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Breastfeeding in the beginning

In the beginning, breastfeeding is a matter of getting to know your newborn and understanding when your infant is hungry. It’s about exploring, together with your infant, what works for the two of you. You’ll need to try different options and give it time. You can make the process easier by reading and learning about breastfeeding.

There are certain patterns in terms of let-down (milk ejection reflex), how newborns signal when they are hungry and what happens in your body when your milk comes in. By knowing more about this, you will better understand how your body reacts and your baby’s signals, making it easier to turn breastfeeding into a positive experience for both.

Intermittent let-down

Once your milk comes in, you might notice that let-down comes intermittently. Your baby sucks, sucks and swallows, sucks, sucks and swallows. Baby might then suck less actively for a while without swallowing, followed by a new let down after which baby starts sucking more actively, sucks, swallows and sucks, sucks and swallows again. First to come out is colostrum and you cannot always see that baby swallows.

Your milk coming in

After a few days, when your milk comes in, you may notice that your breasts get fuller, tighten and hard, and the skin redder. This is perfectly normal. At this point, your baby may have difficulty latching on to the nipple. It’s quite common for this to occur after you’ve returned home even though baby had no problem sucking at the maternity ward. An easy technique called reverse pressure softening (RPS), see the image below, can help soften your breasts so that your baby can latch. You can also try hand expression to relieve the pressure. It’s good to know that it’s equally common for breasts not to tighten when the milk comes in.

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Practice RPS by pressing your fingertips around the base of your nipple for about one minute. This alleviates the outermost swelling, making it easier for your baby to latch on your breast.

Leaking

It’s common to leak breast milk from your nipples when your milk comes in even more. When the baby nurses from one breast, you may leak from the other breast. Either collect the milk in a collection cup (can be purchased in pharmacies) or press one finger against the nipple briefly to stop leaking. It is not uncommon to leak heavily at night in the beginning, and that your bed is soaked in breast milk when you wake in the morning. Know that it will not always be this way. This usually passes within a few days or a few weeks while your breasts get accustomed to producing the right amount.

Fever

You may develop a fever when your milk comes in. It is important to rule out abdominal pain combined with fever (risk of uterus infection) or urinary tract symptoms combined with fever (risk of urinary tract infection). If you have no symptoms other than from your breasts, your fever is most likely due to your milk coming in. If you tolerate Ibuprofen, it is the preferred option to bring down your fever after giving birth.

Your breasts get softer again

When your milk comes in between day 3 and day 5 your breasts will tighten due to an increase in milk. This tightening is also caused by an increase in blood volume, lymph nodes and lymph tissues. As the swelling itself subsides, your breasts will feel considerably softer again when they contain only breast milk. There’s no reason to worry your milk is decreasing when your breasts get softer after a few days. The amount of milk is the same.