Pediatric Associates of the NW Blogs

First Two Weeks of Breastfeeding: Expectations versus Reality

Katie Kennedy, RN, IBCLC
February 12, 2019 03:00PM

As a lactation consultant, I work not only with moms, but expecting moms as well. One question I am frequently asked is what breastfeeding may look like the first two weeks after delivery. They want to know the good and the bad so they can make the choice that is right for them.

Expectation: My baby is born hardwired knowing how to breastfeed.

Reality: Yes, your baby has instincts that draw him/her to your breast. You may even read about the ‘breast crawl’ that describes a baby’s ability to move towards the breast and initiate suckling without assistance. The truth is that although breastfeeding is instinctive and natural, the skill of latching, positioning, transferring milk and reading infant cues may take practice. Breastfeeding can have a learning curve for both mom and baby. Each baby is different so even a second or third time mom may experience this learning curve. While in the learning phase (and later even), it’s normal to have feeding sessions that feel like slam dunk successes or complete disasters or everything in between.

Expectation: Breastfeeding causes painful nipples no matter what.

Reality: If you read enough breastfeeding blogs and talk to enough moms about their breastfeeding horror stories, you may think that bloody, cracked, scabbed and bruised nipples are normal. This is not true! Painful nipples are not an inevitable part of learning how to breastfeed. Early sore and damaged nipples are typically a sign of poor latch or tongue tie. What is more typical? Nipple tenderness with latch initiation that dissipates as feeding progresses is typical as your delicate nipples adjust to the sensation of baby suckling. If you have pain that lingers throughout feeding or between feedings, a lactation consultant can help assess what might be going on. Keep in mind that nipples quickly go from “kinda sore” to really sore to CODE RED sore – ask for help!

Expectation: I won’t make enough milk.

Reality: It is common to worry about milk supply. Maybe this concern stems from the fact that your mom didn’t make enough or your first baby lost excessive weight and needed formula. There are a few circumstances which can affect a woman’s supply, but the truth is that most moms have sufficient milk production (nature can even be overly generous at the start and cause oversupply). Colostrum, the first milk produced, is rich in nutrients but tiny in volume. A good feed the first day of life could be 1-1.5 teaspoon of this liquid gold. Milk usually doesn’t come in until 3-5 days after delivery. In the first weeks post-birth, breastfeeding hormones increase in response to nipple and breast stimulation and milk removal when your baby eats. Like the idea of supply and demand, the more milk drained (by nursing, pumping and or hand expressing), the greater the signal to your body to produce more milk supply. The first few weeks are critical because this is when the body calibrates and sets the foundation for long-term milk supply. If you are worried about your baby or pump’s ability to drain the breast sufficiently and efficiently, seek help sooner than later. Increasing your supply is more likely to be successful if addressed early on.  

Expectation: My pregnancy breasts can’t get any bigger.

Reality: FALSE! They can and they probably will. As the milk comes in, the breasts swell and may feel warm, heavy and uncomfortable. During this phase, it’s important to keep the milk flowing so put your baby to work. Feed, feed, feed!  As your breasts fill, latch may become more challenging so soften the breast tissue by applying moist heat and using massage. If necessary, hand express or pump just enough to relieve the pressure. The good news is that breast comfort should improve within a day or two. Hang in there!

Expectation: My baby will eat around the clock on a predictable schedule.

Reality:  Most babies’ feeding schedules are variable with times of clustering. It is normal for your baby to eat 8, 10, or even 12 times in a 24 hour time period. Breastfeeding during the first few weeks can feel like an exhausting marathon. Eat, sleep, poop, repeat… Your baby is not manipulative and has nothing against YOU sleeping, showering or eating, but it can feel that way. Even though feedings may not be on a predictable schedule, the clock is useful for keeping track of feedings and diapers. In your sleep-deprived state, it can be hard to remember what your baby did at 2 am. For the sleepy or jaundice baby, waking your baby to feed may be necessary to make certain he/she is eating often enough. If your baby is asking to be fed all the time and never seems satiated or consolable, a feeding evaluation by a lactation consultant would be beneficial.   

Expectation: If my baby needs extra milk (pumped milk, formula or donor breast milk), breastfeeding is doomed.

Reality: Some babies require supplementation as a result of excessive weight loss, jaundice, multiples or low milk supply. This supplementation can be short term or long term. Every mom and baby is different, so breastfeeding doesn’t always go as planned and sometimes we are forced to think about an alternative plan that will support infant and maternal health. The #1 rule is always FEED THE BABY! No one should feel like they have failed at breastfeeding when they are doing what is best for their baby. If desired, a lactation specialist can help guide you through a feeding plan that involves giving baby extra milk while protecting the breastfeeding relationship and building the milk supply.

Expectation: You will love your baby immensely.

Reality: You will love your baby immensely!!! The truth is that breastfeeding during the first two weeks after delivery can be emotionally and physically demanding, and at times, overwhelming. If it all goes smoothly, enjoy your baby. If it doesn’t go smoothly, please still enjoy your baby. Infancy is fleeting. Ideally, memories of the early days with your newborn will be filled with fondness (and a sprinkle of fatigue) rather than stress and worry. Take time to soak in all the newness. And be easy on yourself during this transition into parenthood.

By no means is this an exhaustive list of everything that you could experience with breastfeeding. Have more questions? Need cheering on when breastfeeding gets tough? Our lactation consultants are available 5 days a week to answer your questions and support whatever your goals are for breastfeeding, whether it’s exclusive breastfeeding, partial breastfeeding, exclusive pumping, or anything in between. Contact our office to schedule an appointment or talk with one of our lactation consultants.