Plan to exclusively breastfeed your baby. Your baby does not need anything other than breast milk for the first six months of life. In fact, the baby should breastfeed as much as possible after the birth, in order to get used to latching onto your breast and to establish a good milk supply.

Do not give your baby artificial nipples (including pacifiers) or any other bottle filled with formula, water or glucose water. If there is a medical reason for supplementation, the nurse, doctor, midwife and/or lactation consultant should discuss your options. Often times alternate feeding methods with expressed breast milk can be used.

When your baby is born, ask to have him/her placed on your chest immediately, skin-to-skin for at least thirty minutes. If possible, ask that routine newborn evaluations be performed while your baby rests on your chest. Hold your baby skin-to-skin as much as possible. A blanket may be placed over you both for extra warmth, but not in between you. Skin-to-skin has many benefits: babies are warmer, babies are calmer, babies hear their mother’s heartbeat, milk supply is improved, helps get breastfeeding off to a great start!

Plan to initiate breastfeeding as soon as possible after birth (within 30 minutes to one hour after delivery). This means place the baby skin-to-skin on your chest as soon as possible after birth and initiate breastfeeding when the baby seems ready (rooting, licking lips, etc.).

If you plan to deliver in a hospital, allow your baby to stay in your room all day and night so you can breastfeed often.

Breastfeed whenever your baby shows signs of hunger or thirst.  These signs include:

• Squirming
• Sucking on hands and fingers
• Smacking lips
• Coughing
• Yawning

Some babies breastfeed every 1-3 hours a day and night; others breastfeed every hour for three to five feedings then sleep for 3-4 hours in between.  Every baby is different.
Your baby needs to breastfeed at least 8 times every 24 hours many babies breastfeed 10-12 times every 24 hours.

Sometimes a sleepy baby will not ask to eat often enough, and you will need to wake them to breastfeed.  During the first 4-6 weeks, if your baby does not wake to eat at least 8 times in 24 hours, watch for early signs of hunger, such as licking or smacking their lips or sucking on their hands and signs of light sleep.  Offer the breast at these times.  The more milk your baby takes, the more milk you will make.

Hints for waking a sleepy baby:

• Place baby in your lap in a sitting position and talk to them.
• Massage their feet and back.
• Remove their diaper.
• Wipe their bottom with a cool washcloth.

Your baby will let you know when they have had enough!

Some babies may breastfeed 10-15 minutes on each breast, some may breastfeed 15-30 minutes on each breast, and others may breastfeed 15-30 minutes on one breast only.

When your baby stops feeding, burp them and offer the second breast.  If they breastfeed poorly on the first breast, put them back on the first breast before you offer the second breast, so you may be sure your baby gets the fat and calories they need to grow.  Don’t worry if baby feeds on only one breast at a time-each breast can provide baby with a full meal!

Many mothers worry about whether their baby is getting enough to eat.  Your baby’s stomach is the size of his fist, so making enough milk to fill his stomach is easy!  Just remember, baby will not poop or pee regularly unless they are eating well.  You can be sure your baby is getting enough to eat if your baby is:

• Active and alert.
• Happy and satisfied after breastfeeding (calm, unclenched hands).
• Breastfeeding at least 8 times within a 24 hour period.
• Sucking and swallowing while breastfeeding.
• Losing less than 7 percent of his birth weight.
• Gaining 4-8 ounces each week after the first week.
• Having four or more poops and six or more wet diapers a day by day 5.
• Having yellow poop by day 5.
• Having clear or pale urine.

If you see all these signs, you can be sure your baby is getting enough to eat.
If you are unsure, keep breastfeeding, and immediately call your baby’s health care provider or call your WIC clinic for support.

Even before your baby is born, your breasts are making colostrum. Colostrum is the first milk your breasts will make, which may be thick and clear or yellowish in color.

Colostrum:

• Is high in protein, which is exactly what your baby needs in the first few days.
• Contains antibodies that protect baby from infections.
• Helps baby pass the dark, tarry stools they have in the first day or two of life.
• Helps your baby learn how to nurse, then transitions to “mature milk.”

Nurse your baby often in the first few days so he’ll get plenty of colostrum. Nursing often (8-12 times in 24 hours) will also help your milk supply come in.

During the first two weeks after birth, your milk will gradually change from colostrum to mature milk. Your milk also changes as your baby feeds. When your baby first begins a nursing session, they recieve foremilk. Foremilk is lower in fat and higher in lactose, a milk sugar that is important for development. The foremilk quenches your baby’s thirst. As the feeding progresses, your milk transitions to hindmilk. Hindmilk is higher in fat, so it helps your baby feel full longer. During a feeding, it’s important not to switch breasts until your baby has had a chance to get the hindmilk from the first breast. Some people think of hindmilk as their baby’s “dessert.”

Breastfeeding is a supply and demand relationship – your breasts will make as much milk as your baby demands.

The first several weeks of breastfeeding are very important in determining how much milk your body will make. It’s as if your baby is placing their order in advance at a restaurant for the amount of milk they will need to grow and thrive in the future. Each time you feed your baby, you’re telling your body to make more milk.

How does it work?  Prolactin is the hormone which tells your body to make milk. In the first few weeks after your baby’s birth, your breasts grow special nerves (called receptors) that sense prolactin. The more your baby breastfeeds in the days and weeks right after birth, the more prolactin receptors you will have. Having more prolactin receptors means you will make more breast milk to meet baby’s needs.

If you use bottles, pacifiers, or substitute a feeding at the breast with formula in the first few weeks, you’re missing chances to stimulate your milk production and risk setting your supply too low. Remember, your body will produce more milk if you continue to remove milk from your breast.  This may be done by feeding your infant at the breast or by pumping or hand expressing milk from your breast at least 8-12 times within 24 hours.

To ensure you have a good milk supply to meet baby’s needs:

• Nurse your baby whenever they are hungry, even if they have eaten very recently.
• Encourage your baby to fully empty each breast (and get the hindmilk) at each feeding.
• Do not give baby bottles, pacifiers, or formula, unless medically necessary, as this will decrease your milk supply
• Do not supplement with formula or artificial milk; if you must, make sure to pump milk from your breast to make-up for the lost feeding.
• Do not end feedings early – let your baby tell you when they are done by sliding off your nipple, moving their head away, etc.