Having a brand new baby often brings a lot of questions.
The first few days after birth can be challenging. You’re likely dealing with recovering from a major physical trauma while trying to learn to nurse and balance guests, family, and the nearly impossible task of keeping up with household responsibilities. Here you’ll find a list of common concerns and questions that may come up in the first few days following birth.
What Should I Do if My Newborn Can’t Latch?
It can be frustrating and upsetting when a baby doesn’t latch easily. Here are some ideas that might help:
• First try the “gravity” position and see what your baby can do when he takes the lead (but don’t hesitate to move your breast to help him find the nipple).
• Try nursing when your baby is asleep or very sleepy.
• Change positions. Some babies prefer certain positions, at least at first.
• Try standing up and walking or swaying a little bit while bringing him toward the breast.
• Nurse in a quiet room with no distractions.
• Nurse in a noisy room with lots of distractions.
• Try spending time skin-to-skin – with your baby wearing just a diaper and snuggled against your bare chest. Use a blanket around both of you if the room is chilly.
• Sleep next to your baby (Reduce sleeping hazards – for more information on evaluating the safest sleep for your baby see Sweet Sleep from LLLI)
Check The Womanly Art of Breastfeeding, 8th edition, for more ideas, or contact an LLL Leader or International Board Certified Lactation Consultant (IBCLC) right away for help if your baby is still not latching well, to make sure that your baby is getting enough milk.
What Should I Do if My Nipples Hurt?
Breastfeeding should never be more than mildly tender. If your nipples hurt, first try lying back more and let your baby lead the way. When a baby nurses in this position, he’s on top of your breast. Gravity helps his jaw drop open wide so he can get a deeper latch – and that often means less pain. If this doesn’t help, or if your nipples have blisters or open wounds, contact an LLL Leader or International Board Certified Lactation Consultant (IBCLC) for help with positioning or to take a closer look at your baby’s mouth. Sometimes the problem is how your baby’s tongue moves, not how you’re nursing.
While you’re working to solve the problem, here are some ideas that can help with healing.
• Gently rub a few drops of your milk on your nipples after nursing and let them air dry. You can also use a tiny amount of over-the-counter antibiotic ointment after nursing. No need to wash it off before nursing again.
• Or use hydrogel pads tucked in your bra or under a snug-fitting tank top between nursings to relieve pain and promote healing. Hydrogel pads for nursing mothers are available at most baby and drug stores.
• Wash any nipple wounds with soap and water two or three times a day, to reduce the possibility of infection.
If you feel like you can’t continue nursing on painful nipples, contact a Leader or International Board Certified Lactation Consultant (IBCLC) right away for strategies to maintain your milk supply and address the underlying problem.
Why Are My Breasts Uncomfortable Four Days After My Baby’s Birth?
Before your baby is born, your body starts making colostrum, a thick, yellowish, clear type of milk that provides your baby with immunities and helps prevent jaundice. By about the third day, your milk “comes in,” increasing in volume and gradually becoming whiter. As your milk becomes plentiful, your breasts may seem very full. The extreme fullness (engorgement) should subside in 12 to 48 hours.
Here are some ideas for minimizing engorgement:
• Nurse early and often. This means nursing in the first hour after birth and then offering to nurse whenever your baby shows any hunger cues
• If your newborn sleeps longer than two to three hours in the day or four hours at night, wake him to nurse. If talking, stroking, undressing him, changing his diaper, and gentle handling don’t rouse him, try laying him on a flat surface and rolling him slowly and gently from side to side. Or put him skin-to-skin on your chest. Dimming the room often helps, too.
• Use cold compresses (or a bag of frozen vegetables) on your breasts between nursings, or put washed cabbage leaves directly over your breasts inside a bra. Change them when they wilt.
• Before nursing, put a warm, moist cloth on your breast and express some milk to make latching easier.
• Use “Reverse Pressure Softening.” Place your fingertips in a ring at the base of your nipple and press down for thirty seconds or so to soften that part of your breast temporarily, then quickly offer your breast to your baby.
Contact your health care provider if:
• you still feel discomfort after trying the above tips.
• you have a fever of 101°F or more, red/painful/swollen breast(s), or “flu-like” symptoms.
• your baby is unable to latch to your breast.
• after day three or four, your baby is not having three or four stools each day. By the end of a week or so, expect five or six stools each day until your baby is about a month old (when stools may become larger but less frequent).
What If My Baby Fusses When He Starts Nursing?
If you have a forceful milk release (the surge of milk at the beginning of a feeding), your breasts may be delivering more milk than your baby can handle. Some symptoms:
• Fussiness or restlessness at the breast; arching away from the breast during milk release.
• Coughing, sputtering, and spitting up while nursing.
• Gassiness, with green, watery, or explosive stools.
Talk with an LLL Leader to help you determine if a forceful milk release or oversupply is the problem. As long as your baby is gaining well, you may be able to reduce your supply slightly or help your baby manage your supply better with these ideas:
• When your baby stops nursing on the first breast, burp him and offer the second breast. He probably will take less milk from that breast and you can start with it the next time.
• Use a side-lying nursing position, which allows excess milk to dribble out of your baby’s mouth and may make nursing easier for him.
• Use the lying-back position so that your baby has more control during the feeding.
• Try nursing your baby while he straddles your legs.
• Nurse more frequently, which means smaller meals that may make feedings easier for your baby to manage.
• If none of these ideas help, try nursing from just one breast several times, until it feels completely soft, hand expressing just enough milk from the other breast to be comfortable. Then nurse from the other side several times to soften it completely. Keep alternating this way, with two or more nursings on each side.
