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1/5/09 9:02 P

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when does milk come in?
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Edited by: ROAD2HEALTHY at: 1/5/2009 (21:52)
~Lisa~ Pagan mama of three boys! road2healthy-simplelife.blogspot.com
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ROAD2HEALTHY's Photo ROAD2HEALTHY SparkPoints: (0)
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1/5/09 2:33 P

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Once upon a time, we learned to breastfeed from our mothers, grandmothers, etc. Yes, breastfeeding is natural, but natural does not imply that you are born with inherent knowledge of how it works nor that you will be struck dumb with the knowledge upon giving birth. Many natural processes are learned. Eating is one of the most natural things in the world – we do it every day – yet older babies and toddlers have to learn to do this through a gradual process that begins with mushy foods and eventually gets to steaks and salads.

Nowadays many of us are at a disadvantage. Our parents and grandparents were told to formula feed. Of course they wanted what was best for their babies – we all do – but we are left with a huge multi-generation gap of knowledge when it comes to nursing.

This section will be the most reading-intensive section, but I urge you to read the articles I link to. This is the foundation.

HOW MILK PRODUCTION WORKS

First thing's first. You won't have milk available when your baby is born. You have something better – colostrum! This is the baby's perfect first food. It comes in small quantities, but the stomach of a newborn baby is very small, about the size of a marble, so it's all they need. Here is an article on colostrum from the La Leche League (LLL):
www.llli.org/FAQ/colostrum.html

Kelly Mom has a detailed article about how our breasts produce milk. I think it's interesting and encourage you to read it, but I admit that this one is a bit complex and may be more information that you need. I learned a few things I previously misunderstood, but this one is optional:

www.kellymom.com/bf/supply/milkproduction.
html


To simplify the picture for you, remember these three words: supply and demand. If your baby demands it, your breasts will supply it. This is particularly important as you are waiting for your milk to come in and building your supply. The more your baby nurses, the faster your milk will come in and the stronger your supply will be. You can't nurse too often, but you should nurse at least 8-12 times in a 24-hour period for the first few days.

LATCHING

I'm just going over some basics right now. I have an entire section on latching struggles planned for a little later on.

Some basics, including how a baby gets milk out of a breast:

www.wiessinger.baka.com/bfing/howworks/pos
ition.html


Latching on with pictures:

www.wiessinger.baka.com/bfing/howworks/lat
chtalk.html


Finally, the best information on latching from Kelly Mom is included in their article on sore nipples. The reason...sore nipples are usually caused by latch problems. So I'm including this article as well, both for the latching resources and for the information on the care and treatment of nipples. If you're feeling overwhelmed by the reading load, you can just skip to the parts on positioning and latching. The rest of it will come up again.

www.kellymom.com/newman/03a-sore_nipples.h
tml


WHAT TO EXPECT

This one is short, simple, and to the point. You can just read the first part for now – about the first week of life:

www.kellymom.com/bf/normal/newborn-nursing
.html


A few very important points (and some personal experience):

1.Your milk usually takes 2-5 days to come in. Personally, with my second..it took mine 6. I'm not sure why (I never supplemented) but it did. Fortunately, I had a supportive doctor who helped me closely monitor my son's weight while at the same time encouraging me to keep nursing.
2.You will be nursing very often, at least 8-12 times a day. You can't nurse too often. In fact, your baby will almost certainly go through one or more periods known as “cluster feeds” in which he or she wants back on the breast just about as soon as they get off. This can last for several hours and sticking through these times is key to bringing your milk in. It would be a very bad time to supplement. (It is also a time when well-meaning relatives encourage you to give formula because they think the baby is starving. The baby is fine. This is just part of the natural process of bringing your milk in.)
3.Your baby will lose some weight at first. It is quite normal for a baby to lose 5-7% of its body weight. (Once again, I stretched the norm on this one. My son lost almost 10% before he turned it around. Another article I will link to below suggests that this is all right as an outside number. Frequent weight checks told my doctor that at the end of week one, he was on his way back up, which is why he decided that no supplementation or intervention was necessary. I have an entire section planned on growth charts and understanding healthy weight gain.)
4.Your baby should regain their birth weight by 2 weeks of age. This could be a serious problem if it does not happen, but it is pretty rare. Even with my early weight struggles, we were back to birth weight at 2 weeks.
5.Wet diapers: there should be one for every day old your baby is until 5 or 6 days. Thereafter, there should be at least 5-6 wet diapers.
6.Dirty diapers: there should be one for every day old your baby is until day 3 or 4. Thereafter, there are usually at least 3 or 4. (Note: this means quarter-size poops. Your baby may poop a couple of silver dollars and that's fine. Poop actually isn't as good as wet diapers or weight gain as a way to determine if your baby is getting enough, especially as they get older and the range of normal becomes so varied. Some BF babies will poop every feeding and others will go 10 days between poops.)

IS BABY GETTING ENOUGH?

I covered a lot of it above, but here is another very short article:

www.kellymom.com/bf/supply/enough-milk.htm
l


A word of caution on the last line, “Other Positive Signs.” I almost didn't link to this because of it, because it's poorly worded. The presence of those is a good sign. The absence is not telling. It is always best to find a good, BF-friendly doctor and lactation consultant to advise you.

NIPPLE CONFUSION

It's real. You will inevitably hear someone tell you that they gave their baby a bottle at a few days old and he or she went back and forth with no problems. We've probably got a mom here who can share that experience. I'm glad that these babies did not suffer from nipple confusion, however; just because some people can get away with it doesn't mean you can. A great many women who offer bottles have problems and it is difficult to undo this. It's much easier to prevent.

Here is Dr. Sears on nipple confusion:

www.askdrsears.com/html/2/T022400.asp

I wan to add that nipple confusion can be subtle or overt. It isn't just a matter of a baby refusing a breast outright. Sometimes, they simply have a poor latch or have a lazy suck that doesn't get them much milk and causes them to act hungry again at the end of the meal – when this happens a lot of moms will give a bottle and exacerbate the problem.

In the unlikely event that supplementation is necessary in the early weeks of BF, there is an alternative to the bottle. You can use a dropper, syringe, cup, or finger to feed the baby. It is not as convenient, but it does get food in the baby without the risk of nipple confusion.

It is best to avoid pacifiers for at least 4 weeks as well.

HUNGER CUES

www.kellymom.com/bf/start/basics/hunger-cu
es.html


EARLY SUPPLEMENTATION

There is rarely a need to supplement a newborn baby – either with pumped breast milk or with formula. I hate to have to say this, but there are still hospitals, nurses, and doctors who just don't get it...breastfeeding, that is. That is why it is so important to educate ourselves and to find the right resources. (I will have an entire topic on finding the right support later on.)

Early supplements delay your milk coming in, hinder your supply, and if given in a bottle, can cause nipple confusion. It is therefore important to know when supplements are necessary and when they aren't...because it does happen. Heaven forbid, but you or your baby may be seriously ill – you too ill to feed your child or your child so ill that they cannot nurse. The following article spells out when you would need to consider supplementing, when you should probably not supplement, and how to supplement if the need arises. (As I mentioned above, they recommend syringes, droppers, or cups to avoid nipple confusion.)

www.mother-2-mother.com/supplement.htm

HOW OFTEN SHOULD I NURSE?

As often as your baby wants. You cannot nurse a baby too often. If your baby is excessively sleepy, it is best to try to wake them every 2 hours during the day and every 4-5 hours at night for the first few weeks.

HOW LONG SHOULD I NURSE?

Watch your baby, not the clock. You nurse as long as your baby is sucking. When they slow down, it's a good time to burp and switch breasts. Newborns can nurse for a long time (this gets better as they get older). Mine would go 30-45 minutes. Or you may get lucky and have such an abundant supply and heavy flow that your baby gets done in 15 minutes. (This can come with its own problems, though, and I'll be talking about oversupply later.)

NURSING AFTER C-SECTION

If you're planning a c-section, then definitely read this. If you're not, you should read it anyway. If you have to have an emergency c-section, you probably won't be into reading when you come out of surgery. :=)

www.kellymom.com/bf/start/concerns/c-secti
on.html


SKIN TO SKIN CONTACT

Even if you don't choose to breastfeed, I highly recommend taking off your shirt and getting that skin to skin contact with your newborn. Here are all the reasons why:

www.kellymom.com/newman/01a-skin-to-skin.h
tml


NURSING MULTIPLES

Anyone having twins or more? I haven't done much reading on this since it doesn't apply to me, but I don't want to leave you hanging so here are a bunch of articles:

www.kellymom.com/bf/start/basics/bf-links-
multiples.html


GENERAL TIPS AND TRICKS

1.Relax!

What do I mean, relax? Haven't I Just given you a ton of reading to do with all kinds of things to know and things to watch?
Well, yeah, but try not to get anal about it. I think one of the hardest lessons I had to learn from nursing my son was to just go with the flow. He didn't follow all the rules – like I said he lost too much weight initially and only just slid back up to his birth weight by two weeks. But he's not a robot. He didn't download a nursing handbook into his brain and he was healthy. When I just relaxed, followed his lead, nursed on demand and tried not to get too upset about it, we did fine.

2. Room in with your baby

I resisted this one at first – well, not at the hospital but when I came home I was bound and determined that he would learn early on to sleep in his own crib. What followed were two of the most miserable weeks of my life. I can remember walking down the hallway at 3 in the morning and looking down to my son's room, about three hundred miles away, and shivering from a cold that came from within.
Taking him into my room was the best thing I ever did. I realized two things. First, you can't spoil a newborn. They just don't have the same kind of psychology as an older child or even an older baby. They don't manipulate you – they just need you. The other thing I realized was that newborns put you in a kind of survival mode. You do whatever it takes. You may have a different solution that works for your baby, but I encourage you to do whatever it takes, even if what it takes goes against some predisposed notions.

3.Sleep when your baby sleeps.

I mean it. I mean it. I mean it. I'm not kidding. I don't care if if the sun's out and there's laundry to do. Go to sleep. Now's your chance. Time to take care of you.

4.It goes like this: Baby. You. That's it.

Your only job in the first few weeks of your baby's life is to take care of your bay and take care of yourself. You didn't take maternity leave so you could do the laundry and clean the house.



And now...please ask your questions and share your thoughts. Feel free to tell me if you think I left anything out, but I should tell you that I decided to move a number of things to later topics because this one was already too long! FYI, I won't post anything again until next week, maybe even late in the week, to give you time with this.

I would like to give a sweet mama from babyfit a special thank you for giving me permission to use her info. Thank you Christine Amsden!! Also, I want to invite you all to look at her new website! www.christineamsden.com

Edited by: ROAD2HEALTHY at: 1/5/2009 (16:27)
~Lisa~ Pagan mama of three boys! road2healthy-simplelife.blogspot.com
/


Co Leader of:
Crunchy Mamas!
teams.sparkpeople.com/crunchymamas
Breastfeeding moms!
teams.sparkpeople.com/bfing



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