Three to four days after baby is born your milk "comes in," at which point you may feel your breasts getting very full, often to the point of engorgement, which can be painful. The best way to relieve engorgement is to nurse, but breasts that are too full for baby to handle — imagine trying to get your lips around an overinflated balloon and you'll see baby's problem — can be made more manageable by pumping off a bit of milk.
Keep in mind that after your milk comes in it still may take a few minutes of sucking before your milk begins to flow. It is the baby's sucking (or, alternatively, the sucking action of a breast pump) that stimulates your "let down" reflex and allows the milk to flow. Most women alternate breasts so that baby nurses on both breasts during one feeding.
For the first six weeks, babies usually feed every two to three hours. After that their feedings will still be frequent but may begin to be spaced further apart, with exceptions during periodic growth spurts, says Margot Mann, a board-certified lactation consultant, vice president of external affairs for the International Lactation Consultant Association (ILCA) and director of Riverdale Lactation Center in Riverdale, N.Y. Eventually, as babies get more efficient at sucking, they cut their nursing time. By 6 months old, they may finish nursing in as little as five to 10 minutes.
How do you know if baby is latched on and getting milk? "If the mother is not in pain and the baby seems to be feeding well, he's probably latched on," says Ryan. Here are some signs to look for:
- Baby has the entire areola in his mouth.
- His cheeks are round, rather than dimpled, while nursing.
- There is no clicking and popping sound.
- There appears to be good rhythmic sucking.
- You can hear baby swallowing.
- He is gaining weight.
- He is producing six or more wet diapers per day and has at least two bowel movements (although bowel movements will become less frequent after the first few weeks of life).
- He is mostly content between feedings.
- Your breasts are full before feeding and feel less full after a feeding.
Also, while some babies will want to nurse for long periods just to satisfy their sucking needs, if a baby wants to nurse for long periods every time he is fed, it may be an indication that he is not getting enough milk. The AAP recommends that all babies released from the hospital within 48 hours of birth get a checkup by a pediatrician when the baby is two to three days old. This is a good time for the doctor to evaluate the baby's feeding progress.