New Baby, New Questions: A Guide to Breastfeeding in the First Week

A woman breastfeeding her baby.

Breastfeeding in the first week can be some of the most challenging days.  You might be wondering: How do I know if my baby is getting enough? When will my milk come in? What if my breasts feel hard and sore? 

Let’s answer these common questions and concerns to help you feel confident as you begin your journey.

How Often and How Much Should My Baby Eat While Breastfeeding in the First Week?

As a rule, most term newborns breastfeed 8-12 times a day, roughly every 1-3 hours. Every feeding may last 10-20 minutes per breast.

• Watch for Active Sucking: If baby is asleep or you feel like you need to use a wet wipe or a washcloth to wake them up, it is best to take them off, wake them, and re-latch.

  • Some may need an extra nap, and while they are sleeping, hand-express or pump and feed baby 1-2 teaspoons in the first 24 hours.

• Difficulty Waking: If baby is difficult to wake every 3 hours for a feeding, it may be a sign a baby needs a little extra snack after nursing.

• Topping Off: In the first 24 hours, a baby's tummy only holds about 1-1.5 teaspoons. If they need a little extra, that small amount is usually plenty.

  • If you have extra syringes of collected colostrum, this is a perfect use for it.

• Daily Increases:

  • First 24 hours: 1-2 teaspoons per feeding

  • After 24 hours: ~3 teaspoons (1/2 ounce) per feeding

  • Day 3: ~1 ounce every 2-3 hours

  • 1 week: 1-5-2 ounces every 2-3 hours

Important: Anytime you feed baby with a syringe or a bottle, remember to pump. This tells your body that the baby is eating and that you need to keep producing more milk.

Understanding Cluster Feeding

Cluster feeding is frequent back-to-back feedings over a 1-3-hour period. It serves a vital purpose: frequent stimulation helps lay down prolactin receptor cells, which create the foundation of your long-term milk supply.

• When it's normal: It is common in the first few days and during growth spurts.

• When to seek help: Prolonged cluster feeding (lasting many hours without a break) can sometimes indicate low supply or poor milk transfer. If your baby is fussy and won't settle for a nap, don't hesitate to pump and give them a "snack" while you wait for professional help, like at Gulf Coast Lactation.

Oversupply

Overstimulation at this stage may create an oversupply, or some mamas are able to pump more than baby needs. That’s ok. Store the extra milk in the refrigerator and then, in 3 days or so, move it to the freezer if you don’t need to feed it to the baby. It’s easier to decrease a supply than it is to increase a supply for most women. If you end up with too much milk, then the staff at Gulf Coast Lactation can help you decrease your supply.

How Many Diapers Should Baby Go Through?

Monitoring wet and soiled diapers is the best way to track intake at home.

• Days 1-4: Aim for one wet diaper for every day of life (e.g. 2 wet diapers on day 2). In the first few days, babies have meconium poop, a dark black to brown sticky poop.

• Day 5 and Beyond: You should see 6+ heavy wet diapers and 3+ yellow seedy poops per day.

• Watch the Pees and Poops: If baby is pooping at least once a day, baby is probably getting enough to eat. If baby is crying and unsettled, it is okay to feed baby a little more.

  • Please remember to pump every time you give your baby a little extra from a syringe or a bottle. Your breasts need to be stimulated to know to produce more milk.

Weight Watch

Most babies lose 3-7 % of their body weight in the first 3-5 days. When your milk comes in, babies should start to gain weight. Guidelines indicate that babies should return to birth weight by 2 weeks.

If your baby has not returned to birth weight by 2 weeks, please reach out for help so we can assist in creating a plan to increase supply or help baby get more when nursing. There are so many factors that can affect milk supply, transfer, or slow weight gain. Do not sit at home and wonder and stress. Call us. We are here to help.

When Will My Milk "Come In”?

Most women will start to notice their breasts feel heavy between days 2 and 4, with the full milk supply coming in around day 3-5.

• Signs of Engorgement: Engorgement, which causes swelling and pressure in the breasts, is common as the milk comes in and can be painful for some. If baby is not latching well or you aren’t experiencing a softening in your breasts when baby nurses, try hand-expressing, pumping, or using a Haakaa to relieve pressure.

  • Sometimes a nipple shield may help during this transitional phase. Protecting the milk supply and making sure baby gets enough are key to a good milk supply and a full, satisfied baby.

• No Changes? If you do not notice any changes by day 5, your milk quantity may be low, and baby may be hungry. If you are experiencing trouble, please reach out for extra help and support.

  • A good indication that your breasts will make a good supply is the change that happens in early pregnancy. If you do not see any changes in the first trimester, please reach out for an appointment before baby is born so we can help create a plan to ensure a good milk supply.

How Do I Manage Clogs and Sore Spots?

Breastfeeding is a feedback loop: the more milk that is removed, the more you make. If you feel a tender, hard lump (a clogged duct), it is important keep milk moving.

• Gentle Care: Deep tissue massage is not recommended. Use a gently pressure to move the milk out.

• Inflammation Relief: Use an ice pack to decrease swelling.

• Lymphatic Massage: Lie on your back and gently massage away from the areola and towards your rib cage. This may help move excess milk out of the breast.

• When it's an infection: If you experience a fever or flu-like symptoms (mastitis), please call your doctor immediately. Continue nursing and pumping to move the milk out of the breast as much as possible.

You Don't Have to Navigate This Alone

Please don't sit at home and wonder or stress. Whether you have an oversupply or are worried about low transfer, the team at Gulf Coast Lactation is here to help.

• Milkie Way Cafe: Join our free breastfeeding support group, run by an IBCLC (International Board Certified Lactation Consultant), twice a week.

• Private Appointments: We offer in-person, in-home, and video appointments and accept most major insurance plans.

  • In-home appointments are very dependent on the schedule and travel distance.

Reach out today. We are honored to walk alongside you!