10 Tips From A Lactation Consultant That You Need To Know In The First Week

The first week with a newborn is intense - physically, emotionally, hormonally. Feeding questions come up fast, and a lot of the advice parents receive is well-intentioned but incomplete. A lot of the families I see in practice didn't get a chance to speak to a lactation consultant in the hospital for more than 5 minutes - AND their next available appointments weren't until weeks later. So, don't assume you will learn it all at the hospital. Get prepared early.

Here are ten things I wish every family knew from day one.

In no particular order:

1. Baby behavior changes almost daily

What your baby does on day one will not be what they do on day three… or day five… or two weeks later.

Feeding frequency, sleepiness, alertness, and fussiness are constantly shifting in the early days. This is why advice you get in the hospital may not apply even a week later. That's why you shouldn't get attached to feeding patterns because early feeding is dynamic - not predictable.

2. The first day is usually very sleepy - don’t be fooled

Many babies are calm and sleepy in the first 24 hours. Parents often think, “This is easy!”

Then comes day two and three when cluster feeding ramps up big time. This is NORMAL, expected, and important for milk production. A sleepy first day doesn’t predict how feeding will look next. In fact, take advantage of baby's first sleepier day and rest yourself to prep for tomorrow's big cluster feeds.

3. A sleepy baby and a lethargic baby are not the same

Sleepy babies wake for feeds, latch, and actively suck, even if they drift off again.

A lethargic baby is difficult to rouse, doesn’t sustain feeds, has low tone perhaps, or shows little interest in eating. Knowing the difference matters. If something feels off, trust that instinct and get support. I say this because again, baby behaviour changes from day to day... so if you are experiencing the sleepy day 1 baby on day 5 - that's not normal.

4. Learn how to tell if your baby is getting enough milk

This tip may help in distinguishing a normal tired baby from a lethargic baby because a lethargic baby will often not be taking in enough milk.

Milk intake isn’t necessarily measured by how long a baby feeds or how your breasts feel - despite these being somewhat indicative of milk being moved.

Instead, look for:

• Adequate wet and dirty diapers for age

• Baby waking and cueing for feeds (babies need to eat 8-12 times a day minimum)

• Swallowing during feeds - sounds like a gentle 'kuh'

• Gradual improvement in alertness and tone

These signs are far more reliable than the clock or length of feeding at the breast.

5. “Milk coming in” doesn’t mean there was no milk before

Colostrum, the first milk, is present from pregnancy onward. Babies need those small, concentrated amounts in the first days to grow and your breasts need that milk to be removed for supply to ramp up.

Frequent feeding (cluster feeding) before your "milk comes in" is not a sign of low supply. It’s how the system works. It's NORMAL. A baby coming to the breast often might signal some nurses to offer a milk substitute, but if you can manage the cluster feeding to bring in your milk, you are well on your way to an established milk supply.

6. Be gentle with your breasts

Breasts are not dough that need aggressive kneading.

Deep massage and heat after feeds can increase swelling and inflammation. If you’re using warmth, use it before feeding to encourage flow. Afterward, gentle handling, rest, and cool support are often much more appropriate. A well-loose fitted bra

7. Babies can latch themselves if we let them

Sometimes nurses or helpers will physically push a baby onto the breast. This has it's place I suppose, and can be useful for learning when you are exhausted and can't think and someone else has to quickly help out, but it can also overwhelm some babies - and some mums. Using a baby-led approach and having gravity on your side can reduce the need to push a baby onto and into the breast abrasively. When you are leaning forward (as one often does post hospital birth) you would need to pull a baby in to the breast quite a bit to keep them there - BUT, if you are leaning BACK, then baby can do it themselves, with their own pace, a little neck control, and gentle guidance from you. Put those bedside buttons to use and lean back in the hospital bed before latching.

Given time, skin-to-skin contact, and patience, many babies will root, bob around, and self-attach. Really. We don't see this on shows or movies, but it is true. Following your baby’s lead often results in a calmer, deeper latch.

8. Breastfeeding should not hurt

Discomfort in the first seconds of a latch can happen, of course, it's a new sensation for many. But, ongoing pain is not normal.

Pain is information. It often signals a latch issue, positioning problem, or feeding imbalance that is very fixable when addressed early. I always go back to body positioning at the first sign of pain, then latch positioning specifically, then move on to problem solving with aids, or other supports.

Don't give up if you think this is what breastfeeding is going to feel like long term.

9. Engorgement is common, but not normal

It’s common to feel fullness or tightness when milk volume increases. But prolonged, painful engorgement is a sign milk is not being effectively removed.

Anyone who says they were engorged for weeks should have seen a lactation consultant immediately. With effective milk removal, your body usually regulates quickly.

10. If baby gets a bottle, your body still needs to let out milk

Any time your baby receives a bottle, your breasts need stimulation too - through pumping or hand expression.

If milk isn’t removed, your body doesn’t get the message that your baby was hungry at that time. This is what people mean when they say milk is regulated by supply-demand. This relationship of removing milk when baby takes in milk is especially important in the early weeks as your milk making cells are developing.

Final thought

The first week isn’t about perfection. It’s about learning, responding, and getting support early. Small adjustments made in the beginning can prevent big struggles later. If you feel overwhelmed, book a lactation consultant visit prenatally to go over all of this and more in detail.

Thanks for reading!

-Nicole

Disclaimer: The information provided in this blog is for general informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before making any health-related decisions