The first days of breastfeeding

Most full-term, healthy babies are ready to begin feeding within the half-hour to two hours following birth. This time can be considered a window of opportunity. 

It is recommended that babies be placed skin to skin with their mother immediately after birth. Skin-to-skin contact between mother and baby after delivery supports breastfeeding and the development of emotional bonds [1].

The breast crawl describes the movement of the baby from a position against their mother to one between the breasts and then very close to the nipple. It is often difficult to determine when the breast crawl stage begins. It can occur approximately 30 minutes after birth. You may notice that the newborn no longer seems to be in the same position — they will crawl slowly or make a full push with their legs [2]. 

When the baby arrives at the breast, they may massage the breast or nipple, move their hand from their mouth towards the breast, stick out their tongue over it, or suckle the nipple. During this time, the nipple and breast change shape, as oxytocin levels rise and the nipple prepares for suckling [3]. 

Try not to rush the newborn during this period. Research shows that helping a newborn to latch too much during this first hour may be linked to later breastfeeding difficulties [4]. If you feel the urge to support their progress, gently guide them!

Newborns respond to the smell of amniotic fluid and that of their mother [5]. A study showed that the warmer temperature of the areola acts as a signal to guide newborns to begin breastfeeding [6].

The first feed offers protection against infections, and breast milk has been shown to prevent neonatal death from sepsis, pneumonia, diarrhoea, and hypothermia [7]. The welcome feed supports the emotional bond between mother and baby and has a positive impact on the duration of exclusive breastfeeding. The first yellowish milk produced in the early days, also known as colostrum, is an important source of nutrition and immune protection for the newborn [8].

The first liquid produced by mothers after birth is colostrum [9]. 

It is rich in immunological components such as immunoglobulin A (which protects the baby against illness by forming a protective layer, particularly in the baby's digestive system [10]), lactoferrin, leucocytes, as well as developmental factors.

A range of innate, multifunctional molecules also provides significant protection against infections. These molecules are generally more abundant in colostrum, and their levels decrease as lactation becomes established and continues. One of the most abundant is lactoferrin, an iron-binding glycoprotein belonging to the transferrin family, which is effective against a large number of different bacteria, viruses and fungi.

The average level of epidermal growth factor in colostrum is 2,000 times higher than in maternal serum.

Colostrum also contains relatively low concentrations of lactose, but is rich in proteins, fats and vitamin A. 

Important: The quantities of colostrum are always sufficient and its composition meets the needs of the newborn at birth. It is estimated that the newborn consumes between 25 and 56 mL of colostrum during the first day of life.

To properly encourage your baby's suckling, there are a few prerequisites to put in place so that everything goes as smoothly as possible. 

Here are a few tips: 

- Make sure your baby opens their mouth wide enough to latch onto the areola, and not just the nipple 

- They should be well latched on to the breast, so much so that you won't see their mouth and won't feel any pain

If needed, you can guide your baby to the breast.

Don't wait, where possible, for their vocalisations to turn into crying — put them to the breast when they start to root or run their tongue over their lips

Very quickly, you'll learn to recognise your baby's cues: hands to the mouth, lip movements… and you'll know exactly when to put them to the breast so they're calm and in the best state to take in enough breast milk. 

Listen to them — babies know how to send signs that hunger is on its way!

In some cases, a baby may refuse to take the breast. Generally, this presents as a refusal to feed — they may cry, arch their back, and turn away when brought to the breast.

There may be several causes for this, including a physical issue such as [11]: 

- an insufficient milk supply
- An illness, infection, or pain in the mouth, such as thrush 

- Pain, for example cranial tension following a traumatic birth.

They may also experience difficulties for the following reasons: 

- They are using a dummy 

- They are having difficulty latching onto the breast 

- It only takes the pressure applied to their head by someone helping them to latch 

- You are shaking the breast whilst trying to help them latch. 

- You are using a soap or perfume with a strong scent: 

babies are born with very limited vision, and the world outside the womb is highly stimulating and bright for them. Their sense of smell takes over from their sight, before their vision gradually sharpens over time. The scent of breast milk is very similar to that of amniotic fluid, which explains its appeal to the newborn [12]

Try to encourage skin-to-skin contact and stay close to your baby. Offer the breast every time they show even the subtlest feeding cue. 

If you are experiencing difficulties, you can contact an IBCLC lactation consultant, who will be able to support you and identify any potential issues, so that things go as smoothly as possible for you and your baby. 

You may decide not to breastfeed. In that case, it can be helpful to slow down the milk coming in, which will naturally stop on its own within 1 to 2 weeks. 

Medication may be prescribed (lisuride, cabergoline), but mainly when breastfeeding is not initiated for medical reasons. Indeed, the side effects they cause lead health authorities to advise against their use. 

Some plants may be consumed to stop milk coming in. The most well-known are: 

Sage, particularly at a rate of 1 to 3 g of leaves as an infusion per day [13]. 

Chasteberry (Vitex agnus-castus), which has been used to reduce excess breast milk in traditional Persian medicine [14]. 

Peppermint oil may reduce milk production when applied topically [15]. 

Please note that if you use these methods, you must wean baby. These plants should be used if you wish to stop milk coming in altogether, and not simply to reduce milk production whilst continuing to breastfeed at the same time. 

Parsley consumption is also traditionally recommended [16] as a decoction.

The first days of breastfeeding are precious and unforgettable moments with your baby. Listen to yourself and listen to your baby — you are capable of this. 

If you encounter any difficulty at all, or simply to feel well prepared, don't hesitate to contact an IBCLC lactation consultant, who is trained and will be able to support you on this new journey. If needed, she can recommend the best breastfeeding supplement best suited for you. 

Take care mama