Crucial Breastfeeding Advice for Expectant and New Mamas

The baby is the smartest one out of us, and we have to trust the baby, AND trust our body! Those of you that know me hear me say that a lot! Babies know what they are doing, and often, our adult minds can get into our own way, which can create many of the concerns listed above.

I will start by explaining how our body produces milk. Around 24 weeks pregnancy gestation, our body makes colostrum, the first milk. It isn’t until after the birth when the placenta detaches from the uterus, that our body’s drop in hormones signal to produce, what I call, the BIG milk, others call mature milk. This mature milk arrives somewhere between day three to five, depending on if this is your first child or a subsequent child. Everyone makes colostrum. It is impossible to be pregnant and not produce colostrum. How much mature milk a mother will have depends on one thing, the baby! This is where supply and demand come into play, or what I call, milk removal. The more milk we take out, the more milk we will produce. Who takes the milk out? The baby; either by nursing or if not, by a mother pumping.

Here is the kicker I want you to know; our milk supply is determined within the first 2-3 weeks after birth. However much milk we will make FOREVER, is figured out within that first VERY important 2-3 weeks. I explain it like building a house, a house of milk! When you build a house, you have to build the foundation first, before anything else. That foundation will support the size of how big that house will be. Each foundation needs to be a different size for a 4-bedroom, or 6-bedroom house, or 1-bedroom house. For the house to work, we have to know that information in the beginning as we are building the foundation. If someone builds the foundation, starts building the house, and months down the road decides to add a bedroom or a bathroom, it can’t happen. We’ve passed that point, and it won’t work because the support for that addition wasn’t built from the start.

Why is my baby drinking so often? Is he not getting enough?

So let’s return to breastfeeding. In the early days and weeks, it is imperative that a mom allow the baby to nurse ANYTIME and EVERY TIME they cue or desire because every one of those nursing sessions is laying down a brick in the foundation of her house of milk. Even just comfort nursing is laying down the groundwork for her milk supply. This usually means a baby will be nursing about 20 hours out of the 24 hours of the day. I am not exaggerating! They do this by instinct! They know the more they nurse, the more milk they will have made for themselves. And they want a large milk house to live in forever! Keep in mind, it is impossible to overfeed a breastfed baby, so truly, when in doubt, breastfeed them. Once we pass the 2-3 weeks window of time, we cannot increase our milk supply. It is set. The house is built. So relax, follow every one of your baby’s cues, lay back, and just allow the baby unrestricted time at the breast. It will do you both good.

Someone may ask, what is a breastfeeding cue? A feeding cue is anytime they place their hand, fist, finger into their mouth, or when they play with their tongue, sticking it out, swirling it around or just opening their mouth and rooting; turning their head from side to side in search for a nipple. When you see ANY of these, it is time to breastfeed NOW. And yes, you’ll see your baby doing that all of the time, and yes every time it is time to breastfeed. Remember, you are laying down your foundation for your house of milk! So don’t doubt it, just do it!

Now someone will ask, do they always nurse 20 hours out of 24 hours? Of course not. Phew! They will eventually fall into a pattern that will be more predictable and allow for more rest and non-nursing time. But that will be up to the baby. They will naturally fall into that pattern; it should not be directed by parents. And normally that is going to be somewhere around the 8-12 week mark, and many much sooner.

When do I need to stop waking my baby to nurse?

Now the always asked question, do you wake the baby to nurse. The answer is yes and no. In the first 24 hours, when they are naturally sleepy, yes. If it has been a few hours and they haven’t cued or nursed, then you attempt to wake them and offer a breastfeeding. It doesn’t mean they will. Maybe they won’t; they may still be too sleepy, and that is ok. If you can’t wake them after spending 5-10 minutes trying, then stop and re-try in a few hours. But waking a baby for feeding is a very short-lived problem. There are exceptions like premature babies or early term babies; under 38 weeks, jaundice, or weight loss, and those are another discussion for later.

Healthy full-term babies wake up a lot, so it is usually us wishing they would sleep longer, than the opposite. Eventually, your milk will come in, and if they do sleep longer, your breasts will become so full and engorged, and uncomfortable. At this point, you will have every selfish reason to want to wake them up and breastfeed. So usually this “problem” takes care of itself very quickly. And you have a baby who is very interested in building your house of milk by nursing every hour or for hours long, or even cluster feeding back-to-back. And all of those are really good things that get us what we want. We get a baby who is growing, gaining weight, and a mom who has a super milk supply that will help her baby grow for at least the 1st year of life or longer.

So hopefully this answers many of those above questions. The problem again is our adult brain, not the baby. If your baby is fussy, and they just nursed, put them back to the breast. Adults have the idea in their head that babies nurse every 2-3 hours. Which to an adult means: 12:00, 3:00, 6:00, 9:00 and 12:00. Or 12:00, 2:00, 4:00, 6:00, 8:00 etc. This is not how babies function. They do not know math. They are not predictable at these early few weeks of age. They are instinctive. So trash those adult brain ideas, and just expect that your baby will cue and then you will nurse until they fall off the breast and are done until they cue again.

In fact, not looking at the clock, may do you some good. But you can see the misunderstanding how milk making works, and the misunderstanding of how the early days of production work, can push moms into unnecessary worry. I hear things like, “Why is my baby rooting, we just finished feeding 15 minutes ago?” Or “She’s been nursing for 45 minutes, she has to be full, can’t I take her off?!” Or “I’m just going to give her a pacifier because she nursed an hour ago and she shouldn’t be hungry yet.” Or “My baby is greedy, never seems satisfied, and that must mean I don’t have enough milk since they always want to nurse.” These are all comments made by our adult brain and made from a base misunderstanding.

Now that you know about the house of milk, doesn’t it make sense why the baby is doing what they are doing, and why it is vital to follow their lead? Isn’t it neat to see how the baby is smarter than we are, and they teach US? Trust them!

Speaking of pacifiers, why do we want to avoid them? Because they interrupt the building of your foundation for your house of milk. More time spent sucking on a pacifier means less time spent at the breast sucking. The pacifier doesn’t make any milk, so the baby is sucking on the pacifier trying to tell the pacifier to make milk, which it won’t; Instead of sucking on the breast where it does tell the body to make more milk. See where the trouble begins and how this can lead a mom to have a low milk supply?  Not to mention it wastes precious energy of the baby, and can contribute to more weight loss, more jaundice, and possible trouble with latching.

Now onto the next most common concern mothers have; how do I know how much milk the baby is getting, or if they are getting enough…I can’t see the milk go in! We can tell, and we can even count, but with breastfeeding, we count what comes out, not what goes in. Diapers, diapers, diapers! That is the answer! If enough milk is going in, enough diapers will be coming out. Super simple ladies! In the first 4- 5 days, they need to pee and poop as many days old that they are. If they are 1 day old, they need 1 wet and 1 poop; if they are 3 days old, they need 3 wets and 3 poops. 4 days old means 4 poops and 4 pees. And in these first 5 days, it moves from dark sticky black meconium to a bright and runny/watery yellow color. And the colostrum makes that happen.

A mother’s colostrum is a laxative, so the more a baby nurses, the more a baby will poop and the faster it will transition from dark sticky black to runny yellow. By day 5 of life, a baby should have 5-6 wets every day (24 hours), and about 4 quarter-sized yellow poops every day (24 hours). And that doesn’t change. It stays that way as they age. Now that’s a lot to remember, so I would like to explain a shortcut. Four quarters is one-dollar, right? Right! So, once you’ve reached day 5 and yellow poop, your baby will need to poop one-dollar every day! And it doesn’t have to be 4 separate poops. It can be one poop that is the size of 4 quarters all-together. So even if they poop once a day, as long as it is as big as one- dollar, it is enough! Now saying that most breastfed babies will poop like $20-$30 per day. Parents seem to be always changing a diaper with poop that spilled out of the diaper and up the back. That’s a healthy, well-fed and growing baby!

So again, how do you know if your baby is getting enough milk? If they are pooping at least one-dollar per day, and wetting at least 5-6 diapers per day, they are getting enough milk. That it! Isn’t that wonderfully simple?!!!!

My baby is fussy when he nurses, does that mean I am not giving him enough milk?

And I need to say, getting enough milk has nothing to with a baby’s behavior. What do I mean? I mean, you can have a fussy baby, and still, the baby is getting enough milk. Remember count the diapers! Fussy is just annoying, and no one wants that, but it has nothing to do with how much milk a baby is getting. Babies are born with a temperament, and sometimes that temperament is more stubborn, or needy, or loud. Many parents with elementary-aged or teen children, can now look back at the baby stages with that child and recognize that the way the child acted like as a baby makes a lot of sense with their personality as an older kid. Just trust those diapers! They are the proof you need!

How do I know if my baby has a tongue tie or lip tie?  When should I see a lactation consultant?

If breastfeeding is painful or latching seems irregular — this is an appropriate time to see a Lactation Consultant. She can observe a feeding, perform an oral evaluation for the baby, and discuss your specific situation with you. I will tell you that breastfeeding should never hurt. But it is a very new sensation. When a baby is latched on properly, a mom should be able to breathe normally and speak normally, and she should feel tugs, pulls, pressure, suction, stretching or yanking. She should not ever feel anything sharp or pinching or slicing or cutting, or anything that makes her hold her breath or resent feeding time. If she is feeling this, something is not quite right. It could be the anatomy of the baby, it could be the anatomy of the mom, or positioning could be incorrect. But this is definitely a time to see a Lactation Consultant, and she may refer you to an oral surgeon or ENT who can diagnose and possibly perform the release.

Tongue Tie, aka ankyloglossia, is seen when the tongue cannot make the proper movement to latch properly and properly remove milk because the frenulum underneath the tongue is holding it down, restricting it. If a baby is gaining weight, a mother is pain-free, and her nipples are healthy and intact, and the baby has enough wet and poopy diapers, nothing is wrong. I repeat, nothing is wrong, and things are working.

If the baby weren’t latching on properly due to a tongue tie, the mother’s nipples would be bleeding, cracked, and worrisome. If the baby wasn’t latching properly due to a tongue tie, the baby also wouldn’t be getting enough milk, and wouldn’t be having enough diapers. I will say, it is not always about what the tongue and frenulum look like. Babies can have a frenulum that appears to be restrictive but does not get in the way with proper latch nor proper milk removal, and mom’s nipples are happy. That is ok and may not need to be released. But anytime we have a mother’s nipples that are unhappy, a baby with weight loss, and a baby without enough diapers, that is the time to see a Lactation Consultant. She can then evaluate and see what the problem(s) may be and help move you down the right path.

May I also say, lip tie does not usually interfere with breastfeeding. It can be a cosmetic concern when, later, eventually teeth come in with or without a space between. But physically is not usually problematic for breastfeeding. Why? The upper lip and gum have nothing to do with sucking. The tongue does the movement to remove milk. But there is nothing that goes between the upper lip and the upper gum. Nothing. No nipple goes there, nothing. So if a lip is tied, it will not have anything to do with nipple pain at all. The only time it can interfere with breastfeeding is if it is tied to a degree where the baby cannot seal onto the breast for latching. In this case, we would have a baby who can never stay latched on and is constantly on and off after a few seconds. Simply because it can’t perform a seal. But a lip tie does not cause nipple pain at all. So if you hear that, it is incorrect. And to have a lip tie that is severe enough to interfere with the seal, would be very rare.

Can I have a glass of wine when I nurse?

Now onto another common question. Is drinking while breastfeeding safe? Yes, yes, it is. The concern has never been about the alcohol in the milk; the concern is can you care for your baby? The amount of alcohol in your milk is considered sub-clinical, immeasurable, clinically irrelevant even with large amounts of drinking. But when you drink large amounts, you shouldn’t be with your baby, and you should still be pumping at the same pattern to maintain your milk production. Pumping and dumping milk is a long-standing myth. It is so very rare ever to need to discard breastmilk.

Healthy and moderate drinking is healthiest for everyone, non-breastfeeding mothers included. But yes, you can drink as you normally would, and breastfeed your baby as you normally would, without doing anything different, special or any waiting and certainly not any pumping and throwing away! Many moms have heard me say, you should be able to be a mom who happens to be breastfeeding, not a breastfeeding mom who has to do certain things, or not do certain things. You can be normal and just happen to be a breastfeeding mom. Isn’t that great! That’s what everyone around the world does and so can you! For a more detailed response to alcohol and breastfeeding, read on here at my website: Alcohol & Breastfeeding Article – DoneNaturally.com

What books do you recommend for the breastfeeding mama?

I have lots of great book ideas for the breastfeeding mama.

***The Womanly Art of Breastfeeding by LLLI

Breastfeeding Made Simple by Kathleen Kendall-Tackett & Nancy Mohrbacher

Working and Breastfeeding Made Simple (by the same prior listed authors)

Hirkani’s Daughters by Jennifer Hicks

Nursing Mother, Working Mother by Gale Pryor and Katherine Huggins

Bestfeeding by Chloe Fisher, Mary Renfew and Suzanne Arms

The Breastfeeding Book by Dr. William Sears

***Happiest Baby on the Block by Harvey Karp

No-Cry Sleep Solutions (book series) by Elizabeth Pantley

The Baby Book by Dr. William Sears

Nighttime Parenting by Dr. Sears

The Attachment Parenting Book by Dr. Sears

***Baby- Led Weaning by Gill Rapley and Tracey Murkett

…and the list could go on and on.

***Also recommended by Move Mama Move