have not eaten in 3 to 4 hours during the day or 4 hours at night.
How to Know Baby Is Getting Enough
In the first days, it can be hard to tell how much the baby is getting since colostrum is produced in small volumes. A useful rule: the number of wet diapers should roughly match the baby's day of life. Day 1: one wet diaper. Day 2: two. By day 5, the baby should have at least 6 wet diapers per day and 3 to 4 bowel movements. The baby should regain their birth weight by about day 10 to 14. Weight loss of up to 7 percent in the first days is normal. The baby should seem satisfied after feedings, and the birthing person should be able to hear or see swallowing during feeding. If you are worried about intake, a weighted feed with a lactation consultant can give precise answers.
Common First-Week Challenges
Nipple soreness in the first days is common. If it is mild and improves after the first 30 seconds, the latch is probably fine. If it is sharp or persists, break the latch and try again with better positioning. Engorgement when milk comes in around day 3 to 5 can make latching difficult. Hand express a small amount before latching to soften the areola. Apply cold packs between feedings to reduce swelling. If the baby is sleepy and not feeding well, wake them by unwrapping, changing their diaper, or gently rubbing their back and feet.