Read it through now, and have it handy to refer back to once baby arrives.

Breastfeed early

Attempt to put your baby to breast as soon after birth as possible - preferably within the first hour. Early breastfeedings give baby the chance to practice breastfeeding before he enters a normal newborn state of sleepiness that can last for hours or days and before your breast becomes overfull with milk, perhaps making latch-on more difficult. This early nursing also helps your uterus contract to help prevent postpartum hemorrhage.

Room in with baby

Keep your baby in your room, and only send him back to the nursery if you should need to shower or leave your room. Keeping baby close allows you to observe him for early cues that he is ready to feed; ie. stirring in crib, bringing hands to mouth, rooting, etc. Crying is a LATE hunger cue. If your baby is in the nursery, he may not be brought to you when those first hunger cues are noticed. Having baby with you lets you begin to recognize these cues before you go home.

Feed frequently in the early days and weeks

Plan to feed at least every 2-3 hours during the day and at least once at night, or 8-12 times in a 24 hour period, during the early days and weeks. Do this even if you have to wake your baby to feed. This ensures that your milk supply becomes well-established and that your baby receives the fluids and nourishment that he needs. If your baby is unable to nurse within the first 4-6 hours after birth or does not nurse well during the early days or weeks, use a hospital-grade pump to help stimulate your supply.

Allow unlimited time at the breast during a feeding

Allow your baby to nurse the first breast for as long as he wants, or until he goes to sleep or pulls off himself. Then offer the other breast in the same way. Nursing in this way ensures that your baby receives the right balance of milk. Interrupting your baby's active nursing to switch sides may prevent him from reaching the richer, creamier, and more caloric hindmilk that is only available as the feeding progresses.

Avoid supplemental bottles during the first 4-6 weeks

Most of the time supplements of formula are not needed and may only serve to undermine the milk supply. Each time a supplement is offered, that means less time at the breast, and fewer signals to the brain to produce milk. Offering your baby a bottle nipple early on may also confuse him as bottle-feeding is entirely different than breastfeeding and requires less work of the baby. Before babies learn to breastfeed well, they are more likely to choose the easier method of feeding which may mean that they reject the breast. If supplements are medically indicated, choose an alternative feeding device other than the bottle if possible, such as a feeding syringe, nursing supplementer, feeding cup, or spoon, and use your own milk whenever possible to prevent the risk of allergic reactions caused by formula.

Know how to recognize a correct latch and position

Learn how to recognize the signs that your baby is latched-on to your breast well. Being able to observe these will help you detect and perhaps prevent any problems early on. Be familiar with how the baby's mouth should look (lips flanged, wide open mouth), and where the tongue should be (down and cupping the breast) as well as how close the baby should be positioned (chin and nose touching breast and body pulled in close to mom's).

Know what a nutritive suck looks like

It*s important to know that your baby is nutritively sucking, or nursing in a way that ensures he receives the most milk possible. A nutritive suck is characterized by a long and drawing rhythmic motion along the jawline and a wiggle at the temple or ear, and should be accompanied with swallowing. It is the opposite of a short and choppy, pacifier-like, or non-nutritive, suck.

Know how to assess your baby for adequate intake

Keep a log during the first week or so of your baby's wet and dirty diapers. Each time you change a diaper, note it on the log. This will give you a daily look at your baby's breastmilk intake and alert you to possible problems early on. Your baby should gradually increase his wet diapers during the first week to a total of 6-8 by day seven. His urine should be pale in color and mild-smelling. A good "rule"is one wet diaper for every day of life that first week. Your baby should stool at least once every day the first few days after birth, and during the first week the stool should begin to lighten in color and become thinner in consistency. By the end of the first week, your baby should be stooling at least 2-5 times each day and the stool should be loose in consistency and yellow in color.

Have your baby weighed within one week of birth

This is just another check to ensure that breastfeeding is going well. If a weight check is taken early on, any problems can quickly be addressed and measures taken to improve breastfeeding management.

Seek help early on for any problems that may arise

Get help at the first sign of a latch-on difficulty, sore nipples, engorgement, or slow weight gain in your baby. Most of the time, problems have solutions, but this is far more likely if the right help is sought in a timely manner.

Written by Becky Flora, BSed, IBCLC

Last revision: January 23, 2000