Breast milk contains antibodies that help protect babies from infection. Therefore, it’s best to start breastfeeding within the first hour of a baby’s life. Mums who are breastfeeding for the first time may find initial feeds challenging, and knowing what to expect will help make the experience a happy and enriching one.
The sooner the better
Mothers should begin breastfeeding within one hour of giving birth.
Skin-to-skin contact between baby and mother should be established immediately following birth for at least an hour. It has the following benefits:
- Keeps baby and yourself calm
- Keeps baby warm and helps keep his heart beat and breathing stable
- Allows baby to make eye contact with you which is great for early bonding between mum and baby.
- Allows baby to find your breast and self-attach, letting him learn quickly how to suckle effectively
Benefits of early breastfeeding:
- Ensures baby receives colostrum, also referred as the “first milk”, which is rich in substances that protect against infection and disease.
- Baby’s digestion and bowels are stimulated.
- Sucking difficulties may be avoided if baby feeds properly at this stage.
- The mother-baby bond is enhanced.
Breastfeeding after C-section
If you have delivered by C-section, when you can breastfeed your newborn depends on how you feel and how your baby is doing. If you’re both in good shape, you can probably start breastfeeding in the recovery room, shortly after the surgery.
If you’re groggy from anaesthesia or your baby needs immediate care in the nursery, you will need to wait for the first nursing session but start to express your colostrum and get lactation started. The expressed colostrum can be given to your newborn whilst waiting for the first nursing using a spoon or syringe.
The biggest challenge is getting through the first few days of breastfeeding. New mums who are able to overcome this critical period are more likely to continue breastfeeding for a longer period of time. The key is to be calm and determined.
What mums can expect:
During the first week after giving birth, you may experience some drastic changes to your body, physically and emotionally. Don’t worry, these problems happen to nearly all women after delivery. It’s just a transition period.
When first milk arrives, it will leave your breast swollen, painfully tender, throbbing, hard and sometimes seriously, frighteningly gigantic. It can be avoided if you breastfeed frequently and on demand. Avoid long periods between feedings. During the day, if your baby sleeps more than two hours, try waking him up and offer him the breast. This will help to empty the breast before it becomes engorged.
The good news is that this won’t last long. Your milk supply-and-demand rhythm should be established in the matter of days, and engorgement and its effects will gradually fade.
What to do: When your breast is engorged, it becomes very hard, making it difficult for the baby to latch on. Therefore, you must first reduce the swelling by hand expressing some of the milk out. You can also apply warm compresses to the breast or take a warm shower before expressing, which helps the milk to flow. Otherwise, you can also use cold compresses after feeding or expressing, which helps to reduce the swelling.
Worries about milk delivery
The “first milk”, colostrum, which contains antibodies for your baby is present, in small amounts, after birth. Babies aren’t born with big appetite or with immediate nutritional needs. Your newborn’s stomach is the size of a cherry.
After about 3 to 4 days of nursing, your breasts will start to feel less soft and more firm as your milk changes from colostrum to transitional milk that looks like skimmed milk. While babies don’t need much more than some colostrum for the first couple days, the doctor may need to make sure the baby is getting enough to eat.
What to do: Breastfeed more frequently, putting baby to the breast every 2 to 3 hours. If your milk still hasn’t come in within 72 hours after the birth of your baby, you should talk to your doctor.
Leaking breast milk
Sometimes, breast milk may leak unexpectedly from your nipples.
What to do: Press your hand gently but firmly on your nipple when this happens. This usually helps very quickly. Wearing breast pads will stop your clothes from becoming wet with breast milk. Expressing some milk may also help.
Tender nipples can make nursing a frustrating experience. The good news is that the pain will go away as you get used to breastfeeding. Your nipples will toughen up quickly and soon breastfeeding will become painless.
However, in most instances pain experienced throughout a feed is due to poor attachment. So, it’s important to learn the proper latching technique to prevent discomfort and ensure your baby is getting sufficient nutrition from you.
What to do: Apply some expressed breast milk after feeding and use comfortable bra with good ventilation to heap with the healing.
What to expect for baby:
Baby has a very small tummy and needs only a small amount of breastfeed to keep going. They will be able to get enough breast milk by feeding frequently to fill the small stomach. There is no fixed schedule for breast feeding babies. They should feed on demand, i.e whenever they are hungry or show signs of hunger.
- Feeds should occur every 2 hours (8-12 times in 24 hours). This is a general guide. Different babies have different needs. During the early periods, some babies may want to feed every hour or so.
- Baby should not go longer than 4 hours at night without feeding.
- Pay attention to baby’s hunger cues and nurse him immediately whenever is needed. Don’t wait until baby cries to put him to the breast as crying is a late sign of hunger
- Early hunger cues include:-
- Increased eye movement
- Opening his mouth and stretching out his tongue while turning his head around to look for your breast
- Making soft whimpering sounds
- Sucking on hands, fingers or any nearby objects
- Crying softly and gradually louder. (Crying is usually the last hunger sign.)
- Encourage your baby to feed as long as he is actively suckling. Detaching a suckling baby from your breast before he’s finished, or allowing him to fall asleep shortly after beginning to feed, may throw off the breastfeeding rhythm of supply-and-demand.
- Allow him to breastfeed until he seems full – at this point he will probably detach from the breast by himself.
- The longer your baby nurses, the higher the fat content of the milk he is drinking.
- Shorter, timed nursing periods may not allow him the opportunity to enjoy the full benefits of your breast milk and may leave your breasts full of unreleased milk, making you feel engorged and uncomfortable.
- Do not give pacifiers or artificial teats to breastfed babies except upon doctor’s advice.
How to know if baby is feeding well?
- Nappy alert
Take note of baby’s nappy changes. His wet diapers and bowel movements indicate whether or not he is getting enough breast milk.
The following is what you can expect:
For the first three days, baby feeds on colostrum, thus would most probably have green-black sticky poo and about 1-3 wet nappies. As milk volume and intake increases, his poo will change to greenish-brown colour and slowly to mustard yellow after the 1st week. The frequency of bowel movements ranges from 3 to 8 times a day and generally less frequently as baby grows older.
Urine should be clear to light yellow and expect baby to pass urine 6 to 8 times (or more) a day after the 1st week. If you are concerned, always speak to your doctor or lactation nurse/consultant for advice.
- Baby’s growth
It is normal if your baby drops a little weight at first. Babies should stop losing weight by the fourth day, begin gaining by the fifth day, and be back to birth weight by no later than the fourteenth day. Always speak to your doctor if you are concerned with his growth.
- Baby looks healthy and sleeps well
Baby should be sleeping well and looking healthy and alert when awake. If baby is feeding well, he will have a good muscle tone and healthy skin. It won’t be long before he grows too big for his clothes.
4. Cry baby
Baby may be crying often. There are a lot of reasons babies cry, not just to tell you he’s hungry. It could be that he is new to this world and needs more time to get used to his new surroundings, or that he is simply feeling lonely, and seeking attention and comfort. He may also be uncomfortable i.e too cold, too warm, dirty nappy etc. Always keep yourself calm and patient when your baby cries. Try your best to identify the cause of the cry and attend to your baby’s needs accordingly. If you are stressed, your baby will feel it and be stressed too.
For further information on infant and child nutrition, please refer to
- MINISTRY OF HEALTH MALAYSIA (2013) Malaysian Dietary Guidelines for Children and Adolescents. Putrajaya: Technical Working Group on Nutritional Guidelines (for National Coordinating Committee on Food and Nutrition).
- NUTRITION SOCIETY OF MALAYSIA (2011) Breastfeed with Confidence. Petaling Jaya: Mother’s Smart Choice.