Breastmilk- Colostrum amounts in the first few days
I had my first shift back at work today since giving birth. As I work in the community visiting postpartum women, I was genuinely shocked at the number of women who had little understanding of colostrum in the first few days. It is a big issue that we as midwives need to focus on as so many women are giving up feeding due to believing that they have no milk and worrying that they are starving their babies.
We need to let women know that breastfeeding is not the same as bottle feeding and the amount a baby will take from a bottle does not equal the amount a baby will take form the breast.
In the first 24 hours, your baby will feed frequently to encourage your full milk to come in at around day 3 or 4. This might be every hour, half hour or 2 hours - it is not predictable. Some babies literally only feed a few times in the first 24 hours. You will produce approximately 5 mls of colostrum per feed in total - a small amount in comparison to the large quantities you might see in a formula bottle. This is totally normal. On day 2 and 3, you will produce around 10- 15ml per feed thats just 2-3 teaspoons. Again totally normal. Your baby has a small stomach so will feed regularly and cry a lot to encourage the milk to come in. As long as there are a couple of wet nappies on day 1 and 3-4 on days 2 &3 there should be no cause for concern. Here are some facts:
- It is normal for babies to cry often and root around a lot in the early days.
- You will not necessarily notice any milk dribbling out of baby's mouth when they feed.
- A baby will guzzle anything you put in their mouth. Just because a 2 day old baby quickly drinks 30mls of formula does not mean you were starving them with small amounts of colostrum. Feeding from a bottle is easy but often babies will drink too much and vomit some up.
- Once you get through the first few days and your milk comes in, it does become easier as babies become fuller on each feed.
A dehydrated baby will not pee often, may have a sunken soft spot on their head and may look generally unwell. A baby's poop should be yellow by day 6.
A baby will more than likely lose a little weight in the first 5 days - often formula fed babies will lose weight too but not usually more than 5% of their birth weight. A breastfed baby should not lose more than 10%. If a baby has lost this amount or more, then urgent feeding evaluation should take place with a breastfeeding advisor and sometimes supplementation with extra milk (either expressed/donor breastmilk or formula) may be recommended if the baby is dehydrated. Babies CAN fail to thrive when breastfeeding, usually due to poor attachment and not feeding often enough. Tongue tie & lip tie can play a major role in this.
Remember it is normal for a baby to feed lots in the early days to encourage that milk to come in.