What You May Experience During Your 1st Week Of Breastfeeding

You may have heard that the first few weeks of breastfeeding are the hardest, and in most cases, that's true.

I've said it before and I'll say it again, breastfeeding isn't innate - you and your baby both have to learn how to do this!

What will your milk look like at first? When your milk comes in it is white, sometimes with a blue tint. It looks thin. If your milk is green, blue, or pink it may be due to certain vegetables, fruits, food dyes, or dietary supplements you've eaten or taken - its not harmful to the baby. If there is blood in your milk it is usually due to a bleeding nipple and it will not hurt the baby (unless there are large amounts, in which your baby may vomit). Consult your doctor.

You may experience the following:
Engorged Breasts: around 2 - 3 days after you deliver, your breasts will usually become engorged (swollen and uncomfortable). The blood flow in your breasts increases and your milk production starts. The swelling you experience can range from slightly full to very swollen, tender, throbbing an lumpy. You may feel the swelling all the way to your armpit. If your breasts become too engorged (mine did) your nipple may flatten out and make it hard for your baby to latch on. Engorgement will usually go down in a day or two.
Be sure to:

• Wear a good, supportive bra (but make sure it isn't too tight).
• Nurse your baby frequently (every one to three hours - you may have to wake your baby up).
• You may want to express a little milk so that your areola's soften and baby can latch on.
• Nurse at least 10 minutes or longer at each breast.
• Gently massage your breast while your baby is nursing. This will help your milk flow and will help to relieve some of the discomfort.
• Apply a cold pack (or chilled cabbage leaves) to your breasts after you nurse. Contrary to what you may have heard, heat may actually aggravate engorgement. You may use it briefly just to help soften your breasts, but keep heat sessions short.
• You can take Tylenol, Advil, or Motrin.
• After your milk comes in, within two days your engorgement should decrease. If it doesn't and you still find yourself feeling engorged after you nurse, you may need to pump out the remaining milk. Usually (in the first week) pumping (habitually) with nursing is discouraged because it can lead to further engorgement and overproduction. Try to limit your pumping after nursing to just once every 24 hours. If your baby isn't nursing well enough to soften your breast every few hours, you should pump because unrelieved engorgement causes milk production to stop.

If you don't plan on breastfeeding, know that your breasts will still fill with milk after delivery. You may experience engorgement. Milk will only produce if it is needed, so if you don't pump of nurse in these first few days, your production will stop. You may experience leaking in the first few days or weeks.
 
Late Onset of Milk Production: If your breasts aren't feeling heavier and fuller (large breasted women may not feel much different) within 72 hours after delivery, you may be experiencing late onset of milk production. Your baby will try to nurse, but get very little. They may have infrequent bowel movements, may seem either sleepy and content or hungry and dissatisfied, and they may lose more weight than normal. You may experience late onset if you were overhydrated with IV fluids during a long or induced labor or if you had a postpartum hemorrhage. You may need to supplement with formula until your milk comes in, but continue to nurse frequently.
You can do the following:

• Keep an eye on your baby's weight.
• If he/she has lost less than 10% of his/her birth weight, continue to nurse frequently (every one to three hours) and monitor your baby's weight daily.
• If your baby has lost 10% of more of his/her weight, use a pump after each nursing. Feed your baby the colostrum you collect and any necessary formula.
• When your milk comes in try to estimate your production and wean your baby off formula and pumped milk and resume breastfeeding.

Sore Nipples: This can be what deters a mother from continuing her breastfeeding efforts. You may feel tender during the first few days, at the beginning of breastfeeding, when the baby latches on. If they become really sore you may be experiencing damaged of irritated nipples which will require treatment. You should try to identify what is causing the sore nipples first. If you are unable to tolerate the pain, and changing positions doesn't help, consult a lactation professional. If you don't have anyone to talk to about it, you may want to stop nursing and pump for a 24 - 72 hours, or until your nipples heal. There are two types of sore nipples: traumatized nipples or irritated nipples.

Traumatized nipples may blister, scab, or crack. This usually happens due to improper positioning; the baby's gums are probably latching on the nipple and not the areola. You'll need to teach the baby how to open his/her mouth wide before latching.

Irritated nipples are very pink and often burn. This can be caused by dermatitis, thrush or yeast, eczema or impetigo.

Sometimes a mom will experience both (I did; no blisters, but very light scabbing, some cracking, pinkness, and the burning. It subsided though!!). See the following link for comfort measures and treatments for sore, traumatized, or irritated nipples: http://mommadoulamn.blogspot.com/2011/06/comfort-measures-and-treatments-for.html

Leaking Milk: You may experience dripping, leaking, or spraying (yes...spraying). This is all normal. Your milk has let-down. You may find that when you nurse on one side, your other side leaks. Leaking may occur unexpectedly as well. You may leak during your sleep, when you hear your baby make noise, when you think about nursing, or at any given moment. Warm-showers may stimulate this as well. Some moms may never experience this.

• Always have something to soak up the leaking while you're breastfeeding on one side (and leak from the other).
• Change nursing pads often and avoid those with plastic liners.
• Wear pads at night if you're leaking in your sleep. You may also want to sleep on a towel (there were so many times that I would actually soak a pad to extraordinary proportions - haha - and would wake up soaked...trust me, sleep on a towel if you're leaking at night). 

Let-Down Difficulty: If you're nursing regularly and often, this is a rare thing to encounter. For the first week you should nurse every two to three hours around the clock. Don't limit the time at the breast and make sure the baby is properly positioned. Let the baby drain the breast. Make sure you are nice and comfortable. I used a nursing pillow every single time. During the first week, when your milk lets down, you may feel some uterine cramping (when nursing), increased vaginal flow (when nursing), dripping, leaking, or spraying of milk (especially during nursing), occasional sensations in the breast during nursing (but you probably will not feel this during the first week), and some softening of the breast after nursing. You'll know your milk has come down when you hear the baby swallowing (every one or two sucks).
 
Difficult Latch-on: Flat, Dimpled, or Inverted Nipples
This can be very frustrating for both the mother and the baby. These types of nipples can have even more intense problems if you are engorged or just too full. Persistence and patience is the key. Mothers with nipple problems are more prone to soreness.

What you can try:

• Put your newborn baby to the breast within the first 2 hours after birth.
• Avoid artificial nipples.
• Roll your nipples between your fingers or apply ice just before the baby attempts to eat to help your nipples stand out.
• Make a flat nipple stand out by pinching it between your thumb and forefinger (this wont work with a dimpled or inverted nipple).
• Make a dimpled or inverted nipple stand out by placing your thumb bout 1 1/2 to 2 inches behind the nipple and placing your fingers beneath and pull back towards your chest.
• Try the cross-over or football hold; these work the best.
• Wear a breast shell for 30 minutes before nursing if your breasts are engorged.
• Pump just before nursing to pull the nipples out. 
• Express a little colostrum or milk on your nipple and rub the baby's lips - this could help entice him/her.
• Stop nursing if your baby is becoming frantic and calm him down.
• Try the side-lying position (this really worked for me).
• Begin bottle feedings 24 hours after birth if your baby has not latched on. Electric pumps are the best choice for collecting milk and improving nipple shape. Continue to try putting the baby to the breast. Pump at least 8 times a day and try to put the baby to the breast at least 3 or 4 times a day (on a soft breast when the baby isn't upset).
• Have a good support system. You'll need a lot of encouragement.

Fatigue and Depression:

• The best advice I was given when it came to being tired was "sleep when the baby sleeps" and I did.
• Turn off your phone when you're sleeping, as well.
• Be sure to eat and snack to keep your energy up.
• If you need help, ask for it.
• Don't keep your feelings to yourself.
• Visit http://mommadoulamn.blogspot.com/p/life-after-baby.html to read about depression after the baby.

(Some information gathered from The Nursing Mother's Companion 4th revised edition by Kathleen Huggins, R.N., M.S.)