Breastfeeding can be a miraculous thing.
“It’s one of the times when I think a woman starts to [think], ‘Dag, it feels so good to be a woman. I am so powerful! I have all these capabilities that I didn’t even know,’” says lactation educator counselor and doula Anjelica Malone.
But it can also be the source of many WTF moments. For moms who want to breastfeed their children, knowing what to expect before the baby arrives can help reduce some of the fear and anxiety around the whole process.
mater mea founder Anthonia Akitunde asked Anjelica to explain what the first few days of breastfeeding actually looks like for moms and babies, and she spared no details.
As soon as you give birth and the placenta comes out of the body, your body is going to begin to release colostrum.
[Editor’s note: Colostrum is the golden-hued first milk moms produce. It’s packed with antibodies to protect newborns from disease, and also helps babies make their first bowel movements.]
Colostrum is amazing! If you don’t breastfeed except for a couple of days, those first couple of days are the best. They lay the foundation of the baby’s gut that allows them to be less likely to have allergies later on in life. It actually protects them. So even if you only breastfeed one or two days, that’s amazing.
Day one, day two, day three, it’s colostrum.
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[For] some moms, it takes a little bit longer for their mature milk to come in, especially if they had medications throughout their labor; if they had a very, very long labor; or if they had a C-section birth.
With lots of medication, it can take longer for your mature milk to come in—up to five days. In that situation, it’s even more important to have a lactation professional that you’re working with one-on-one so they can make sure that the baby is getting on your breast often enough to stimulate that mature milk.
Getting to Know Your New Body and New Baby
Once you get home from the hospital and you start seeing engorgement is when that mature milk starts comes in. Literally you’ll wake up one morning and you’ll feel like you had breast implants. [Laughs] They get much bigger, there’s inflammation, there’s a little bit of swelling. And it’s just your body pretty much [saying], Oh man, there’s a baby here? We need to get all the milk we can to this baby. And it doesn’t know how much your baby eats yet, so it provides more than enough milk.
It’s really important to have a doula, because a doula will let you know all this stuff. Doulas don’t always have a huge in-depth knowledge of breastfeeding, but they have enough that they can give you really good advice to help you out.
If you had a rough labor, they’re going to be able to say, “You know what? You might be expecting this to happen during this day, so we want to get on breastfeeding like this. We want to call someone in to help with this.”
[Between] day two…and day five, the mature milk will begin coming in. Before that, feeding the baby exclusively at the breast [with] colostrum is perfectly fine. They do not need any supplementation, they do not need formula unless they have some kind of medical condition.
The most important thing is getting the baby to latch onto your breast.
That’s something you’ll hear from the pediatrician, [supplement with formula]. But if your baby is born healthy [and] you’re healthy, there’s no reason to supplement those first few days. All you need to do is put the baby to the breast and allow the baby to get the milk. That colostrum is so little in volume, you can not really pump it out. If you try and pump it out, you’re going to get very discouraged because you’re not going to really get anything, and you’re going to waste that really important milk that the baby’s supposed to get.
The baby’s belly when it’s born is like the size of a shooter marble. It’s super, super tiny. It’s meant to only get little bits of milk. So if you’re trying to pump it, if you even get anything and try to pour it into the baby’s mouth, it’s too much. So put the baby at the breast [and] offer both breasts.
Day five, the engorgement is starting to set in, the breasts are producing an overabundance of milk. Now it can actually be difficult to get the baby to latch on because there’s a lot of swelling and inflammation. The breast can become kind of hard and taut, and when we try to latch the baby on, it’s hard to get the nipple and the areola tissue to compress down enough to get the baby’s mouth on there.
That’s why it’s really important to have a lactation professional come in, or a really skilled doula, to show you how to get that milk back and out a little bit to allow you to compress the breast and help the baby get on. That’s probably the second area where women begin to really struggle. If they’ve already struggled in the hospital because they weren’t able to get the baby to latch and they’re having pain and cracked and bleeding nipples, now they have the engorgement set in, now it’s double whammy.
Even if you get over the hurdles of those first two or three days, if you get to the engorgement stage and you don’t have anyone there to help you relieve some of the pressure around the areola and [help] get the baby on, it could really become difficult. That’s usually when women begin to pump, because they think, I have all this milk, I need to pump it out and feed it to the baby in a bottle.
Well, if you do that, what you’re doing is your body is not able to learn how much milk the baby actually needs. Pumps are very strong or aggressive, and so you’re pulling out way more milk than you need to. Your body is going to continue to make an overabundance of milk, so your breasts are going to be leaking for weeks and weeks, even months sometimes if you’re pumping. Women think, Oh, I’m getting it out of my breast, it must be better! But no, you’re actually prolonging that engorgement, that pain, and that oversupply of milk. And it adds so much stress.
The thing is we’ve been sold this idea by companies and brands that pumps are needed day one. And of course you want the best, top of the line, double electric pump day one, right? So then women assume, I need to use it. You even have women bring them to the hospital, which is a huge no-no.
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The most important thing is getting the baby to latch onto your breast. [Using] small hand expressions during that first engorgement phase, using a hot or warm rag on your breast can help the milk to flow a little bit easier.
Like I said, they’re very taut and hard and so it’s a little hard for the milk to come out. But you can put a warm compress on or you can step into a hot shower on your chest and just kind of squeeze, and the milk will begin to flow out, just a little bit at a time. That allows your breast to soften just enough so you can get the baby on there, but it hasn’t pulled out so much milk that your body’s thinking, Oh, we need to make a lot more, and keeps you engorged. Once you get the baby latched on, allow the baby to feed as long as they can on that side.
Now the next thing that mamas tell me is the baby is super sleepy, which is very normal. Literally, you put the baby on, they start drinking milk, and they go right into a coma. And that’s normal. But it’s very important for the first 10-14 days of life to aggressively try and keep the baby awake at the breast.
Now the reason why I say 10-14 days is because that’s the time period that pediatricians are looking for babies to regain their birth weight. Typically babies will lose 7-10% of their birth weight around, or up to, day 4-5 after birth. That’s normal. They’re pooping out meconium, they’re losing fluids—if you had a lot of IV fluids, that can contribute to the baby coming out extra plump. They begin to lose all that extra water weight, and they drop birth weight.
Using a hot or warm rag on your breast can help the milk to flow a little bit easier.
But by day 10-14, the pediatrician wants to see that the baby is back up to their birth weight. If you have not been feeding normally, if you’ve been struggling with breastfeeding, [if] the baby’s been falling asleep and you haven’t been waking them up to feed, or [if] you haven’t been offering both breasts, they will not be back at their birth weight at day 10-14. And many times for women of color you’re going to get a little extra pressure. They’re going to say, “Oh, she doesn’t know what she’s doing, she’s not working with a lactation professional. Just formula feed, mama.”
If you don’t have someone there to help you or give you advice, what are you going to do? You’re going to think, Oh, I’m horrible, I’m failing, so you get formula. Oh man, they’re telling me my baby is starving, they’re not at their birth weight. Women really begin to doubt themselves. I’m looking down at my breast and I see there’s lots of milk, but obviously I’m not capable of feeding my baby because they’re not at their birth weight.
That’s another reason why it’s very important to get a lactation professional as soon as you can because they will be able to let you know, “This is what you do to get the baby latched on. I can see the baby’s transferring milk.”
For the first seven days of the baby’s life, you should have an equivalent amount of pee and poop. So if your baby is two days [old], you should see about two pees and two poops. By the time [the baby] is five days old, you may be seeing about five pees, five poops a day. It may be slightly less, slightly more, but that’s about right.
That’s another thing you have to be looking at. This does seem like a lot, [but] because I know the first week or two after birth is the most important, I provide a little log at the back of the book [Milk Boss 101: The Modern Breastfeeding Journal & Guide].
I typically tell women not to use logs or apps because it can really stress a mama out. But it is good to have an idea or a place where you can look back on. And the good thing about putting paper to pen is that it’s a moment to actually be away from social media. It’s a moment to be away from these forums that are telling you everything about breastfeeding. It’s a moment that you can just take away from all that. You can take a little moment and think, Ok, we’ve done three pees today, two poops today, so we should see two more poops or two more pees, or whatever it may be.
Also remember to offer both breasts. If you are feeding regularly and your baby is able to feed exclusively at the breast—which allows them to tell your body how much milk you need exactly—your body will accommodate and that one breast will do all the business and feed your baby.
If you do that [though], you’re going to end up with one very large breast and one very small breast that is not producing a lot of milk. So it’s very important that you offer both breasts. [However], if you only have one breast to feed your baby on, you could survive on feeding your baby on one breast.
[So back to baby’s falling asleep at the breast]. Run your fingers—kind of with your nails—to stimulate their nervous system, down their spine, on the back of their head where their head meets their spine, and then down the bottom of their feet. All of that will stimulate the baby to stay awake.
That really should be something that poppa is doing, grandma is doing, sister-in-law is doing, because there’s not really room for you to do that at the same time you’re holding your breast and holding your baby and trying to relax and lean back. So it’s a two-person job. Breastfeeding is a two-person job minimum in the beginning.
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If I walk into a mama’s house for consultation and she’s standing up with a baby in one arm and a blanket draped over her and she answers the door, I know breastfeeding is not going well.
[For single moms], call your girlfriend who you go work out with. There are a lot of women who are waiting later and later in age to have children, but they are still very interested in supporting their girlfriends who [are] having a child. They just don’t know how. They think, You have a child now, you don’t want anything to do with me because I don’t know what to do. I don’t have any knowledge of what you’re going through.
But this is the opportunity to pull that girlfriend in and say, “I really can use your help. You really do have a role to play. I really could use your help and your support. Our friendship could actually be strengthened during this time, instead of creating a wedge.”
Whoever that travel buddy is, whoever that friend is you go to yoga with, whoever it may be—there is someone there who can help you. You just need to let them know, “I would really love to have you around during this time.”