Often I share that my practice is a blend of what we understand in today's science (as I am a full-fledge nerd in every way and absolutely love breaking down the methodology of our professional literature so I can understand the plethora of variable involved) and the art of ancient wisdom (because I am equally intrigued by healing practices throughout the world and past generations).
The art and science of #breastfeeding is potentially one of the best expressions of that, in that I have an undergraduate degree in breastfeeding - yes, you can get a college degree in breastfeeding because there is that much science on the topic in spite of most of healthcare ignoring that fact.
While most all of my professors were researchers and I learned more about analyzing literature in that degree than even in my own doctoral studies, my degree was an arts major. I studied #anthropology a great deal in effort to understand the perceptions of breastfeeding, even women's history, our rights and oppressions. Of course, relationships, bonding, connection, and social support was also an important part of understanding the breastfeeding experience in my undergraduate studies.
My own experience is fun too. I breastfed all six of my babies. One for only a few weeks because she was born prematurely and then as she was growing and gaining in the #NICU, a nurse passed her an infection that caused her to need ventilator support for a few more weeks. I was pump-dependent with no support in the hospital or out, so I ended up losing my supply. The remaining babies nursed way past what most in our culture would deem appropriate, but you can ask them about their experience and they'll share that they remember it fondly and are breastfeeding advocates themselves. My third child though passed in those early days, so in my grief and healing, I continued pumping for another ten months and donated my milk to anyone and everyone. Those are stories for another day. My point is that my personal experience is broad; I've nursed half my life.
Professionally there is a bit of a unique journey as well. Frustrated obstetrical intensive care nurse turned Breastfeeding Counselor, turned super passionate neonatal intensive care nurse, turned International Board Certified Lactation Consultant (IBCLC) burnt out on hospital bureaucracy turned #homebirth midwife makes for a decade of supporting women fighting for their right to breastfeeding and newborns facing every hurdle to accomplish this to breastfeeding being the expectation and the only babies who struggle are those with either underlying issues or a momma with way too much milk to offer. Breastfeeding literally went from a super challenging thing to endure for both momma and baby to it being so normal that when it isn't super successful then it raised a red flag for pathology, so that even neonatologists thought I was crazy for referring a pretty good looking baby into them for no other reason until they scanned and found either a significant cardiac defect or brain defect, babies that easily might have been assumed SIDS had we not had this early warning sign.
I've seen both ends of the spectrum. I can say with certainty that it makes profound difference in your experience if you have a minimally interventive birth and you have good support at home or if you're having a more standard hospital birth and minimal support at home. Mommas in the latter scenario, know that babies are super resilient and many have even established lactation for their adoptive babies, so much can be overcome but it is a harder route. Those challenges aren't true to the breastfeeding experience when birth is supported in its physiologic journey, so if you are struggling, know this is typically temporary and with good support, you can kindle a sweet, nurturing relationship as well. For my pediatric clients, I've written quite a bit about getting off to a good start in our educational forum, so take a peek there, but I did want to share a smidge here about getting through those first six weeks. This is the steepest climb, so peek here for guidance on those early days and let's talk about week two through six.
What's Normal?
Nursing frequently remains the norm, but maybe you are starting to figure out a little bit of a pattern. Don't get too detail-oriented here because baby may switch this up, but your little one is likely nursing ten to twelve times each 24-hour day. If they are super efficient and otherwise self-soothing, they may nurse just 8 times, but lots of nursing is common. This is a tricky little dance though, in that one partner may be super efficient at nursing and transferring milk, but maybe the other partner makes just enough and isn't super speedy at getting the milk into the filling station. The opposite can also occur where mom is making an abundance of milk and can even deliver it like a fire hose, but baby is a bit more timid and gentle so is easily overwhelmed. There are a variety of combinations and all of this determines the frequency and length of each session, not to mention the distractions in your environment that will impact each nursing session. While you want to be mindful of the frequency each 24-hour period in those early days, these details will and should modulate based on circumstances imposed on either partner so tracking later can be a bit compulsive and feed into your anxieties.
Nurse at the first signs of hunger, when your little one is stirring, rooting, and putting their hands in their mouth or smacking their lips. Don't wait until baby is crying as they will be a bit more frustrated and uncoordinated at this point, less likely to achieve a good latch. Time at the breast should be pretty unlimited, again, giving them lots of practice time and opportunity to tell your brain that more milk does need manufactured. As well, the closer baby is to you during these first six weeks, the safer they are overall. You help them regulate their heart rate, breathing, and temperature, and even their mental and emotional development is improved because of the time spent at your breast.
At first we watch for three golden yellow poopies each day, through the first six weeks especially, as this tells us baby is effectively transferring milk and we have little to be worried, but at some point closer to six weeks, you'll start to recognizing a good weight pattern being established, arms and legs are getting chubby. Milk will drool from the corners of their mouth and you'll recognize that milk drunk baby and just know, all is well. Then it is our intuition that guides us in if baby is getting enough. More generally though, I like to recommend Mommas consider offering the first breast like they would a dinner plate. Allow baby to nurse here as long as they desire. When they come off to burp, offer the other side as dessert. Maybe they want it, maybe they don't, but don't stop them in the middle of their dinner to offer dessert. This helps assure your baby is getting enough of that fatty milk that comes more towards the end of the meal.
So what's normal these first few weeks? Frequent feedings and long feedings are quite normal, as long as your baby is thriving. If they are eating frequently though, or eating for long sessions and you feel they are still hungry, they may be struggling to transfer milk and you'll need support. Connect with our office or your own trusted breastfeeding-friendly primary care provider. Don't time feedings. Don't schedule them. Give your little one much of the control here.
If your little one shakes it up a little, maybe nursing more frequently in the evening and then all of a sudden stays up a bit later, this can be normal and happens for a plethora of reasons, not unlike our own evening and bedtime routines. It would be more weird to be super scheduled. Cluster feeding is super common, and often occurs in the middle of the family chaos, which makes sense because when things are crazy, the safest place for baby is right in her arms. Hopefully you will find that they sleep longer through the night after cluster feeding, or maybe you need to reconsider some of the evening chaos and let your partner or other trust neighborhood friend provide some of those evening meals. There are growth spurts in here too, that the science likes to negate from time to time, but anecdotally mommas will tell ya that at about two weeks and about six weeks, there seems to be an uptake in nursing and a subsequent burst of growth.