Breastfeeding Guide

Breastfeeding Physiology

The first days with your baby and the journey of breastfeeding

If all is well with you and your baby, skin-to-skin contact is extremely important in the first moments after birth, both for breastfeeding and for creating the mother-infant bond. If there is no medical indication there is no reason for Mum to be separated from her baby in the first hours after giving birth.

Skin-to-skin contact with your newborn will give them the signal to start looking for the breast. This in turn triggers the breast to start producing milk. 

When the baby is born and for the first 24 to 72 hours the breast produces the so-called colostrum. This first milk is not produced in large quantities but is filled with all the nutrients your newborn needs in the first few days. 

The above image shows us that in the first days large quantities of milk are not required as the quality is what matters. That’s why Mum should eat well and drink a lot of water!

After the first 24-72 hours, and if the newborn feeds from the breast 8-12 times in a 24 hour period, the milk begins to change. As a result the newborn, around the second to third night, begins to feed continuously. And I mean all the time! This is the so-called cluster feeding.

This occurs because your newborn’s body is so in tune with you that it “knows” that on that day the milk begins to change. And so they do you the favour of expediting the situation. Good eh?

This will last a night or two and settle, but it is a completely normal part of the newborn’s developmental cycle. Don’t worry, you’re not doing anything wrong. 

Psychologically, this developmental stage of the newborn and the mother also contributes to the appearance of baby blues in some cases. Large hormonal changes during lactation play a large role in the emotional changes of the mother. 

This is important for you and your partner both to know this as you can be very sensitive, fragile and cry “for no reason”. This is perfectly normal. However, if you see that your feelings and thoughts worry you, get in touch with your midwife. 

Composition of milk in the following days

The composition of breast milk changes both from one day to the next as well as during breastfeeding each time. Initially, as we said, we have colostrum which is yellow in colour and transparent.

From the second to third day this changes and when we say “the milk comes in” it becomes whiter in colour and the quantity increases.

It should be noted here that the expression “milk comes in/down” is not a very appropriate term as milk is created through the rule of “supply and demand”. That is, the more you offer the breast, the more you produce milk and your body responds to the messages it receives from the infant. The reason we say “comes in” comes from the feeling of heaviness that the woman feels in the breast due to the hormonal changes that occur during lactation.

When breastfeeding is established, you may see that the milk is dripping or that the breast is heavy if you wait for too many hours without the baby going to the breast or pumping breast milk. This is a normal reaction of the breast during lactation and it is important to listen to your body. We don’t want you to feel discomfort with full breasts.

As previously mentioned, the World Health Organization and UNICEF recommend at least 8-12 breastfeeds or pumping sessions 24 hours a day and at least 2 at night.

Pro tip: To increase production a good trick is to breastfeed or pump at least once from the hours of 1am to 4am. Your hormones are at their best these hours!

Now, a few words about the composition of milk during breastfeeding. It has been established that the consistency changes even during a feed. That is, at the beginning of the feed and for the first 10-20 minutes the milk is filled with nutrients and immune elements that help growth and protect your baby, while after the first 20 minutes the lipids that help weight with weight gain increase.

That is why the old rule of 10 minutes on the one side and 10 on the other does not apply!

This way not only reduces the nutritional value of breastfeeding but also increases the likelihood of mastitis.

It is important also, to remember that not every breastfeed will last the same amount of time. Breastfeeding, as we know, does not only offer nourishment but also helps in the emotional bond between mother and newborn. Also, like adults, babies sometimes want a whole meal while other times they want a snack! 

5 Practical Rules from our Midwives

1. Mum must be comfortable with a full glass of water available next to her (With a straw)
2. We bring the baby to the breast, not the breast to the baby
3. The baby needs to open their mouth widely to get as much as possible of the nipple , not just the tip
4. Belly to belly, not to turn the head to drink, but with the head free and supported so that breathing is unhindered
5. You should not be able to hear the baby sucking when breastfeeding

Signs that indicate that breastfeeding is effective

1. Good opening of the baby’s mouth
2. Their cheeks look full, they do not make dimples
3. The baby swallows every 2-3 sucks. Practically, this means that every 2-3 sucks they will stop and start again. That doesn’t mean the meal is over!
4. The baby is calm during breastfeeding
5. Your nipple should be the same shape at the end of breastfeeding and there should be no pain on the nipple
6. Your baby will have over 2 wet nappies every 24 hours 
7. Your baby will have at least 2- but usually more- soiled nappies with poop in 24 hours

Normal evacuations for newborns and older breastfed infants

Breastfeeding is a beautiful but long journey that often hides difficulties especially in the first days and weeks.

It is important to have support and knowledge on the subject offered by Hera Family Care by experienced and qualified midwives in breastfeeding. Why not join our classes and benefit from postnatal visits for up to 6 weeks after birth?