What Really Happens in the First Week of Breastfeeding

Theresa Moutafis, MA RD CDCES IBCLC

In 2017, 84.1% of women in the US initiated breastfeeding after birth. This is amazing! But what happens after that first feed? What happens when you get home with this new adorable baby? Here are the must-knows for that first week of breastfeeding.

The First 12-24 Hours

If you and baby are healthy and alert (or as soon as you are), baby will be placed skin-to-skin and will likely complete their first feed within an hour or two. What you may not know is that your baby is actually following an incredible, instinctual process called the breast crawl. 

After this, you and baby will be VERY tired. Baby may be quite sleepy for the first 12-24 hours, but you should try nursing baby every couple of hours at least. Many moms think that they don’t have milk yet, but in reality colostrum, or your first milk, is produced in very small quantities, perfect for baby’s tiny belly. Colostrum is very thick and some women are only able to express colostrum using hand expression (the amount and the thickness can make it difficult to use a pump in this time!). Hand expression is exactly what it sounds like. Here is how to do it. 

You will know things are on the right track if baby has their first bowel movement within the first day. The first bowel movement or movements are pretty thick and tarry, but will transition over to yellow/seedy breast milk poop within a couple of days.

Days 2-3

This is typically when baby starts eating VERY frequently. This is a good thing! Although you may constantly hear that baby should eat “every 2 hours”, in reality babies are not little robots. They still have very small bellies and are growing and developing at a ridiculously rapid rate. Plus they were just thrust into this bright and scary new world. Of course they are going to want to be on the boob frequently! Definitely get all the help you can with latch at this point. If baby is struggling with feeding, you can hand express and feed via syringe, spoon, tube, etc.. Baby still has a tiny belly – she will only take a VERY small amount of milk (~1 oz) at each feed.

*A note about jaundice. Sometimes jaundice is an indicator of baby not getting enough milk, however it can also occasionally occur due to blood type incompatibilities with mom. Discuss with your health care team the best steps. Keep in mind that there is nothing magical about formula and that standard formula contains the same amount of calories as breast milk, so if you are able to express breast milk then that can be used as a supplement instead of formula.

Days 3-7

At this point, you are likely on your way home or home. Now what? Continue to do lots of skin-to-skin, nurse as frequently as baby wants and keep up with all pediatrician appointments. 

I want to emphasize that baby should be feeding frequently, and his patterns will be all over the place in the first week of breastfeeding. That is normal! This is a GREAT guide on baby behavior from California.

When you should seek help from your pediatrician or a lactation consultant

Do any of these things ring true? It’s better to ask for help sooner rather than later. You’ve got this!

  • Baby continuing to have meconium after the first couple of days
  • Less than 3 dirty diapers by Day 3 *Note that if baby is getting any formula, this can cause some constipation.
  • Less than 5 wet diapers by Day 5
  • An excessively sleepy baby (rarely wakes to feed)
  • Baby has a high-pitched cry and cannot be consoled
  • Your nipples are painful, sore, and/or cracked/blistered
  • Your mom instinct tells you something is wrong

Tips for the first week of breastfeeding (and beyond)

  • Do lots of skin-to-skin. 
  • Breast compressions can be helpful while you are feeding your baby. 
  • Learn your baby’s hunger cues, she’ll tell you when she wants to feed!
  • Remember that baby AND you are still learning, and this learning process will continue throughout the first few weeks. Be kind to yourself and appreciate your amazing body!!!
  • Need to talk to a lactation consultant? The experts at Fooblie are ready to help. Book a time today.