What to expect when establishing breastfeeding – from your baby’s first feed after birth to finding comfortable breastfeeding positions and recognising feeding cues.
Breastfeeding may be natural, but that doesn’t mean it’s easy. If you and your baby are breastfeeding beginners, it will probably take time and a lot of practice for you both to get the hang of nursing after the birth.
- Latching on
- Breastfeeding on the postnatal ward
- Breastfeeding if your baby’s in NICU
- Breastfeeding positions
- Colostrum vs mature milk
- Feeding cues
- How often will my baby breastfeed?
- Taking medicines while breastfeeding
Your breastfeeding journey starts with your baby’s first feed, which usually happens within an hour of the birth. The ideal way to get things started is by having your naked baby on your bare chest as soon as possible after the birth.
Skin-to-skin contact is important because it:
- stimulates your baby’s feeding instinct
- makes your baby feel calm and regulates their body temperature
- helps you produce more breastfeeding hormones, which increases your milk production.
If you have a vaginal birth, the midwife or doctor will usually place your baby straight on your chest when they’re born. Your baby may even start to feed before the cord has been clamped.
If your baby is born through a c-section you should also be able to have your baby skin-to-skin very quickly, often while you’re still being stitched up in the operating theatre.
While most midwives and obstetricians will offer you skin-to-skin by default, it’s still a good idea to include it in your birth plan so everyone who looks after you knows it’s something you’re keen to do.
When your baby is lying on your bare chest after the birth, they may start rooting for your nipple and even latch on to your breast by themselves without much input from you. However, many new mums and babies do need a bit of help at first, especially if the birth was long and tiring.
Your midwife will stay in the room with you after the birth to make sure that the first feed goes well and answer any questions you have, so you won’t have to figure it all out on your own.
Talk to the midwives if you’re having trouble latching your baby – either if it’s painful, or if your baby doesn’t seem to be able to take milk or they aren’t interested in feeding. You may need some tips on positioning, or your baby could have a tongue tie that needs treatment in order for breastfeeding to work as well as possible.
Breastfeeding on the postnatal ward
After your baby’s had their first feed, you’ll both be moved to the postnatal ward if you need more medical treatment or observation overnight.
If you’re staying on a postnatal ward, there should be midwives available to help you with breastfeeding at any time of the day or night. You may have a buzzer which you can press to get assistance if you’re unable to pick up your baby or need help getting into a comfortable position for feeding, for example if you’re unable to move after a c-section.
If you’ve gone home from the labour ward or birth centre, or if you had a home birth, you should have been given contact details for midwives so you can call them if you’re having problems with breastfeeding after the initial feed.
Find out more about getting breastfeeding support in the hospital and after you’ve come home.
Breastfeeding if your baby’s in NICU
Things can happen during labour which mean that you and your baby are separated, for example if your baby is unwell or premature and needs to be admitted to a neonatal care unit.
It can be twice as difficult to be separated from your baby and not be able to breastfeed them straight away if it’s something you’ve been looking forward to.
While it can be harder to get breastfeeding established if you’re separated, it’s not impossible. It’s really important that you get support from the hospital, for example from the infant feeding coordinator, so they can help you work out a plan for feeding your baby as soon as possible.
The plan could include you using one of the hospital breast pumps to express milk for your baby, and having your baby skin-to-skin in NICU as often as you and your baby are able to.
‘I extracted colostrum overnight and sent it to my baby in NICU, and I was able to establish breastfeeding with him the very first morning. The nurses supported me by holding his wires while he was feeding and it was an amazing feeling when he latched on.’ Read Alicia’s birth story
There isn’t any one breastfeeding position that is ‘right’ – it all comes down to what is comfortable for you and your baby. How you position your newborn while feeding can depend on:
- the type of birth you had (for example, some positions can be painful after a c-section birth)
- the size and shape of your breasts and nipples
- whether your baby needs help to hold their head in position.
Your midwife can observe you when feeding, either after you’ve given birth or at one of your postnatal appointments, and give tips and advice on which breastfeeding positions might work best for the two of you.
Here are a few of the most common breastfeeding positions you may like to try:
Colostrum vs mature milk
When you first start breastfeeding, you’ll make a very concentrated nutritious liquid called colostrum. It’s yellow in colour and perfect for newborn babies as their stomachs are very small, so they can only take in a small amount of milk at a time.
After a few days, usually by day five, the colostrum will change into mature milk which is white in colour and more watery. This is known as your milk ‘coming in’ and when it happens, you may find your breasts suddenly feel very full and warm, or engorged.
Try to feed your baby whenever your breasts feel full, as it can help prevent breastfeeding problems like blocked ducts and mastitis.
Most people imagine a baby will scream to let you know that they’re hungry, but babies have earlier and far more subtle feeding cues too.
You baby may be looking for a feed if they:
- wake up and act restless
- suck their fingers or fist
- stick their tongue out
- make smacking or sucking sounds
- root for your nipple by turning their head and opening their mouth.
How often will my baby breastfeed?
In the early weeks, your baby will need to feed often, both in the day and night. You can expect your baby to want to feed every three hours or more, so at least eight times a day.
It’s best to feed your baby any time they show that they want to, or when your breasts are full or you just feel like a snuggle.
It can be good to know that it’s not possible to overfeed a breastfed baby – they’ll simply unlatch when they’ve had enough. So if you’re ever in doubt about whether your baby wants a feed, offer it to them.
If your baby seems very sleepy and not interested in feeding, or goes very long between feeds in the early days, it’s important that you seek help from your midwife. It can be a sign that your baby is not getting enough milk.
Taking medicines while breastfeeding
Right after you’ve given birth, the midwives and doctors will make sure that any painkillers you’re prescribed are safe for breastfeeding. As your baby gets older, make sure you mention that you’re breastfeeding whenever you go to see your GP, so you’re given medicines that are safe for your baby.
What should I do if I’ve been told I need to take a medicine that is incompatible with breastfeeding?
Before you make any decision to stop or pause breastfeeding, it’s important that you find out:
- if the medicine you’ve been prescribed actually is incompatible with breastfeeding, and
- if there is an alternative medicine that is safe for breastfeeding that you can be prescribed instead.
To make sure that the information you’ve been given by your doctor is correct and up to date, you can check with The Breastfeeding Network. It’s run by pharmacists and they have drug factsheets where you can look up the safety of the most common medicines and alternatives.
For any more specific questions on medications, you can contact The Breastfeeding Network’s volunteer team of qualified pharmacists on social media or by email for personal advice and help.
More from Which?
- Breastfeeding essentials: From nursing pads to maternity bras – what to get ready before the birth so you’re prepared for breastfeeding.
- Best breast pumps: Our reviews combine mums’ experiences with our tests to find pumps that are powerful, comfortable and quiet.
- NHS vs NCT antenatal classes: Discover the differences between classes and how they help to prepare you for birth and parenthood.