When I see a new family, one of the things I say often is if they can get through the first two weeks, things will feel totally different on the other side. It doesn’t matter if your feeding journey is complicated or it’s been smooth sailing. The first two weeks are a whirlwind of milk, hormones, feedings, emotions, and uncertainty. I put together a list of things you can expect to happen so you’ll know you’re on the right track. If you’re not, you’ll know when to seek out licensed, professional support to help you get back on track to confident, peaceful feedings.
The first 24 hours will be a blur. After your Golden Hour, babies usually pass out. If you had a hospital birth, you’ll be bombarded with people checking on you and your new baby, doing all of the tests and procedures and charting they need to do before you leave. It can be overwhelming. In non-pandemic times, visitors stop by to meet your new family. If you have a doula or supportive partner, it can be helpful to discuss your postpartum plan with them. In my opinion, a postpartum plan is just as important (if not moreso) than a birth plan when it comes to establishing your relationship with your baby. Milk supply depends on supply and demand, and establishing healthy hormone levels in those early days. The best thing you can do is keep your baby close (skin to skin is best) and feed them on demand as often as they ask for milk. Keep those Golden Hour goals in mind - low noise level, dim lights, warm room. Your baby will likely “power down” for much of this overwhelming time. Baby brains are immature, and when they’re overstimulated, they shut down and go into a deep sleep. Good luck waking a baby in this state. It’s nearly impossible. You’ll feel uterine cramping during feedings. This is normal, and helps prevent hemorrhage while shrinking your uterus a little more each day until it returns to its pre-pregnancy size.
48-72 hours out, usually right about the time you’re getting home and settled in after a routine hospital birth, your baby wakes UP. They’re alert, sometimes irritable, and ravenous. They want to live on you, eat constantly, and may fuss. This can be exhausting and lead many parents to assume that baby isn’t getting enough to eat, or surely they’d be sleeping like they did the day before. Some top off with a bottle, “just to be sure”. Often that topped off baby does pass out and sleep soundly. Does that mean they were starving? Oftentimes no. A baby belly grows gradually, but can stretch like a balloon if forced. If you’ve ever overeating and stuffed yourself to capacity, all you want afterward is a good nap to digest all that food. Overfeeding a baby has the same effect. They shut down to digest such a large meal, missing feedings in the meantime and going a longer time without stimulating your milk supply. By going a long stretch without removing milk, you’ve just told your body the milk you’ve already made is not needed, and it slows down production to make even less milk for next time. You can see how this would be a vicious cycle. The more often a baby feeds and the more milk they remove, the opposite message is sent. All those hormones are on high alert, cranking up milk production to make sure there’s plenty for next time. Your baby’s behavior is normal. If they’re eating 8-12 times in 24 hours and their poop is transitioning according to this guide poop post, you’re on the right track.
Around Day 4-5, your nipples, areolas, and breasts may feel the most tender, and your breasts may have grown, feel heavy, or leak milk. It may feel sensitive to have anything touching your skin, even a bra or shirt. You may find that an ice pack feels soothing, or hydrogel pads applied after a feeding. This sensitivity is hormone-related and will pass in a day or two. Some people notice a prickly, tingly, itchy, or electric feeling during the first few minutes of a feeding on one or both sides. This sensation is caused by the Milk Ejection Reflex. Driven by the hormone oxytocin, nipple stimulation will cause tiny nerves to react and the milk ducts to widen, allowing milk to flow rapidly. If you’re breastfeeding/chestfeeding directly, you’ll notice your baby’s suckling pattern change. They’ll go from fast, short sucks to long, slow pulls with big swallows of milk. After a minute or two, the pace slows down, and so do the swallows. There’s still plenty of milk in there, but the Milk Ejection Reflex has subsided and the milk is thicker, fattier, and slower. If your baby seems to stop for more than a break to take a few breaths, try massaging or gently compressing different areas of the breast. Often you’ll notice that baby perks up when they realize the meal isn’t over just because the milk has slowed down. If baby is full, they’ll often just roll off.
Somewhere around 7 days, your baby will go back to being insatiable. It seems like as soon as you’ve gotten to a more stable place, this baby suddenly wants to eat non-stop. Does this mean you’re not making enough milk? Quite the opposite. Your baby’s belly is about to grow yet again, and they’re telling your body to up the milk content. Plan to do very little besides feed your baby, especially in the evenings. This shouldn’t last more than a couple of days, and the end result will be more milk to fill that tummy that’s grown just a little bit larger. The next time they go through another period of growth, it’ll be around 4 weeks. After that, your milk supply stays completely stable. If you have a normal milk supply of 19-30oz at 4 weeks, that’s the best indicator of long term success feeding your baby. You never need to make more!
Now that you’ve made it through the list of “normals”, what happens if what you’re experiencing isn’t on this list? Let’s go over a list of red flags. If what you’re going through is on this list, reach out to an IBCLC for help.
Pain and nipple trauma. If you’re not just experiencing mild tenderness and sensitivity, but true pain, that is never normal. If your nipples have cracks, scabs, bruises, aren’t round when baby releases them, or if they’re white and pinched instead of pink, something is not right.
If your baby loses more than 10% of their birth weight or isn’t back to birth weight by 2 weeks. A baby eating breastmilk exclusively gains 5.5-8.5oz/wk their first 4mos of life.
You feel like you HAVE to pump, either mentally or physically. Unless you’re planning to exclusively pump, there’s a medical reason or you’re separated from your baby, or you’re going back to work very soon after birth, there is no reason to touch a pump in the first 4-6 weeks. This includes a Haakaa, hand pump, or electric pump.
Your baby isn’t pooping, or they’re having explosive, watery, green, stringy, or slimy poops. Their poop after Day 5 should be mustard yellow and seedy, and applesauce to hummus consistency. Straining, wiggling, grunting, or crying before a poop is not usually a cause for concern.
You’re struggling with blocked ducts, clogged nipple pores (blebs), mastitis, postpartum depression/anxiety/OCD.
Your baby is eating less than 8 or more than 12 times a day, or your baby has a hard time staying awake long enough to be satisfied.
Your baby is gagging, choking, coughing on the milk, or gulping so quickly they’re swallowing a lot of air while they eat.
You FEEL like something is off. I always trust a gut feeling. If you feel like things are weird, they probably are.
I know this is a lot, but hopefully this is a reassuring list that you’re doing a great job, and what you’re experiencing is very normal. If not, send me a message! We can help you get to a better place, or refer you to someone in your area if that’s what you need. There are IBCLCs all over the world, and we’re here to help!