The First 72 Hours - Building a Strong Foundation

​As a private practice IBCLC, it’s not very often that I begin working with a family within the first few days of birth.  At best, I will see them when baby is 5 days old, but normally I don’t see them until 6 weeks or later, and sometimes as a “last resort”.  This can be a challenging case, as the older a baby is, the more difficult it can be to solve breastfeeding problems.  Not impossible, mind you!  Just more difficult.  I find myself wishing I’d been connected with the family in the first few hours, as they are the *most* important in setting up a successful breastfeeding experience.  If I were to start working with a family this early on, here are the things I would impart to them.

Feed your baby as often as you can!
The more stimulation your breasts get in the first few days after baby is born, the greater your milk supply will be.  Put that baby to your breast as often as they will go, be sure baby is feeding 8 or more times in 24 hours, and never worry that your baby is at the breast too much, or feeding too often.  Remember, it won’t always be this way, but the more your baby feeds in those first days, the more milk you’ll have as baby grows.

Your milk volume is low, but that’s ok!
Many moms worry that they don’t have milk in those early days, before their milk “comes in.” But they already have milk!  The first milk, colostrum, is called “liquid gold” by lactation professionals.  This is because tiny amounts of this amazing substance are nutrient dense, with high concentrations of protein, carbohydrates, vitamins, minerals, and antibodies.  So your baby only needs a small amount to receive its benefits.  Another thing to consider is that your baby’s belly is tiny, the size of a teaspoon on day 1.  Your milk will transition from the low volume, nutrient packed first milk to the higher volume mature milk within 3-5 days of your baby’s birth.  

Frequent feeds aren’t a sign that baby isn’t getting enough!
Many parents worry when their brand new infant seems to want to feed around the clock - they mistake this as a sign that baby isn’t getting enough from those feeds.  This isn’t true - babies feed often for many biologically appropriate reasons.  During pregnancy, babies are swallowing amniotic fluid, and are born with bellies full of thick, black stool, known as meconium.  The act of feeding and sucking initiates peristalsis which moves that meconium through baby’s gut and helps them to eliminate it.  Frequent feedings also increase prolactin (the milk making hormone) receptor sites in the breast and the more receptor sites present, the more prolactin available which will translate into a larger milk supply.

Seek help when things aren’t going well
The information above assumes that baby was born at full-term gestation and breastfeeding is going well - but that sometimes isn’t the case.  Here are some signs within the first few days that there are problems present and help from an IBCLC (International Board Certified Lactation Consultant) is necessary:

• Baby won’t/can’t latch within first 24 hours following birth.
• Baby was born pre-mature.
• Baby isn’t stooling/peeing appropriately (1 of each per day of life for the first 5 days.)
• Baby has lost more than 10% of birth weight
• Breastfeeding hurts - some tenderness and sensitivity is expected, but anything beyond this could indicate there is a problem.

There are other signs that problems are present, but these are the most important and common ones in the first few days of life.  If you are experiencing any of the issues listed above, contact a board certified lactation consultant right away - many are available to come to your home within 24 hours of your call. With the right help, early on, you will be be able to establish a successful breastfeeding relationship with your new baby.

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