Breastfeeeding 101: How Is My Body Even Doing This?

For some mothers, breastfeeding will be the most natural thing they’ve ever done. For others, it can be a wild and uncertain ride. We consulted withtalked to Sarah Moore, a certified lactation educator and counselor, and Dr. Kelsey Kossl, a board- certified OB/GYNob-gyn in New York, to answer those yourthose questions—and prepare you for this journey.

  1. Before Birth
    1. MILK: Fourteen weeks into your pregnancy, your body begins to produce colostrum, the first phase of breast milk. 

      BREAST: The best way to prepare your nipples is with nipple balm increases elasticity and helps prevent pain. If you’ve heard that scrubbing your nipples will toughen them up, stop right there. Scrubbing your nipples is not only painful, it can cause abrasions, even infections. Don’t do it.  

      FEEDING: Have an insurance letter prepared and ready to be signed in the hospital so you send it out for a breast pump reimbursement. [LINK TO SAMPLE LETTER]

  2. Immediately After Birth
    1. MILK:  There is already enough colostrum in your milk ducts to nourish your baby for the first few days after birth. After childbirth, two hormones—prolactin and oxytocin—signal your body to begin producing more breast milk.

      BREAST: The goal is to put the newborn directly on the breast as soon as possible in the first hour to start the skin-to-skin contact. “This is an ideal and something that we should try to do, but you shouldn’t be upset if doesn’t happen for various reasons, whether the baby needs medical attention or you do,” says Dr. Kossl.

      FEEDING: Communicate your breastfeeding feeding plan with your support team (your partner, doula, or midwife) and providers, including the nursing team. But keep in mind that things don’t always go according to plan. What happens in the first day or two after birth doesn’t dictate your feeding journey for the year (or years) to come.

  3. First 24 Hours
    1. MILK: The colostrum you are feeding the baby is thick, yellow in color, and has exactly the nutrients that your baby’s brain, eyes, and heart needs, hence the nickname “Liquid Gold.” Colostrum is rich is immune-boosting antibodies, promotes gut health by coating the stomach and intestines, encourages the release meconium (the black poop built up in the baby’s colon while in utero), and reduces jaundice. Colostrum is also low in fat, which is why your baby is likely to lose weight in the first few days after birth.

      BREAST: For a good latch, position the baby so that the chin is the first thing to touch your breast and making sure that the nipple goes all the way back to the soft palate in the baby’s mouth. This may not be possible right away for any number of reasons—but that doesn’t mean you won’t be able to breastfeed. A lactation consultant or nurse can show you how to stimulate your breast with manual expression or a pump.

      FEEDING: Plan to breast-feed every one and half to two hours or whenever your baby seems hungry, including overnight. During these first feedings—which ideally last between 20 and 30 minutes—the baby is getting about a tablespoon of colostrum. By feeding often you are also stimulating your body to create breastmilk and establishing your milk supply.

  4. Week 1 and 2 
    1. MILK: Around 3 to 5 days after birth, the composition of your breast milk begins to change. Transitional milk is a combination of colostrum and milk. It starts off yellow and creamy and gradually becomes thinner and whiter. 

      BREAST: Your breasts are filling up with milk. For some women, it can be uncomfortable, even painful. This is called engorgement. [LINK TO ENGORGEMENT/MASTITIS STORY]. You can use cold packs to ease swelling or safe pain medications, like Tylenol and Ibuprofen. But the best way to ease engorgement is to breastfeed through it (don’t pump). If you are feeling extreme pain, have a lactation consultant check your latch, teach you how to massage your breast to relieve symptoms, and teach you how to reduce swelling near the nipples to improve latching on to an engorged breast. Red flags to look out for include cracked or bleeding nipples [LINK TO NIPPLE STORY].

      FEEDING: Expect to feed every 2 to 3 hours, especially during the day. Twenty-five percent of women have to go back to work two weeks after giving birth [LINK]. If you are among them, lactation experts suggest that you pump for a few minutes after each feeding to begin to build a stockpile of frozen breastmilk.

  5. Week 3
    1. MILK: Your breast milk has transitioned into mature milk, and fully come in. Although mature milk is high in fat, sugar, and calories, it may look thin and similar to skim milk. Breast milk is digested every one and half to two hours, so babies who breastfeed need to eat more often than babies who are formula fed.

      BREAST:  If you are still experiencing uncomfortable engorgement (this may happen if the baby is sleeping through feedings or cluster feedings), you can use warm compresses to stimulate letdown before breastfeeding or pumping or relieve the pressure with hand expressions in the shower. 

      FEEDING: The more you breastfeed, the more milk your body will make. A baby that is 1 month old takes about 2 to 3 ounces of breast milk at each feeding. It’s impossible to measure exactly how much milk your baby consumes when you are breastfeeding, but you will know that your baby is getting enough breastmilk if they are nursing frequently, producing dirty diapers, and gaining weight at each pediatrician appointment.

  6. Weeks 4 to 8
    1. MILK: Every feeding includes foremilk (the first milk to flow out of your breasts) followed by hindmilk. The hindmilk is richer in nutrients and higher in fat and calories, which helps the baby gain weight and grow, and also keeps the baby fuller longer allowing you to stretch out feedings. To make sure the baby is getting enough of hindmilk, allow the baby to completely empty one breast before switching to the other. 

      BREAST: Engorgement has likely eased as you and the baby are hitting your stride with regular feedings. Looks out for blocked ducts, which are painful and present as a red circle right at the spot of the infection, or a fever, which could be a sign of mastisis. [LINK].

      FEEDING: Statistics show that 85 percent of breastfeeding mothers use a pump at least some of the time. (Obviously, when to start varies by mother and baby.) If you want to build a storage of breast milk, lactation consultants suggest pumping for a few minutes at the end of every feeding.

  7. Months 3 to 6
    1. MILK: Proper nutrition can help you encourage and maintain a good milk supply. [LINKS]

      BREAST: Maintaining breast health is an integral part of the breastfeeding journey. Keep up with regular feedings, maintaining a proper latch, and use a balm to ensure your nipples well moisturized after every feeding. Many women experience early undesired cessation of breast feeding due to pain. Experts advise contacting their provider for an exam if pain persists.

      FEEDING: Some changes you may see in your baby’s feeding pattern: shorter feedings (10 minutes instead of 30 minutes) and fewer feedings a day. This is because your baby has become more efficient on the breast. As long as you continue to monitor weight gain and the amount of wet and dirty diapers, rest assured that this is all normal and your baby will not go hungry.