Over the first few days, babies should not be allowed to sleep more than 4 hours to insure adequate intake and avoid dehydration. Skin to skin contact is a great way to ensure that the baby is nearby and can feed on demand.
Make sure that the baby’s position on the breast is good, allowing the baby in an asymmetric feeding position which should not cause pain. Watch for feeding cues, such as rooting, REM sleep patterns (in which the baby’s eyelids are starting to move), or the beginning of a cry to put the baby to breast. Don’t wait until the baby is screaming – it will be much more difficult to latch a screaming, starving baby than a calm waking baby. The baby should feed until he/she is falling asleep.
For the first 4-5 days, the baby will feed frequently and will be getting colostrum, which is high in antibodies and will enhance the baby’s immune system. When the milk comes in, usually on day 4 or 5, the baby will begin to swallow more, and may need to learn how to cope with the volume of milk.
It is very common to feel a tingling at the breast when the milk is starting to flow, and also common to have milk coming out of both breasts at the same time. Please call or come in to the office if the baby seems sleepy and will not latch, if the baby does not have multiple wet diapers and stools, or if pain, bleeding or sores of the nipple occur.
There are multiple choices of formula on the market. Typically we will start your baby with an iron fortified milk-based formula unless medically contraindicated. Most babies will feed every few hours and should wake up to feed. Your baby should be stooling and urinating a few times in the first few days of life, and by five days of life should have 4-5 stools and wet diapers.