Breastfeeding Part 2 – The First Days Home

Congratulations…you gave birth, decided to breastfeed, and made it through your hospital stay!  With the support of doctors, nurses, and lactation consultants, by the time you are discharged, hopefully, you are feeling pretty comfortable with the breastfeeding process.

This is exactly how I felt with my first son…so, when I got home and started having difficulty and pain, I felt frustrated and started doubting my ability to breastfeed. He was fussy and frantic at the breast, which lead to painful feeding sessions. I knew some pain was normal, so at the time I didn’t even know I needed help. Most parents would agree that the first couple of nights home with your first infant are the longest, most exhausting nights of your life. Add in difficulty with breastfeeding, and a time that should be filled with joy, becomes one that is filled with frustration. The good news is that this time passes quickly and with some patience and support, breastfeeding can get easier every day!

In my opinion, the biggest reason that new mothers are in this situation, is the fault of our current medical system. We send mothers and their infants home within 48 hours of delivery – well before most mother’s milk “comes in.”  So, many infants start to get very hungry within 24 hours of going home. This is a time when they start to gain back the weight that they lost after birth. If your milk is not “in” yet, then you are dealing with either a sleepy baby who does not have the energy to feed or a frantic, fussy baby.

The second problem that many mother’s run into is engorgement. Once the milk “comes in,” the breasts become hard, swollen and painful. A baby who was latching on perfectly before engorgement, can develop difficulty finding a comfortable latch – especially at the beginning of a breastfeeding session, when your nipple can lay flat against your areola.

Here are my tips to help you get through the fist days of breastfeeding, with as little difficulty as possible:

  1. Find support – a friend, relative, or lactation consultant
  2. Put your infant to the breast as often as they want (every 1-3 hours) – you can work on a feeding schedule later. In the first couple of weeks, the more your infant feeds, the faster your milk will “come in” and the more milk you will produce
  3. If your infant is too sleepy to feed or falls asleep at the breast, attempt to breastfeed for 10 minutes on each side, then pump to let your body know that you need more milk. If your infant is not gaining weight or having problems with jaundice, feed the baby this pumped milk (either with a supplementing tube/syringe or a bottle) after attempting to breastfeed. As a side note, this is exhausting – so utilize your partner or a relative to hold or feed the baby in between breastfeeding/pumping sessions. 
  4. If you are having pain or difficulty latching your infant due to engorgement, express breastmilk either with your hand or with a pump for about 1 minute prior to attempting to breastfeed. Be advised not to pump too much during this time (like after every feed) because you will overproduce milk and this can lead to lots of discomfort.

You will know that your infant is getting enough milk by the number of wet and dirty diapers they are having. They should increase every day until day 5 or 6. They will also start gaining weight around this time. So follow-up with your pediatrician is important.

It is normal to feel nipple discomfort for the fist 1-2 weeks of breastfeeding, though if the pain is making breastfeeding a dreaded task or you develop red sores, cracks or blisters – then find a lactation consultant to help work on your infant’s latch. You will also feel pain and fullness during engorgement – starting days 3-4 and resolving slowly over about a week. This pain should be tolerable with a supportive bra and cold packs.

Within 10-14 days, breastfeeding should become comfortable for both you and your infant. If it is not, or your infant is not gaining weight – seek help, because there are fixes for most breastfeeding problems. However, you need to know that some infants are not great breastfeeders and some moms don’t make enough milk – which makes me very thankful that formula was invented!

Heather Joyce, MD

2 thoughts on “Breastfeeding Part 2 – The First Days Home

  1. I really love reading your blogs! My son was born with jaundice and was so lethargic it was hard to get him to stay awake and in addition my milk had not “come in” yet. This was very frustrating. After seeing you in the hospital, I pumped and supplemented that pumped milk. for the longest time I thought that breastfeeding would be “so easy” you just put them on and the angels sing and they eat theres no pain no crying haha boy was I wrong. I do stongly encourage anyone who is starting to breastfeed to give it about 3 weeks. At that point Nicklaus and I got used to one another and recognized things that work for us when nursing and things that dont. plus most of the baby blues are gone and it makes keeping a level head easier.

    • I’m happy that it is finally working for you. I find that most mothers have high expectations and are let down when it doesn’t go well at first. I want everyone to understand that most mothers are going through the same thing and it takes time and patience to make it work. Congrats!!

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