Breastfeeding FAQs: Getting Started

Breastfeeding is natural, but it takes practice to get it right. Here's what you need to know about getting started.

When Will My Milk Come In?

For the first few days after your baby's birth, your body will make colostrum, a nutrient-rich "pre-milk." Colostrum (kuh-LOSS-trum) has many benefits, including nutrients that boost a baby's immune system and help fight infection.

For some women, colostrum is thick and yellowish. For others, it is thin and watery. The flow of colostrum is slow so that a baby can learn to nurse — a skill that requires a baby to suck, breathe, and swallow.

After 3–4 days of making colostrum, your breasts will start to feel firmer. This is a sign that your milk supply is increasing and changing from colostrum to mature milk. Your milk may become whiter and creamier, but this varies between women.

If your milk takes longer to come in, don't worry. This is normal and usually isn't a cause for concern, but let your doctor know. While babies don't need more than colostrum for the first few days, the doctor may need to make sure your baby's getting enough to eat. It can help to breastfeed often during this time to stimulate your milk production.

When Should I Begin Breastfeeding?

If possible, start nursing within an hour of your baby's birth. Babies tend to be alert in the first few hours of life, so breastfeeding right away takes advantage of this natural wakefulness. After this, newborns will sleep for most of the next 24 hours. At that point, it might be harder to get your baby to latch on.

When placed on your chest, your baby will naturally "root" (squirm toward the breast, turn the head toward it, and make sucking motions with the mouth). To breastfeed, babies latch onto the breast by forming a tight seal with the mouth around the nipple and areola (the dark part of skin around the nipple). Even if your baby doesn't latch on now and just "practices," it's still good for your baby (and you!) to get used to practicing breastfeeding.

In the first few days of life, your baby will want to feed on demand, usually about every 1–3 hours, day and night. As babies grow and their bellies can hold more milk, they may go longer between feedings.

How Can I Tell When My Baby's Ready to Nurse?

On-demand feeding means breastfeeding whenever your baby seems hungry. How can you tell? Hungry babies:

• move their head from side to side
• open their mouth
• stick out their tongue
• suck on their hands and fists
• pucker their lips as if to suck
• nuzzle against mom's breasts
• show the rooting reflex (when a baby moves their mouth in the direction of something that's stroking or touching their cheek)

Crying is a late sign of hunger. So try to nurse before your baby gets upset and harder to calm down.

To calm a crying or fussy baby before a feeding, try soothing "skin-to-skin" time. Dress your baby in only a diaper and place your little one onto your bare chest.

How Do I Get My Baby to Latch?

When you your baby shows hunger signs, follow these steps:

1. Make a "nipple sandwich." Hold your breast with your hand, and compress it to make a "nipple sandwich." An easy way to remember how to hold your hand: Keep your thumb by your baby's nose and your fingers by the chin. (The thumb and fingers should be back far enough so that your baby has enough of the nipple and areola — the darker circle of skin around the nipple — to latch onto.) Compressing your breast this way lets your baby get a deep latch. Your baby's head should lean back slightly, so their chin is touching your breast.
2. Get your baby to open wide. Touch or rub your nipple on the skin between your baby's nose and lips. When this happens, your baby should open wide (like a yawn) with the tongue down.
3. Bring your baby to your breast. When your baby's mouth is open wide, quickly bring your baby to your breast (not your breast to your baby). Your baby should take as much of the areola into the mouth as possible. Your baby's nose should almost touch your breast (not press against it) and their lips should be turned out ("flanged").

When your baby is properly latched on, you may have a few moments of discomfort in the beginning. After that, it should feel like a tug when your baby is sucking.

To make sure you're doing it right, it's best to be observed by a lactation consultant, or someone else who knows about breastfeeding.

How Do I Know My Baby Is Getting Enough to Eat?

Your baby's diapers can help you tell if your little one is eating enough. The more your baby nurses, the more dirty diapers you'll see.

Pee

Because colostrum is concentrated, your baby may have only one or two wet diapers in the first 24 hours. After 3–4 days, look for:

• 6 or more wet diapers per day, with clear or very pale pee. Fewer wet diapers or darker pee may mean your baby's not getting enough to drink. If you see orange crystals in a wet diaper, call your baby's doctor. They're common in healthy, well-fed babies and usually not a cause for concern. But sometimes they're a sign that a baby isn't getting enough fluids.

Poop

A newborn's poop is thick and tarry at first, then more greenish-yellow as mom's milk comes in. After 3–4 days, look for:

• 4 or more yellow, seedy poops per day, usually one after each feeding. After about a month, babies poop less often and many may go a few days without pooping.

Your baby probably is getting enough milk if he or she:

• feeds 8–12 times a day
• seems satisfied and content after eating
• sleeps well
• is alert when awake
• is gaining weight

If you're worried that you baby isn't getting enough to eat, call your doctor.

I'm Having a Hard Time. What Can I Do?

Nursing takes time and practice. In fact, it can be one of the most challenging — and rewarding — things you do as a new mom.

While you're in the hospital, ask for help from a lactation consultant, the nursing staff, your baby's pediatrician, or your OB-GYN. When you get home, see if there's a lactation consultant in your area. You can search online at:

• United States Lactation Consultant Association
• International Lactation Consultant Association

The pediatrician will want to see your baby 24–48 hours after you leave the hospital. During this visit, the doctor will check your baby's weight and your feeding technique. If you have trouble or questions before then, call the doctor.

Whatever you do, don't let it get you down. With a little patience and some practice, breastfeeding is likely to get easier.

For more help or if you have questions, talk to a lactation consultant, your doctor, or someone who knows about breastfeeding.