The initial intense excitement of delivery wanes and reality begins to set in. Time to start taking care of the tiny human you just delivered. You already decided during pregnancy that you want to breastfeed your baby, so you’ve already told your labor and delivery nurse when you were admitted to an L&D room at the hospital. Perfect! The best time to let your desires known for labor and delivery care by your medical team is when your care first begins at the hospital.
Subsequently provided you or baby do not have any complications that require immediate medical attention, your nurse helps to place baby skin to skin at your breast within the first hour after delivery. Enjoy this special time bonding with baby! Often called “The Magical Hour” or “The Golden Hour,” observe and take delight in seeing your baby go through nine innate and instinctive stages.
Both you and your birth partner should check out and read Dr. Ann-Marie Widstrom’s research of “The Nine Instinctive Stages of the Newborn After Birth,” and Dr. Kajsa Brimdyr’s “The Magical Hour.”
The video “The Magical Hour: Holding Your Baby Skin to Skin in the First Hour After Birth” produced by Dr. Brimdyr, Dr. Widstrom, and Kristin Svensson is a good resource as well: https://amzn.to/4eonKrT
(DISCLAIMER: As an Amazon Affiliate/Associate, I earn from qualifying purchases.)
While skin to skin, the nine instinctive stages after birth generally occurs within 1.5 to 2 hours after delivery, but the process may take longer. Holding baby skin to skin as long as possible after birth and through the postpartum period at the hospital is essential to establish breastfeeding for mother and baby. But holding baby skin to skin even beyond the hospital stay, at home in the first 4-6 weeks continues to enhance breastfeeding and help baby transition from life in-utero to the outside world. Moreover, even Dad or another family member may hold baby skin to skin.
Baby will hopefully latch onto the breast during this skin to skin time after delivery, but if baby is too sleepy or just won’t latch, hand express colostrum to your nipple. Either put the colostrum directly on baby’s lips which may entice baby to latch, or collect your colostrum in a baby feeding cup or via a colostrum collector kit and feed the colostrum to baby. Baby is able to drink from a tiny cup, by placing the cup on baby’s lower lip with open mouth, and tipping the cup slightly so baby can taste and lick with his tongue the colostrum from the cup.
For collection and feeding of colostrum, check out Maymom Baby Feeding Cup, 1oz.: https://amzn.to/3z0b2zr
An alternative to look into for collection and feeding of colostrum is a Haakaa Colostrum Collector Kit, 4ml: https://amzn.to/4eko9f9
(DISCLAIMER: As an Amazon Affiliate/Associate, I earn from qualifying purchases.)
Frequent breastfeeding and hand expression from birth forward is key to practice for you and baby, and to establishing your milk supply. Baby may not cooperate with your initial breastfeeding plans, so be flexible, and just follow baby’s lead. Breastfeed on demand, whenever baby is showing hunger cues. Allow baby to nurse as long as he wants and to get a full feeding. Do breast compressions periodically throughout the feeding to keep baby suckling, especially when baby stops or falls asleep. The more baby nurses and the breast drains of milk, the more milk your body will produce to feed your baby. Hand express if baby doesn’t want to nurse and it’s been 3-4 hours from last breastfeeding. Also if baby has difficulties latching at the start, hand expression is recommended to obtain the colostrum and feed your baby. Massage your breasts beforehand to stimulate milk let-down. In the first few days after delivery, you will only be obtaining small amounts of colostrum. Feed the expressed colostrum to baby immediately after collection. Remember the small amounts of colostrum, 8-12 times per 24 hours, is all baby needs to fill his small stomach, which is the size of a cherry, in the first few days after birth.
If baby is breastfeeding on cue or demand, 8-12 times per 24 hours, at least 15 minutes and as long as baby desires, and having 6-8 voids and up to 3 stools per day (from day 5-7 of life onward), then you are off to a good start! If on the other hand, baby does not breastfeed consistently, and seems uninterested in nursing, then pumping is highly recommended. Hand expression to entice baby to latch is still encouraged, but additional stimulation through pumping is needed to help boost your milk production. The earlier pumping begins, the better for stimulation and milk production, especially if baby is not providing the stimulation needed. A hospital-grade double electric pump is best to stimulate the breasts. Pump both breasts at the same time (double pump) for 15 minutes. While pumping, do breast compressions periodically to help drain all areas of the breast, and to induce release of fat into the milk. The breasts never empty, so if baby shows hunger cues while pumping or afterward, stop pumping, and put your baby to breast. If possible though, have a rest between breastfeeding or pumping: a 1.5 hour break between sessions is encouraged to boost milk production.
In addition to the doctors and nurses assisting breastfeeding mothers after delivery, most hospitals also have a lactation consultant (IBCLC) available during your postpartum stay. Any lactation support as you start your breastfeeding journey is invaluable! If you didn’t have an opportunity to take a prenatal breastfeeding class, the hospital lactation consultant is there to teach you about breastfeeding and to address your concerns. Ask a lot of questions and get the help you may need to succeed in your breastfeeding goals. Remember knowledge is power: when you know more about breastfeeding, you will feel empowered to reach your goals!
Periodic visits with a lactation consultant after going home from the hospital is highly recommended. The first days and weeks of breastfeeding are critical for establishing a healthy milk supply, so having lactation support from the start, can make a significant difference. Having a lactation consultant is encouraged early on, to check baby’s latch, do a weigh and feed assessment to check baby’s transfer of milk, and especially to get help, if you’re having breastfeeding problems. Often breastfeeding issues may be resolved using lactation tools/aids on the market, after you receive recommendations during a visit with a lactation consultant. An IBCLC has a wealth of knowledge to share and encouragement to cheer you on!
The Affordable Care Act requires most insurance policies to cover the cost of prenatal and postnatal lactation support, counseling, and the cost or rental of a breast pump for the duration of breastfeeding. Additionally the Affordable Care Act requires many employers to provide break time for breastfeeding women and a private space that is not a bathroom for nursing or pumping.
Check your insurance policy for coverage of breastfeeding counseling, and schedule an initial visit to a lactation consultant (IBCLC) within 1-2 weeks after you and baby are discharged from the hospital, or sooner if you are having breastfeeding difficulties. Depending on your insurance policy, you may be allowed one to six lactation consultant visits. Schedule an appointment as soon as possible, especially if you are having problems.
For help, contact The Lactation Network, a national company who works to verify insurance benefits and connect families with International Board-Certified Lactation Consultants (IBCLC) across the United States. To verify insurance coverage: https://go.lactationnetwork.com/MommaAndBabeLactationConsulting
It cannot be overstated how assistance and support from beginning to end of your breastfeeding journey makes for a good, successful experience more often, than not. So in addition to lactation consultant support, one last recommendation is to consider joining your peers in a breastfeeding support group like La Leche League, Breastfeeding Cafe, or your local community breastfeeding or mothers’ group. You’ll be glad you did!