The Smart Parents Guide to Breastfeeding. Jennifer Ritchie
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keep eating, and it will not stimulate any of the reflexes that can interrupt the feeding (for example, touching a baby's cheek may cause the baby to pull off of the breast because of the reflex). Another great way to keep a baby awake is to increase the volume. How do you do that? Simply grab and squeeze the boob like a lemon. Not a massage, but literally grabbing a hold of a section of the breast and squeezing. Your breast is filled with tons of little sacks of milk, so you can’t grab a wrong spot!
Chapter 8: The Second Stage of Lactation
A huge hormonal shift will happen after the delivery of the placenta, and your milk will increase in volume around day 3. This is commonly referred to as the milk “coming in.”
When you deliver your baby, your prolactin levels remain high, while the delivery of the placenta results in a sudden drop in progesterone, estrogen, and HPL levels. This abrupt withdrawal of progesterone, in the presence of high prolactin levels, stimulates increased milk production (the second stage of lactation). This hormonal shift is what also causes us to develop Postpartum Depression and Postpartum Anxiety.
The milk supply increasing in volume typically happens in humans around day 3, but it can be delayed for several days due to 3rd Spacing. During this stage, the more that milk is removed from the breasts, the more the breast will produce milk.
Why wouldn’t your milk “come in” or increase in volume around day 3? Water!!! If you have an epidural or a C-Section, they need to give you IV fluids to keep your blood pressure low, to prevent you from having a heart attack. A heart attack is the last thing we need, so we just need to look for signs that we need to flush some of that water out of the system. About 14 hours after delivery, look at your feet. If they are swollen, place two fingers on your feet to see if the fluid moves and creates an indentation. If it does, that is the fluid moving and you have 3rd Spacing. This fluid is not only in your feet, it is also in anything that hangs: Your butt, nose, hands, and breasts. We need to get as much of this fluid out of your body as soon as possible, or your milk will not increase in volume and your baby will start losing too much weight. If you see this swelling in your feet about 14 hours after delivery, you need to drink A TON of water. Tap water, Vitamin Water, a cut-up watermelon, whatever! The only way you will get rid of this extra fluid is by peeing it out, and the only way to pee is by drinking.
3rd spacing is a very common cause of supplementation in the first 2 weeks, and could severely impact your success at breastfeeding. Here is a photo of a mom that labored with IV fluids for 14 hours:
Chapter 9: Welcome Home
Why are you so darn tired! Because your baby has a different sleep cycle than you do, and you are waking up and functioning when you would normally be in deep sleep. The amazing team at UC Davis has taken data, dating all the way back to the 1800s, and has shared this information with us. Remember, what you read below is not theory, or someone with a great idea on how to listen to your baby's cries, this is evidence-based fact.
How Often Should I Be Breastfeeding?
You will need to breastfeed your baby 8 or more times in 24 hours (in a perfect world that is every 3 hours each 24-hour period).
Do you have to wake your baby every 3 hours around the clock? The answer is yes, until your baby regains their birth weight.
Babies are happy to starve, and if they lose too much weight, they will not have the strength or endurance to tell you they are hungry.
After a baby regains their birth weight, try to feed every 2 1/2 hours in the daytime. Babies are born wanting to sleep all day and party all night, so the more calories you pack in them during the day, you may get a 4 hour stretch of sleep at night. Infants “cluster feed” or “load” calories by having several breastfeeding sessions within a short time. This is most likely to happen between the hours of noon to midnight, when you are making the least amount of milk.
Although you only need one breast to breastfeed, nipple stimulation is crucial in the first 2 weeks. From day 1 to day 3, feed the baby on one side for 15 minutes, and then switch to the other side. Once your milk “comes in” or increases in volume somewhere between day 3 and day 5, feed the baby on one side and when they self-detach, or they are no longer actively sucking when you stimulate them, remove them from the breast, burp them, then offer the other side. It’s a good idea to get used to always offering the other side, even if they don’t want it. Just think of it like dinner and dessert. You always offer desert, but if they don’t want it, it’s ok.
Milk production is a constant, ongoing process. Every time the nursing baby consumes milk, the mother’s body automatically makes more milk to replace it. The more often the baby feeds, the more milk the mother’s body produces. If the baby does not take the milk directly, it must be regularly removed by hand or with an efficient breast pump about as often as the baby usually feeds. This process is called expressing milk. If a baby does not breastfeed and the mother does not express milk, the mother’s breasts become overly full and uncomfortable. This can lead to an infection and potentially a drop in her milk supply.
Chapter 10: Infant States
One of the most astonishing things about newborns is their ability to communicate almost from the moment they are born. Without words, they manage to let their parents know when they want to eat, learn, play, or rest. They also can use their bodies and some awful noises to send unmistakable signals when they need a break (or a diaper change!). In the past, experienced friends and family members were there to help moms “decode” baby messages.
Babies have several different states. They can move through states very quickly, making it hard for parents to know why their baby is behaving the way she is. Being aware of cues and paying attention to the baby’s surroundings can help you understand why the baby might be upset or overly sleepy.
Here are a few things the research has shown us:
Infants “cycle over and over” through active sleep, quiet sleep, and waking
Active sleep (REM) is considered to be important for brain development
Babies dream and blood flows to the brain bringing nutrients to active brain cells
Your baby will cycle through quiet sleep, a deep sleep with no dreaming or movement. It is important for the baby’s brain to rest, and this will be your only true break during the day. Use them wisely!
Although all healthy babies are different, most move through the states in similar ways. If babies are very sleepy or very upset, it may take some time for them to respond. If a baby does not respond at all to the suggestions below (after several minutes), please see your doctor.
Infant States - Birth to 6 months
DROWSY
Variable movement
Irregular breathing
Opens and closes eyes
Tired eyes
Delayed reaction time
LIGHT SLEEP (Active Sleep)
A lot of your baby’s brain development happens AFTER they are born, and that requires them to dream a lot. Infants are on a 60-minute sleep cycle, and the first 20 - 30 minutes of sleep they will be in light sleep (dreaming). If you put them down in this state, they are very likely to wake up. Husband and grandma job! Hold the baby for 20 - 30 minutes after you breastfeed, until they transition to deep sleep.
Some movement
Irregular breathing
Facial movement
Rapid eye movement (REM)
Easily awakened and