All your early breastfeeding questions, answered.

There is so much to learn when it comes to breastfeeding, and you're learning on the job so those questions can come fast! Plenty of new moms hear talk about how your "mature milk" hasn't "come in yet" and you need to supplement with formula. But here's the thing-- if your baby is healthy and full term and you haven't been diagnosed with anything that may hinder breastfeeding, you probably don't need to worry right away. I'm here to explain!

What's mature milk? And when do I worry it's not coming in?

In the first few days, your body will be making colostrum. This thick and sticky first milk is super nutrient dense and perfect for your baby and their teeny tiny stomach! Did you know a newborn's stomach is only the size of a marble? They'll probably only drink about an ounce over all their feedings in the first 24 hours, and that will be plenty!

The rest of your milk supply will start to come in gradually, and your babe will drink a little more with each feed. This Transitional Milk (colostrum with an increasing supply of mature milk) expands their stomach– by Day 10 it's the size of a ping pong ball! Around day 10-14 your milk will be fully mature.

Source: USDA WIC Breastfeeding Support

You'll know your supply is starting to mature because you'll probably start to feel engorged around day 3-5. Don't worry-- the engorgement won't last as your babe's stomach expands and they get more practiced at feedings. According to Motherhood Untamed Lactation on Instagram, if you haven't gotten a feeling of fullness/engorgement by day 5, it's time to call your doc and check in with your pediatrician. It may well come in on Day 6 and be fine, but nevertheless it's time to check in with your providers.

How long should each session last?

Newborn breastfeeding sessions can last up to 20 minutes on one or both breasts (it's recommended you switch sides halfway through). Some newborns are extra sleepy and need to be kept awake during a feed-- undressing them and going skin-to-skin is a useful tool if they're prone to dozing. As they get more practiced and alert, it will probably be more like 5-10 minutes on each side.

How often?

In the first month, newborns should breastfeed 8-12 (or more!) in each 24 hour period. Feed whenever your baby is hungry ("on demand") and no less than every 4 hours, even overnight. (You've heard the saying "never wake a sleeping baby"? It's incorrect. If they're not stirring on their own, wake them to feed every 2-3 hours. Your breasts will probably tell you when it's time!)

By 1-2 months, your baby will probably be nursing 7-9 times a day. They might get a little more predictable, creating a bit of a routine which will vary from baby to baby. One may nurse every 90 minutes, and their best friend down the street may nurse every 2-3 hours.

How do I count the time between feedings?

Track from the time your baby begins to nurse to when they start nursing again. So if they start their first feeding at 7:02 am, finish at 7:24, and start their next feeding at 9:07 am, that's about 2 hours between feeds.

But how do I know if my baby is getting enough breastmilk??

They will probably let you know! According to La Leche League, here are some signs of a satisfied baby:

• Baby seems content and happy after a feed, releasing the breast on their own. Their hands may be in fists before feeding, they will then often relax and open.

• Weight gain is as expected, about 155-240 grams or 5.5-8.5 ounces per week until four months of age.

• Baby has periods of obvious gulping of milk during sessions. This is where baby is getting larger mouthfuls of milk because mom is having a letdown. Baby’s rapid sucking encouraging the letdown slows during these periods to one suck per second as larger volumes of milk fill their mouths before they swallow, and watching their throats will show the rise and fall that occurs with swallowing.

• Baby’s stools transition to yellow with a loose and seedy texture by day five. Baby should have 3-4 stools every day by four days of age.

• Baby may not pass much urine at first but this increases each day. By day two look for two wet diapers over 24 hours, days three and four look for three or more wet diapers each 24 hours. By the time your baby is five days old, wet diapers should be more frequent, usually six or more over 24 hours. It can be tricky to tell if disposable diapers are wet – after five full days, when copious milk comes in, they should be heavy. Many disposable diapers have a faint line down the middle which changes color when wet.

• Baby is alert and active when awake, and meeting their developmental milestones.

Wait. I'm tracking their diapers?

Yup! You were (or will be) probably briefed at the hospital, but a newborn's diapers are important vital signs. The first few days their stool will be a black, tar-like substance called meconium (btw, olive oil is very effective for meconium cleanup!), and they'll have very few wet diapers. Gradually, their stool will turn mustard yellow and both their wet and dirty diapers will increase in frequency. Here's a great chart from the USDA on what to expect in the first week:

Source: USDA WIC Breastfeeding Support

What if I'm having other issues or baby isn't happy?

If you're worried about baby's diapers or (lack of) weight gain, talk to your pediatrician. If your breasts feel inflamed talk to your own doc. And if you're having consistent pain during the duration of a nursing session or your baby seems upset/distressed during feedings, reach out to a lactation consultant. A postpartum doula can help you navigate the highs and lows of breastfeeding and can help you decide when to reach out to a specialist of any kind!