Q/ When will my breastmilk come in?
The first milk is colostrum, a rich source of immune protective factors, is stored in breast tissue from approximately 16 weeks. Towards the end of the third trimester (and sometimes earlier), some women may experience secretions of colostrum on their nipples. Others may only be aware when they actively hand express (with the support and understanding of your health care provider from 36-37 weeks onwards) in preparation for birth. Both are perfectly normal and healthy.
When allowed unrestricted time with their baby from birth, skin-to-skin and able to feed on demand (aiming for a minimum of 8-10 feeds in 24 hours), your breastmilk will change from colostrum, into transitional milk, usually between day 2-5. ‘Transitional Milk’ is termed by many as “your milk coming in”, which is closely associated with breast fullness. You may hear another term called ‘mature milk‘, which establishes approximately two weeks after your baby’s birth.
Q/ Is breastfeeding supposed to be painful?
The short answer is no – but it is also helpful and reassuring to share the normal and varied sensations that mums can experience:
“A feeling of tingling, noticeable warmth, or pins and needles” – a sensation in the breast as the milk begins to flow. This is called the ‘let-down reflex or the ‘milk ejection reflex. Some mothers never feel this sensation of the let-down reflex, which is also normal.
Others may describe the pressure on their nipples as “a tugging or pulling” sensation when the baby is actively sucking.
“Really firm pressure” on the breast and nipple that subsides once the baby has been actively sucking for 15-20 counted sucks (approximately 30 seconds) is a good and reassuring sign that your baby is attached deeply. Baby’s have the same palette as ours. After the initial deep latch onto the breast, their tongue and mouth cups and creates a vacuum around our breast tissue that allows the breast tissue and nipple to be taken deep into their mouth. With a deep attachment – the breastfeeding parent will often say, “Oh, that feels better….”
- Comfortable tugging pressure = normal
- Stinging, burning, pinching discomfort = not normal (reattach your baby, always aiming for a deep latch).
“Nipple pain = nipple damage.”
It is important to remind ourselves and always remember breastfeeding – not nipple feeding.
^Ref: “Born to breastfeed. The first six weeks and beyond.” Rowena Gray
Q/ How do I know if my baby is latched correctly?
How it feels for you: what can look like a deep and comfortable attachment to the observer is no comparison to how it may feel for the breast/chestfeeding parent!
Once the baby has completed approximately 15-20 active sucks (around 30 seconds), ask yourself – Is it comfortable? Any stinging? Pinching? Or Burning sensations? If there is discomfort or pain, you need to detach your baby safely by gently inserting your finger into the corner of their mouth to break the suction. Reposition yourself and reattach your baby using the correct positioning and attachment techniques listed below.
For more information:
Look at the shape of your nipple when your baby detaches. The shape of your nipple should remain the same when your baby comes off the nipple after a feed. The best way to describe it is – if it looks misshapen, it’s likely your baby needs a deeper attachment to protect your nipples, milk supply and breast health long term.
When well attached, your baby’s cheeks will appear full and rounded, with no noticeable dimpling of cheeks or clicking sounds when actively sucking.
Aim to have your baby’s nostril clear of breast tissue, so the baby remains sucking at the breast for the duration of the feed. Babies are nasal breathers, so if your baby is regularly pulling off, it is worthwhile looking at the alignment of your baby’s body against yours. ‘Chest-to Chest’ and ‘Tummy to Tummy’ with you, with their bottoms cuddled in close, will allow for a good position.
You want the baby’s head to be slightly extended. Imagine the position of your head and neck when you raise a glass of water to your mouth to drink; you naturally tilt your head back; it is the same for bub. This position allows bub to open their mouth wide and take in a large portion of breast tissue beneath your nipple and a good transfer of milk.
Note: Some babies will pull off if mum’s milk flow is fast, not because of an uncomfortable latch. Adjusting your position, for example, reclining back or side-lying may be all that is needed to help your baby with a fast flow. Gravity is working for you both.
As your baby grows, different positions will evolve as you learn together.
Q/ How will I know if I am making enough milk for my baby?
The main factors to be mindful of are:
- Baby is waking for feeds and regularly demanding feeds and is feeding well to soften your breast. To check this, feel your breasts to recognise how full they are before attaching, and again after you either take your baby off the breast, or the baby detaches themselves. Does your breast feel softer? If the answer is yes, milk has transferred beautifully to your baby.
- Your baby is settled between breastfeeds.
- Your baby is gaining weight.
Your Registered Midwife, International Board Certified Lactation Consultant (IBCLC) or Maternal Child Health Nurse (MCHN) will check this regularly.
MAMA have scales available to weigh your baby. MAMA holds a drop-in breastfeeding session Mondays from 10-11 am at Kensington. It is a great time to have bub weighted and meet new mums who share their breastfeeding journey (Booking online essential).
- Be aware of how many wet and dirty nappies you are changing in 24 hours. For a newborn baby, we like to see:
- Day 1: 1 wet nappy + 1 stool (meconium- sticky, tar like consistency)
- Day 2: 2 wet nappies + 1-2 meconium stools
- Day 3: 3 wet nappies + 3 greenish coloured stools
- Day 4: 4 wet nappies + 3+ mustard coloured stools
- From Day 5 onwards:
- Once your milk is established, and mature milk is flowing, good signs that your milk supply is perfect for your baby’s needs are indicated by:
- 5-7 heavy wet disposable nappies or 6-8 soaked cloth nappies per day. Bowel movements for an exclusively breastfed baby can fluctuate, and on average, three soiled nappies a day is typical. Still, it may also be more, and this is also considered very normal for your baby. It is worth knowing that some babies may go several days without a bowel motion.
- If your baby appears well, continues to have a minimum of 8 breastfeeds in 24 hours, is active and alert and settles post feed, there is no need for concern. But if you do have a concern, reach out to your midwife, IBCLC or MCHN for support.
- If your baby’s bowel motions and wet nappies have suddenly changed from what you consider to be normal for them, don’t hesitate to reach out and seek help. You know your baby best so follow your instincts. If you feel something is not quite right, always ask.
A Registered Midwife; IBCLC; MCHN; Australian Breastfeeding Association National Breastfeeding 24/7 Helpline – 1800 686 268; Nurse- On-Call 1300 606 024 are helpful and supportive resources.
Q/ How long should I breastfeed my baby?
For as long as you like.
The World Health Organisation’s supportive statement is:
WHO and UNICEF recommend:
- early initiation of breastfeeding within 1 hour of birth;
- exclusive breastfeeding for the first six months of life; and
- introduction of nutritionally-adequate and safe complementary (solid) foods at six months together with continued breastfeeding up to 2 years of age or beyond.
Breastmilk is all the food and drinks your baby needs for the first six months of age. There is no official time to wean for a breast/chestfeeding parent. It is personal or even a baby’s decision to wean from the breast/chest. Each family will be on the individual breastfeeding journey that feels right for them. However long you feed your baby, breastmilk is wonderful in every way!