Breastfeeding - Getting Started

This fact sheet gives you tips on how to establish good breastfeeding practices in the days after your baby is born and beyond.

Milk production

During pregnancy, in response to changing hormones, a woman’s breasts begin to prepare for breastfeeding. Glandular tissue develops and the breasts increase in size.

The first milk - which may be cream, yellow, or clear in colour - is called colostrum and provides all the fluid and nutrition a healthy baby requires. Some women see this as early as 20 weeks in pregnancy. Over the first few days colostrum gradually changes to mature milk, and we talk about the milk ‘coming in’ as the amount increases and your breasts feel firm, full and sometimes uncomfortable. This will settle as you breasts and milk supply adjusts to meet your baby’s needs.

Your milk production depends on frequent stimulation and drainage of your breasts. Breastfeeding is most effective way to do this or if this is not possible expressing your breast milk.

During breastfeeding or expressing your body produces a hormone called ‘oxytocin’ to move your milk through ducts to the nipple openings. This is called the ‘let-down’ reflex. Mothers may feel a tingling sensation or fullness in the breasts, milk leaking from the opposite breast or changes in a baby’s suck and swallow action.

Breast milk helps prevent common infections such as gastroenteritis, chest infections and some long-term illness. Breastfeeding is also recommended to reduce the risk of SIDS.

Good feeding practices

The following points are a guide to initiating and establishing breastfeeding.
When your baby is newly born:

• Have your baby placed directly onto your chest (skin-to-skin).
• Feed your baby soon after birth, preferably within the first hour.
• We will help you position and attach your baby for a breastfeed.
• Babies usually feed 8-12 times in 24 hours.
• You and your baby will be together so you will get to know your baby’s feeding cues and your baby can breastfeed frequently and according to need.
• If your baby is having difficulty attaching to the breast, express some milk and give it to your baby using a cup or spoon.
• Breastfeeding takes time and patience. Don’t be afraid to ask for help.
• Avoid using dummies, teats and infant formula unless you are advised to do so by a midwife, lactation consultant or doctor.

Establishing your breastfeeding

• To prepare for breastfeeding, find a position that is comfortable and safe for you and your baby.
• Follow your baby cues as they try to attach to your breast.
• Offer feeds frequently, 8–12 feeds every 24 hours especially in the first few weeks of life.
• Look to see that your baby is both sucking and swallowing during feeds, if you are not sure ask your midwife.
• Encourage your baby to stay awake and actively sucking whilst feeding at the breast. Feeding skin-to-skin and gentle stroking may help.
• With each feed, allow your baby to finish feeding from the first breast before offering the second. You may like to gently massage your breast during feeding to ensure it is well drained.
• If your baby is having difficulty attaching or feeding express some milk to feed and ask your midwife for advice.
• Remember that your own health is important, rest when you feel tired and are able to, eat sensibly and drink plenty of fluids.
• Your baby will not need infant formula or any other fluids unless advised by a medical professional.

Signs your baby is receiving enough milk

• Baby settles between most feeds.
• After your milk comes-in, expect 5-6 heavy wet nappies every 24 hours.
• During the first few days, your baby’s stools change from a black meconium to a soft mustard yellow appearance. Most babies will have at least one bowel action per day in the first 6-8 weeks after birth.
• Your baby starts to gain weight after an initial weight loss and regains birth weight by around two weeks of age. In the first three months of your baby’s life there is an average weight gain of 150 grams or more per week. Your maternal and child health nurse will be helping you with this.

DISCLAIMER: This fact sheet provides general information only. For specific advice about your baby or your healthcare needs, you should seek advice from your health professional. Burnside War Memorial Hospital does not accept any responsibility for loss or damage arising from your reliance on this fact sheet instead of seeing a health professional. If you or your baby require urgent medical attention, please contact your nearest emergency department.