Breastfeeding in the first 24-48 hours

Mums and their babies need to be together to enable the best start to breastfeeding. From the moment of birth – when a baby is placed on mum’s naked chest (known as ‘skin-to-skin’) – the mother’s powerful ‘mothering’ hormone, prolactin, is stimulated.

• Prolactin triggers a good milk supply, even if the baby is not interested in feeding initially.
  
• The closeness of her baby stimulates the ‘love’ hormone, oxytocin, which helps mum fall in love with her baby.
  
• Oxytocin has a calming effect on both mum and baby, encouraging the release of hormones which counteract the effects of the adrenaline produced during birth.
  
• Even if a baby does not feed initially, his or her digestion will be stimulated by instinctive ‘rooting’ and ‘nuzzling’ behaviour against mum’s breast.
  
• Skin-to-skin contact at birth encourages further neuro-behavioural responses from the baby, such as crawling to the nipple, hand-to-mouth movements and massaging the breast.
  
• Dad can provide skin-to-skin if mum can’t – there’s no time limit and it’s not a ‘one-off’ activity. It should be unhurried and uninterrupted as far as possible. Skin-to-skin with dad reinforces father-baby bonding.

Not all babies will want to feed as soon as they are born. Don't worry - just watch for the cues that your baby is ready.

• Sucking on tongue, lips, hands or fingers while asleep.
  
• Moving hands and arms towards his mouth.
  
• Restless movements while asleep/rapid eye movements under the eyelids.
  
• 'Rooting' or searching for the nipple.
  
• Making small sounds.

Crying and fussing are late hunger cues and babies can be quite grumpy by this point, making attachment to the breast more challenging.

• Rooting - when something touches baby’s nose, cheeks or lips he will respond by opening his mouth and sticking his tongue forward and down in readiness for scooping a large mouthful of breast.
• Sucking - triggered when something touches baby’s palate, which is why baby needs to take a large mouthful of breast so that the nipple reaches the back of the roof of the mouth, stimulating sucking.
• Swallowing - triggered when baby’s mouth fills with colostrum or milk. Hearing and seeing a baby swallow during a feed is an important way of assessing how well he is feeding.

Babies are often alert in the first few hours following birth and keen to have their first breastfeed. They may need encouragement if mum had pain relief, such as pethidine, in labour (this crosses the placenta and may make baby sleepy). The average amount of colostrum taken at the first feed is up to 5mls or the equivalent of a teaspoon.

Healthy term babies might not feed very much in the first 48 hours. They use their energy stores until mum’s milk levels start to increase from the second day. The mother should offer her baby her breast whenever he or she is awake and showing signs of wanting to feed. All babies are different – some may only feed a few times in the first 24 hours while others may feed up to eight times. It’s important for mum and baby to not be separated at this time so she can get to know her baby and recognise his feeding cues.

In the first 48 hours a baby will produce only two to three wet nappies. This increases to at least six per day once the baby is five days old. Colostrum acts as a natural laxative, helping baby to pass the black, tar-like meconium stool (baby’s first poo) which will gradually change in colour – passing through a spectrum of black, dark brown, greenish brown to mustard yellow by day five.

Although breastfeeding is natural, it’s a skill that both mother and baby can take time to learn. If you have any questions or concerns, your midwife and local breastfeeding advisor will be around to help.