Last week, while I was doing clinical observations in the maternity ward, I met Rashmi (age 27). She was a mother who had given birth to her first child two days earlier. She was holding her baby and crying.
"Doctor Priya, my milk hasn't come in yet. The baby is crying because he's hungry. I'm afraid the baby won't get enough milk and will get sick. Should I give him formula?" Rashmi asked me, scared and nervous.
I sat next to her, calmed her down, and explained: "Rashmi, don't worry at all. In the first 2-3 days after delivery, only a very small amount of milk is secreted from the breasts. This is called colostrum (the golden first milk) . The baby's stomach is the size of a very small marble at this time. Therefore, the amount of colostrum that you get from your body, a few teaspoons, is completely enough to fill the baby's stomach and develop immunity. Establishing breastfeeding is a process that needs to be done successfully with patience and following the right methods. Today, let's see how to successfully start breastfeeding in the first days after the baby is born."
🚨 Red Flags that require immediate medical attention
If the following danger signs appear in the early days of breastfeeding, you should see a doctor or midwife immediately:
- The baby is very sleepy, making it difficult to wake him up, and shows no interest in drinking milk (this may be a sign of low blood sugar or dehydration).
- The baby has not passed a wet diaper or stool for 3 days after birth (Day 3 Red Flag).
- Yellowing of the baby's skin and eyes (Jaundice - a rapid spread of symptoms of jaundice in infants).
- The mother has a high fever, chills, and severe pain in the breast, along with a red spot (signs of mastitis infection).
Key steps to successfully initiating breastfeeding
Follow these steps to properly stimulate breast milk supply as soon as your baby is born:
1. Early Initiation: Try to put the baby to the breast within the first hour after birth. This stimulates the hormones prolactin and oxytocin in the mother's body and accelerates milk production.
2. Skin-to-Skin Contact: Holding the baby naked on the mother's exposed chest (Skin-to-skin) stimulates the baby's natural desire to suckle, and also stabilizes the baby's body temperature and heart rate.
3. Responsive Feeding: Instead of feeding at a specific time based on the clock, feed whenever your baby shows signs of wanting to feed (teething, mouth opening, crying). Usually, 8 to 12 feedings are needed in a 24-hour period.
4. Correct connection (Latch-on / Attachment):Proper attachment of the baby to the breast is essential to prevent nipple soreness and ensure good milk flow.
Comparing Colostrum and Mature Milk
| Characteristic | Colostrum (first milk) | Mature Milk |
|---|---|---|
| Production time | The first 1-3 days after childbirth. | 4-5 days after delivery. |
| Appearance | Thick, golden yellow. | Thin, whitish or bluish. |
| Size | A very small amount (a few teaspoons). | A large amount (as if the breasts were overflowing). |
| Nutritional value | Rich in antibodies and proteins (like a child's first vaccine). | Rich in water, fat, and carbohydrates (to help gain weight and quench thirst). |
Do's & Don'ts
| ✔️ Things to do (Do) | ❌ Don'ts |
|---|---|
| Make sure the baby opens his mouth wide and takes most of the dark area around the nipple (areola) into his mouth. | Don't rush to give formula or pacifiers/teats as soon as your baby cries, thinking that there is not enough milk. |
| Before feeding the baby, the mother should sit comfortably, with pillows behind her back for support. | Do not limit breastfeeding to just 10 minutes; let the baby suckle until he or she releases the breast on his or her own. |
| Even if the baby is sleeping, try to wake him up at least every 3 hours in the first few weeks to breastfeed. | If you feel pain, don't endure it; if it's not connected properly, insert a finger, release the connection, and reconnect. |
❓ Some other problems you may encounter (FAQ)
If you can't see any milk when you express it in the first two days, is there no milk? ▼
No. The colostrum produced in the first few days is very thick and very small in quantity. It may not be visible just by squeezing the breast. However, if the baby is positioned correctly and encouraged to suck, the baby will be able to suck the required amount.
How do you know if your baby is getting enough milk? ▼
If the baby sleeps soundly after feeding, urinates more than 6 times a day and is pale yellow, and the baby's weight gradually increases within 2 weeks, it is clear that the baby is getting enough milk.
How to prevent sore nipples? ▼
The main cause of sore nipples is poor latch. The baby should take not only the nipple but also the dark area around it into his mouth. After feeding, putting a drop of milk on the nipple and letting it dry can also help heal the sores.
Is it difficult to breastfeed after a cesarean section (C-Section)? ▼
No. It may be difficult to hold the baby due to pain after surgery, but breastfeeding can be successfully achieved by lying on your side (side-lying position) or by holding the baby on your stomach (football hold) with a pillow.
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