This guide is an attempt to provide helpful tips to get breastfeeding off to a good start.   Many mothers give up during the first month of breastfeeding.  The mistakes made early on in breastfeeding are hard to correct later.  Hopefully, this guide will provide some insight into why the first fourty days are the most critical to establishing and maintaing a good milk supply.

The first fourty days after the birth of your baby are critical to establishing a plentiful milk supply for the first month and well into the first year of breastfeeding your baby.  For the past nine months, your body has been busily preparing for the arrival of your baby.  The hormones released during pregnancy prepared your breast by stimulating your milk producing glands.  When your baby is finally born, it is the separation of the placenta from the uterus that triggers the hormanal chain of events that cause your milk supply to increase by the third and fourth day.  During these early weeks your baby's breastfeeding will stimulate more breast growth and development.

Your baby's stomach at birth is only the size of a marble and can only hold about a couple of teaspoons to an ounce of milk.  The colostrum that your baby will receive immediatly after birth serves many purposes, but most importantly, it serves as a laxative to help remove the meconium that is inside your baby's intestines at birth.  Meconium when passed looks like tar and is very dark, or black in color.  If breastfeeding is going well, days 1 - 3 you will see the dark tar in your baby's stool, by day four you should notice your baby's stool are changing from the dark tar, to green.  Towards the end of the first week, stools should look tan or yellow.  The consistency will be very watery and may look like seedy.   This color stool is evident of your baby nursing well and getting the hindmilk during each feeding.  On a happy note: breastfed babies stools dont stink!  This is because your baby's digestive system is equipped to handle the nutrient rich, low fat, low protein make-up of your breastmilk. 

During these first fourty days, baby knows best!  It is very important to let your baby develop his or her own feeding rhythm.  You should not feel the need to try and put your baby on a feeding schedule during this time.  Frequent feedings - every hour or even every 30 minutes is NORMAL.  I cannot stress this point enough.  This is normal for your baby.  His/her stomach is too small to hold large feedings.  As your baby grows, and his/her stomach stretches to accommodate more milk, they will be able to go longer between feedings.   These frequent feedings known as "CLUSTER FEEDINGS" usually don't last long, but are helpful in establishing that delicate cycle of supply and demand.

Early supplementation can wreck havoc on your body trying to establish your milk supply.  Each time you supplement a feeding with formula (no matter how small), you are sending the message to your breast to not make milk.  You should commit the first fourty days to EXCLUSIVELY breastfeeding your baby.  This will give you and your baby plenty of time to practice the art of breastfeeding while getting to know each other finding out which latching on techniques work best.

On average, you should expect for your newborn to breastfeed eight to twelve times per day.  However, these times do not need to be spaced out over a specific time span. i.e - every 2 - 3 hours.  Remember, BABY KNOWS BEST!  Let you baby dictate when it's time to feed and how long to nurse.  Ideally, babies will tend to nurse for a total of twenty to fourty minutes.  The best rule of thumb is to allow your baby to nurse one breast until they decide they are finish.   Switch nursing, defined as offering one breast for ten to twenty minutes, then "switching" to the other breast for a second ten to twenty minute feeding session was the holy grail of information years ago, but now it's known that there are several stages of milk produced during a single feeding.

When your baby is latched on, and nursing, your body releases the hormone oxytocin.  This hormone stimulates the milk ducts to contract and push the milk down towards the nipple.  The first milk that your baby receives is called the "foremilk."  This milk (usually seen at the onset of milk-flow when a breast pump is introduced - pictured is the Ameda Elite Hospital-Grade breast pump)  serves to quench your baby's thirst.  However, this milk lacks the necessary fat to allow your baby to go longer between feedings.  As your baby continues to nurse (same breast) the FAT which is stuck to the walls of the milk ducts is pushed out and at about 5 - 10 minutes the milk starts to change from the initial foremilk to a milk that now looks cloudy. 

To give you a better visual since you can't see it for yourself, the foremilk would be considered (SKIM MILK or FAT FREE MILK), the second milk would look like (1% or 2% MILK), however, as your baby is allowed to continue nursing (the same breast) usually within 20 - 40 minutes the fat content continues to rise and the milk will begin to look like (WHOLE MILK).  Wholla!  This is your GOAL.  Getting your baby to nurse at the breast until the whole milk/fattier milk is released from the milk ducts is the key.  Once your baby's stomach has been filled with this higher fat content milk, they will tend to fall alseep, or come off the breast on their own.  They will usually have that very satisfied and content look (actually - no pun intended, they actually look drunk) and they are - drunk on the fat of your breastmilk.

Now, if it's during normal waking times during the day, it's not advised to do this at night since night time should be as unobtrusive as possible, you should change your baby's diaper.  This will usually wake them up and they will be alert.  If so, offer the other breast and start the process again.  If they refuse, then they are content (for now).  Remember to offer the other breast at the next feeding.  If you are fortunate to have a breast pump on hand, then expressing or pumping milk from the breast not taken is quite helpful in that it will stimulate the breast to make more milk.

Research indicates that on average, babies take about 75% of the milk in the breast during a single feeding.  This would mean that 25% of the milk is left in the breast after a feeding.   If you are trying to increase your milk supply, keep in mind that full breasts make milk more slowly over time.  The breast should be frequently emptied since in this case, LESS is equal to MORE!  The less milk in the breast at the end of a feeding, the FASTER the breasts will make milk for the next feeding.

During the first week or two after birth, it will be important for you to note the # of dirty diapers and the # of feedings per day or 24 hour cycle.  These two events are significant in letting you know that everything is going well.  Keeping a simple written log works best.  What's recommeded is a blank piece of paper with a line drawn down the middle.   Decide when you want to start your 24-hour day.  Anytime of the day is fine, but usually most mom's start with their first feeding in the morning.  Mark one column # of times breastfed, and mark the other column # of stools.  Make a tally mark for every breastfeeding with at least 10 minutes of nutritive suckling.  Make a tally mark for every stool about the size of a quarter (after the stool turns greenish or tan/yellow).  Count your totals at the end of EACH 24 hour period.

The number of breastfeefings should be at least 8 or more, and the number of stools should be at least 3 or 4.  If your baby is not feeding at least 8 to 10 times per day, and sleeping longer stretches during the day, you may need to wake your baby more frequently for feedings.  First make sure your baby is not too warm.  Note: if you are hot, then your baby generally is hot also.  Dress your baby in the same weight clothing that you would wear, and something even lighter when breastfeeding.  Skin to skin contact promotes breastfeeding and can calm your baby when he/she is upset.  I've also found that a cool damp cloth dabbed across your baby will tend to keep them awake and alert for successful feedings.

Try to limit your use of a pacifier during the first fourty days of breastfeeding.  Pacifiers send mixed signals to your baby.  More often than not, pacifiers are used to delay a feeding, but remember as mentioned earlier, YOUR BABY KNOWS BEST!  Don't interrupt the natural rhythm of your baby's feeding cues by offering a pacifier during the first 5-6 weeks.  After you have established your milk supply, feel free to introduce a pacifier at that time.

Be sure to SLEEP when your BABY SLEEPS!  Getting rest is beneficial in establishing your milk supply early.  This is not the time for you to worry about whose going to do the laundry, go grocery shopping, clean the house, or fix dinner.  As you pamper your baby, make sure that someone is pampering you as well.  Be sure to let family and friends know that the best help they can give you is to let you bond with your baby during these first fourty days.

Eat a balanced, and healthy diet.  Everything you eat is acceptable, as long as it's in MODERATION!  Many will tell you to increase your fluid intake while breastfeeding, but drinking more fluids than your body needs can actually DECREASE your milk supply.  The best rule of thumb is to drink when you are thirsty.  More than that is not necessary. 

Frequent and consistent breastfeeding sessions (NO SUPPLEMENTATION) over the next fourty days is going to be the key to successfully nursing your baby for the first year.  Once you have established a full milk supply (25 - 35 ounce per day) after the first month, the number of times you will need to breastfeed or drain the breast will vary.  The ultimate goal is to breastfeed as many times per day as your baby wants to, remembering NOT to introduce any supplements that would upset the delicate balance of your supply.

Congratulations and GOOD LUCK! 

I hope this guide was helpful to you.  If so, please let me know by submitting your rating.  If you are interested in learning more about what Maternal Expressions NC offers, please visit us at http://stores.ebay.com/Maternal-Expressions-NC