Getting Started: The 5 Keys to Success

  1. Feed early & often: Do skin to skin after delivery and breastfeed during that first 1-2 hours.
  2. Engage or express: Hand express or pump your colostrum every 2-3 hours until the baby is nursing that often, and feed it to your baby when possible.
  3. Expect the expected: Understand what is normal the first week.
  4. Learn the latch: Be sure you know how to latch the baby.
  5. Supplement smartly and safely: Avoid bottles until 2-3 weeks old. If your baby needs supplements, use a syringe, spoon, or other method, not a bottle.

1. Feed early & often!

  • If possible, do skin to skin contact after delivery and often during the first few hours
  • Try to breastfeed during the first 1-2 hours of life
  • Try to feed every 1-3 hours BUT may only eat every 4-5 hours the first day (that’s okay!)
  • Feed when your baby shows signs, and try to wake to feed every few hours.
  • Try to feed 7-10 times a day BUT may only eat 3-4 times the first day (that’s okay!)
  • Your baby’s stomach is small!, only 1/2 to 1 tsp big! Feedings are tiny; you may not even notice anything!
  • Colostrum is all most babies need
  • Research shows that doing skin-to-skin and nursing within the first few hours improves milk supply over the next few weeks. It also improves the baby’s feeding while in the hospital and decreases the risk of dehydration and jaundice. Most babies naturally move towards the breast during skin-to-skin contact, and you can also place the baby there yourself to nurse.

2. Engage or express

This is key: you should empty your breasts every few hours, either by nursing, or by hand expressing (or pumping) your milk. This can really improve your milk supply and get breastfeeding off to a great start.

  • Hand express (or pump) your colostrum every 2-3 hours if your baby does not nurse.
  • You can feed it to your baby with spoon or syringe (but you don’t have to feed it every time).
  • Get the milk out!
  • Since many babies do not nurse very often the first day or two, this is the time when hand expression is usually needed. If you are having breastfeeding problems on later days and the baby is not nursing well, it is helpful and necessary then as well.
  • It is helpful to feed your baby some or most of the colostrum you express. It will lessen your baby’s normal weight loss and help prevent dehydration and jaundice. It will also probably make your baby less fussy.

3. Expect the expected

  • Most moms do not have milk until about day 4, especially if this is your first baby, and this is fine for most babies.
  • Babies are supposed to lose weight for the first 3-4 days, up to about 10% of birth weight is normal.
  • They are not back to birth weight until 10-14 days old, sometimes longer for breastfed babies born by C-section.

4. Learn the latch

  • Be sure you are comfortable and not leaning forward. Bring the baby to you, not you to the baby.
  • Be sure your baby’s chest is facing your chest, not the ceiling.
  • Use a position where the baby’s head is in your hand (cross cradle or football hold) until you and the baby have gotten into a groove. You can also use laid-back or lying down positions.
  • Use your free hand to support and shape your breast.
  • Stimulate the baby to open her mouth.
  • Bring her head and mouth to your nipple, chin first then mouth.
  • The lips should be flared out and resting on your areola and the whole nipple in the mouth. The nipple should be pointed towards the roof of the mouth.
  • The chin should rest on your breast more than the nose.
  • You should not have pain after 10-15 seconds (unless you have nipple damage already). If you do, take the baby off and reposition.

5. Supplement safely

  • If your baby needs supplements, use a syringe, spoon, or medicine cup, not a bottle. Use expressed breast milk or formula if expressed breast milk is not available.
  • Avoid bottles for the first 2-3 weeks if possible.