5 things you need to know about the first days of breastfeeding
Now that you have researched everything there is to know about pregnancy and childbirth, here you are– planning on how to feed your baby after they are born. There is so much information on the internet about breastfeeding that it may seem daunting to sift through all of it.
Spoiler alert, breastfeeding was really hard for me in the beginning and I felt totally lost. I didn’t take any classes or talk to anyone, except for reading one book, a few articles and joining a Facebook group that said it was evidence-based. I assumed that breastfeeding would just *work* if I kind of knew what to do. And if it didn’t? Oh well, better luck next time!
I was extremely lucky to have been seen and helped by an excellent IBCLC, not only once, but twice before being discharged from the hospital! The pediatrician I chose, well, they just happened to have an IBCLC on staff for families having trouble. So when I found out that my daughter’s tongue-tie was the reason that latching was so painful and difficult and why she wasn’t gaining weight, I had lots of help!
I learned months down the road that the help I received was really uncommon and quite privileged- most people don’t get that kind of support from their healthcare providers (that’s another story!). So naturally, I decided to be part of the solution and spend the next 7 years working toward becoming an IBCLC. As a lactation nerd and someone who has talked to many parents about their experiences, this is what you really need to know for those first few days. Hopefully, you get excellent support like I had, but just in case…
It’s important to follow up with care within a couple days of going home if you have trouble in the hospital/birth center- if your baby is jaundiced, has a special medical condition, is not latching well, or you have pain with latching- early intervention helps create positive outcomes. Don’t wait for weeks for things to get better before deciding to get help!
Sleepy babies are not good babies in the first few days! Sleep is a hot commodity among new parents- babies that sleep more are equated with being good. It’s very important for babies to eat every 2-3 hours in order to get 8-10 feeding sessions in 24 hours. Babies that are sleepier or harder to wake may not be transferring enough milk and are at risk for developing jaundice, inadequate weight gain, thus lowering your milk supply. Once babies are back to their birth weight in 10-14 day, can you relax and let them sleep and wake on their own.
Tracking diaper output is very important in the first few days to monitor milk intake. Making sure that your baby is getting enough milk is the number one concern of new parents. Frequency, color, and consistency tell you a lot of information on how your baby is doing- weight checks are the gold standard, but not everyone has access to professional pediatric scales at home.
Bodyfeeding is not supposed to hurt! Normal discomfort and pain is different for everyone, but nipple soreness is most common in the first two weeks for the first 30-60 seconds of latching. Your nipples should not hurt throughout the feeding session and your nipples should look round afterwards. If you are experiencing more nipple pain than is normal or your nipple looks creased- like a new lipstick tube, it's time to see an IBCLC.
It’s normal to feel like you have no idea what you are doing! A baby being born means that a new parent is born too! All the education you may have done prenatally can be erased in just a couple minutes of an infant who won’t stop crying! Adding new siblings to the family can be just as confusing- “my first baby didn’t do this!” Breastfeeding can be confusing and intimidating at times, but it does get easier with practice.
So, what’s an IBCLC?
IBCLCs, or International Board Certified Lactation Consultants, are healthcare professionals whose expertise is in breastfeeding clinical management. IBCLC candidates go through an in-depth education, clinical training, and certification process. Unfortunately, there is no clear division between what is complex and otherwise normal nursing challenges. Some problems that appear to be complex may be simple mismanagement, while others that appear to be normal may turn out to be complex. Your visits with an IBCLC may be covered under your insurance plan, or reimbursable from your insurance company because of the Affordable Care Act.
Okay, so how can they help me?
A board-certified lactation consultant is an invaluable asset to families providing human milk, reassuring you when breastfeeding and lactation are going well, and by providing information and support to help prevent and manage common and not-so-common concerns. IBCLCs help with:
Prenatal counseling about the factors that may affect breastfeeding and lactation
Basic position and latch of the infant
Information about practices that promote successful breastfeeding and lactation
Preventing and managing common concerns such as poor latch, inadequate milk transfer or supply, nipple or breast pain, oversupply, plugged ducts etc.
Milk expression and storage for parents
Strategies for breastfeeding and lactation after returning to work
Breastfeeding and lactation in challenging situations, such as feeding twins or triplets, a premature or sick infant, or infants in special medical situations
Weaning or how to stop breastfeeding
Preparation for a visit with an IBCLC starts with them reading over your intake forms, plotting your baby’s weight chart, looking up any medications you may be on, and researching specific medical situations if applicable. During an initial visit, which can last from 90 minutes to 2 hours, includes a thorough medical history for you and your baby, weight check, and observation of a feeding session with help on various techniques if needed. An oral exam may also be performed to assess your baby’s tongue action and mouth structure. Lots of education on the mechanics of breastfeeding and milk production and answering any other questions or concerns you may have about feeding your baby your milk. Together, an individualized plan of action is created to support your goals and work through challenges you or your baby are experiencing. A written care plan will be given to you explaining everything that was discussed and a report to your pediatrician or doctor, where appropriate, to inform them of your care plan and discuss any medical concerns. Message/email support is often included after the appointment to answer questions and allows the IBCLC to assess if the care plan is working and if any changes need to be made.
Hopefully, you don’t need to see an IBCLC for feeding troubles, but if you do, you are in great hands! We love our jobs and we love helping families!