A breastfeeding guide

Beginning to breastfeed
With the birth of your baby and the expulsion of the placenta the level of prolactin in your body rises, which stimulates the secretion of milk. Within the hour after birth, a baby's sucking instinct is at its strongest, and the baby will instinctively seek his mother's breast. When he wants to nurse depends on his quickly emerging personality.

Some babies are slow to develop an effective feeding pattern; they seem to prefer to open their eyes wide and look around or to nod off to sleep. Other babies suckle vigorously and often. Let your baby breastfeed whenever he indicates an interest, and aim for a minimum of 8 feedings in 24 hours. Some babies may breastfeed as often as 10 to 12 times in 24 hours. Look for hunger cues such as changing facial expressions, sucking, rooting, and bringing his hands up to his face.

From colostrum to mature milk
During the first days of nursing your first milk (called colostrum) is thick, sweet, and yellowish. New mothers have between 2 and 20 mL each day for two or three days. Not only does it give complete nourishment, it also supplies antibodies that protect the baby from disease. It has a laxative effect that helps clear out the meconium, the dark greenish material (a baby's first feces) that is passed by the third or fourth day. If the baby is nursed soon after birth and frequently thereafter, transition milk (a mixture of colostrum and mature milk) will be flowing within three or four days (with a first child) and will last until about the tenth day when a mother's mature milk begins to flow.

Breast engorgement
On day three after the birth, when your milk production increases, you may look like a fertility symbol but your painful breasts will make you feel like anything but a goddess. Day three engorgement is almost inevitable. The best way to treat this and other engorgement (which may occur later if you miss a feeding or two) is to nurse the baby frequently. You may be able to avoid further engorgement altogether by giving your baby frequent unrestricted opportunities to breastfeed. Engorgement makes your breasts hard and nursing difficult. You might express some milk with a breast pump until your areola softens, which will allow your baby to latch on to your breast more effectively. To relieve soreness before nursing, have a hot shower, or apply heat to your breasts with warm compresses or hot wash cloths. Gently massage the breast to help the milk flow.

If your breasts are very painful, take a pain reliever 20 minutes before nursing. Acetaminophen will not affect your baby. After feeding, apply ice packs for 15 to 20 minutes to help decrease swelling. With regular nursing, engorgement does eventually go away. For more information on breastfeeding problems, see Problems with breastfeeding.