Breast feeding optimization:
Tips for Optimized Breastfeeding
Avoid excessive IV fluids in labor, if possible (not always possible and not always something that can be controlled). Unless medically necessary, avoid large volumes of fluids especially the last few hours of labor. This can artificially increase baby's birth weight causing concern for weight loss in the first few days. Avoiding induction unless medically necessary is the easiest way to minimize fluids in labor. For planned cesarean, don't start fluids if possible until within 30 min of planned anesthesia start (ie don't have them running the whole 2 hour preop time).
Also, make sure you get a weight on baby around 24 hours (and write it down). The 24 hour weight is a more accurate starting point when evaluating newborn weight loss and considering need to supplement. The fluids from labor diurese within the first 12-24 hours.
Immediate skin to skin at delivery. No separation. All baby assessments on your chest. Dry quickly on your chest then naked baby belly facing belly on your chest. Stay skin to skin for at least the first couple of hours. Delay "routine" newborn procedures for at least an hour and until after baby nurses (weight, vitamin K, etc). Vitals can be done on your chest. Spend as much time skin to skin in the first 24 hours as you can.
Nurse when baby shows any signs of interest. Fist sucking, rooting, pushing up and around on your chest. Try laid back nursing so baby can help latch. Google/youtube a video of this. YouTube "breast crawl".
Nurse frequently, as often as baby shows interest. Don't limit nursing because "it's only been 30 min".
Feed on demand at any early feeding cues, even if it's only been 15 min or is 20 times in a day (especially the first two weeks). 8 times per 24 hours is the minimum, not the expectation. 12-20 is more usual. One of the baby tracking apps pooled their data and reported that 16+ nursing sessions a day was average.
Hand express after each feeding until the milk is fully in. Hand express within the first hour after birth, whether baby latches well or not. Collect colostrum in a cheap plastic spoon (hospital or Chinese take out type cheap spoon). Dribble colostrum into baby's mouth immediately.
Antenatal expression may be of benefit. You may collect colostrum in small oral syringes and save in freezer to supplement with after birth if needed. It's also an excellent way to learn hand expression before delivery and feel more confident in this skill. Start antenatal expression at 36 weeks. Express 2-3 times per day.
Delay the first baby bath for at least 8 and preferably 24 hours (or even until you go home from the hospital if you like).
Hydrate and eat. Take care of yourself and baby. Let someone else do everything else.
If baby is not latching well in the first 24 hours, hand express after each feed and give colostrum to baby. If baby is still not latching well at 24 hours, start pumping after nursing about every 3 hours (at least 8 times a day), in addition to nursing on demand. Hand expression while attempting to nurse the first 24 hours is generally sufficient. If still having latch issues at 24+ hours, add in pumping. Work with LC to evaluate latch, evaluate tongue and suck function, assess tongue tie.
If latch is good and baby is nursing well, early pumping is not necessary and may be harmful. Pumping too early can induce oversupply, with risks of clogged ducts, mastitis and pump dependence.
A prenatal appointment with lactation may be beneficial. They can troubleshoot concerns you have. They can measure for flange size for future pumping needs. They may give you other tips to help maximize nursing early on. This is often covered by insurance.
Breast feeding optimization: Tips for Optimized Breastfeeding
Also, make sure you get a weight on baby around 24 hours (and write it down). The 24 hour weight is a more accurate starting point when evaluating newborn weight loss and considering need to supplement. The fluids from labor diurese within the first 12-24 hours.
Immediate skin to skin at delivery. No separation. All baby assessments on your chest. Dry quickly on your chest then naked baby belly facing belly on your chest. Stay skin to skin for at least the first couple of hours. Delay "routine" newborn procedures for at least an hour and until after baby nurses (weight, vitamin K, etc). Vitals can be done on your chest. Spend as much time skin to skin in the first 24 hours as you can.
Nurse when baby shows any signs of interest. Fist sucking, rooting, pushing up and around on your chest. Try laid back nursing so baby can help latch. Google/youtube a video of this. YouTube "breast crawl".
Nurse frequently, as often as baby shows interest. Don't limit nursing because "it's only been 30 min".
Feed on demand at any early feeding cues, even if it's only been 15 min or is 20 times in a day (especially the first two weeks). 8 times per 24 hours is the minimum, not the expectation. 12-20 is more usual. One of the baby tracking apps pooled their data and reported that 16+ nursing sessions a day was average.
Hand express after each feeding until the milk is fully in. Hand express within the first hour after birth, whether baby latches well or not. Collect colostrum in a cheap plastic spoon (hospital or Chinese take out type cheap spoon). Dribble colostrum into baby's mouth immediately.
Antenatal expression may be of benefit. You may collect colostrum in small oral syringes and save in freezer to supplement with after birth if needed. It's also an excellent way to learn hand expression before delivery and feel more confident in this skill. Start antenatal expression at 36 weeks. Express 2-3 times per day.
Delay the first baby bath for at least 8 and preferably 24 hours (or even until you go home from the hospital if you like).
Hydrate and eat. Take care of yourself and baby. Let someone else do everything else.
If baby is not latching well in the first 24 hours, hand express after each feed and give colostrum to baby. If baby is still not latching well at 24 hours, start pumping after nursing about every 3 hours (at least 8 times a day), in addition to nursing on demand. Hand expression while attempting to nurse the first 24 hours is generally sufficient. If still having latch issues at 24+ hours, add in pumping. Work with LC to evaluate latch, evaluate tongue and suck function, assess tongue tie.
If latch is good and baby is nursing well, early pumping is not necessary and may be harmful. Pumping too early can induce oversupply, with risks of clogged ducts, mastitis and pump dependence.