Jennell Orozco, lactation specialist at the Cherese Mari Laulhere BirthCare Center at MemorialCare Miller Children’s & Women’s Hospital Long Beach answers frequently asked questions regarding breastfeeding.
Q: How do I know if I'm making enough milk?
The body starts to produce colostrum (your first milk) during pregnancy and is available to the infant immediately after delivery even if you are unable to express any with either your hands or a pump.
It's a common misconception that colostrum (your first milk) is not enough for your baby, but this is simply not true. Your body produces tiny amounts of colostrum for your baby's tiny tummy, which is the size of a grape. In time, and with enough stimulation, milk volume increases between days 3 - 5 postpartum. This is also when milk becomes what we expect milk to look like. If your baby is meeting their daily goal for output, you can feel confident that enough milk is being consumed.
For days 1-5, infants need to have one wet diaper and one soiled diaper for each day of life.
- For example, day 1, your baby should have one wet diaper and one soiled diaper
- Day 2, two wet diapers and two soiled diapers, and so on.
- After day 5, your baby should consistently have 6-8 wet diapers and 3-4 soiled.
Q: How often do babies eat?
Babies need to eat eight or more times in 24 hours. However, it's very difficult to put babies on a schedule. Watch your baby for signs that they want to eat, such as opening their mouth and turning their head side to side. Infants will usually latch to the breast within the first hour after delivery if given the chance. This is usually their most alert state for the next 24 hours and their best feeding until they have finished what we like to call "the birthday nap," where all they want to do is sleep.
During this sleepy period, keep your baby skin to skin as often as possible and watch for feeding cues. Babies may feed less in the first 24 hours, but do not be alarmed, this is normal newborn behavior.
You can ask for help to express drops of colostrum to give to your baby until they are ready to latch to the breast again. After the first 24 hours, infants start to wake up and are ready to get to work. Their job is to tell your body how much milk to make and to actually aid in recovering the maternal uterus, which contracts in response to the breast stimulation. This helps bring it back to its pre-pregnancy state. Infants are hard-wired with a strong instinct to suck and want to do so frequently, usually at night.
Over the second and third days and nights, infants will "cluster feed," which is back-to-back feedings in a short period of time. This is why we encourage "on demand" feedings and keeping track of feedings in a breastfeeding log so you know if your baby is coming to the breast often enough.
Q: I'm planning to do both formula and breastfeeding. What is the best way to accomplish this?
The breasts work off supply and demand and require sufficient stimulation to know how much milk to make. Providing milk that your body didn't produce (formula) while still working to establish your milk production may sabotage your goals of producing a full milk supply. It is recommended to establish breastfeeding prior to beginning supplementation with formula unless medically indicated.
Infants have small tummies (about the size of a grape when they are born) and do not need large meals. They are also born full of fluid and meconium (your baby's first poop). Your first milk (colostrum) functions as a laxative and pushes the meconium through the gut getting your baby ready for more feeding.
Milk volume may not seem like it's enough at the beginning, but those drops are the exact amount your baby needs, and it is very nutrient dense. We recommend establishing the harder skill of breastfeeding prior to offering a bottle, which is better introduced around 3-4 weeks.
Human nature is to find fast, easy calories and bottles provide just that. If there is a faster, easier way to eat, infants tend to lean toward it and may begin to refuse the breast as it is a much more challenging skill.
It is also very easy for babies to be overfed with bottles and your baby's eating habits that they will have for the rest of their lives are being established now. If infants start overeating, it is more likely that that behavior will continue as they get older.
If early supplementation is desired, we recommend using alternative methods to bottles, which you can learn while in the hospital along with using a breast pump for additional stimulation.
Q: What supplies do I need to be successful with breastfeeding? What should I bring with me to the hospital?
Breastfeeding requires very little supplies. The milk is always at the right temperature and always ready. However, here are a few recommendations:
- A breast pump should be used as needed for breast stimulation and milk removal when directed by a health care professional or when returning to work or school. Breast pumps are usually free through your insurance but work with your OB/GYN ahead of time as this can take a few weeks to be delivered to you. You do not need to bring a pump to the hospital.
- Consider bringing items for nipple care, such as cream or butter, breast shells, and/or hydrogel pads. These items may help if you experience nipple pain, but breastfeeding shouldn't be painful and achieving a deep latch is the most important thing to keep your nipples pain free.
- Breastfeeding pillows can be beneficial at home, but you do not need to bring it to the hospital. We have pillows to support you after delivery. The idea is to "build your nest" with whatever pillows and blanket rolls you need to get comfortable and to maintain your alignment for a deep latch.
- Bring clothing that allows easy access to your breasts, such as button-down tops, robes, and stretchy fabrics.
Q: What kind of support is there for breastfeeding once I go home?
We will continue to be here for you throughout your breastfeeding journey whatever that may look like. You can call our lactation department at (562) 933-2779 for advice at any stage in breastfeeding and lactation. We aim to return calls within 24 hours.