How milk is made: 

• After birth, the delivery of the placenta causes a change in hormones, signaling the body to produce milk.
• The breasts produce colostrum, a thick, yellowish milk rich in nutrients and antibodies, ideal for the newborn's first feeds. Colostrum may be present during pregnancy as well.
• Colostrum is produced in small amounts (about 1-2 teaspoons per feeding) as the newborn’s stomach is tiny.
• Early and frequent feeding and skin-to-skin contact signals the body to produce more milk.
• Breasts begin to feel more full between day 3-5, due to increased milk production and colostrum starts to transition to mature milk.
• Breastfeeding or milk removal should begin as soon as possible after birth. The more milk that is removed in the first few weeks, the more milk your body will produce overall.
• Babies should feed often; at least 8 times in 24 hours. Approximately every 2-3 hours.
• Babies will likely feed more frequently through the night and during growth spurts.

Skin-to-Skin Contact

Hold baby skin to skin for at least the first hour after birth and continue daily for the next few weeks.

Skin-to-skin provides many benefits to parents and babies:

• Stabilizes baby’s temperature
• Helps the baby’s breathing and heart rate pattern
• Improves breastfeeding success
• Helps the baby’s brain development
• Babies cry less and are less stressed
• Increases bonding with parents

Position and Latch

Having a good latch: 

• Promotes good milk transfer at the breast
• Helps to maintain a good milk supply
• Promotes adequate weight gain in baby
• Prevents nipple pain or damage.
• Can prevent other breastfeeding challenges

Positioning

1. Find a comfortable position supported with pillows and/or footstool as necessary.
2. Have a water bottle and anything else that you will need within reach.
3. Breastfeeding positions can include laid back, side laying, cradle, cross cradle, and football hold.
4. Cross cradle and football positions work well for parents and babies when learning to breastfeed.

Latch

• Ensure a relaxed, comfortable, well-supported position.
• Baby should be dressed in only a diaper to allow for skin-to-skin contact.
• Baby’s body is in a straight line, not twisted or turning.
• Supporting their whole body with your arm, place your hand on baby’s shoulders to support their neck, allowing baby to extend their head slightly.
• Tuck your baby in closely to your own body, with their hips, shoulders, and head well aligned in a “tummy to tummy” position.
• Position the baby to have their nose in line with your nipple.
• Press baby’s chin into the breast
• Wait for a wide open mouth before bringing them onto your breast.

Signs of an effective Latch

• Baby's mouth is opened wide
• Baby's lips are flared or curled out
• Baby's chin is touching the breast
• Baby's head is slightly extended. When the head is back, the nose is free (not buried into the breast)
• There is more areola visible above the baby's top lip than below the bottom lip
• An effective, deep latch allows baby to take in more milk and is more comfortable for you

During sucking

• The baby’s cheeks remain full and rounded, not dimpling or indrawn.
• There may be a strong tugging sensation when baby suckles, with no pain. There may be some initial discomfort from suckling but not after a letdown. If pain persists, reassess the latch.
• Active sucking and swallowing of breast milk may be heard (audible swallowing or “kah” sounds).
• Baby is comfortable, managing the flow of breast milk and maintains the latch.
• Baby relaxes during the breastfeed and does not get tense or agitated.
• When the baby comes off the breast, the colour and shape of nipple remains unchanged. Sometimes the nipple may be elongated, but not pinched or compressed.

How do I know if my baby is hungry?

Feed your baby when you see early feeding cues.

Early Feeding Cues:

• Rapid eye movements, under the lids
• Soft cooing or signing sounds
• Sucking or licking movement
• Sucking sounds
• Restlessness
• Hand-to-mouth movements

Crying is a late sign of hunger.

Baby is getting enough breast milk if:

• Has frequent wet/dirty diapers
• Is gaining weight consistently - back to birth weight by about day 10
• Settles between most feedings

Hand Expression & Pumping

Hand expressing or pumping breastmilk is done to provide breastmilk to a baby when they cannot directly nurse at the breast, for example:

• baby is not able to latch to the breast
• poor latch
• separation from the baby
• a medical condition affecting the baby.

Other reasons for hand expression/pumping may include:

• hand expressing a few drops before latching to get the baby interested in feeding
• relief of engorgement
• to stimulate milk production
• to collect colostrum in the early days after birth (hand expression)

Milk Storage Times