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. 

Il se peut que vous décidiez de ne pas allaiter. Dans ce cas, il peut être utile de freiner la montée de lait, qui s’arrêtera naturellement seule en 1 à 2 semaines. 

Des médicaments peuvent être donnés (lisuride, cabergoline) mais surtout en cas de non allaitement pour des raisons médicales. En effet, les effets secondaires qu’ils procurent amènent les autorités de santé à les déconseiller. 

Certaines plantes peuvent être consommées pour stopper la montée de lait. Les plus connues sont : 

La sauge, notamment à raison de 1 à 3 g de feuilles en tisane par jour [13]. 

Le gattilier, qui a été utilisé pour diminuer l'excès de lait maternel dans la médecine traditionnelle perse [14]. 

L'huile de menthe poivrée peut réduire la production de lait lorsqu'elle est utilisée en application topique [15]. 

A savoir que si vous utilisez ces méthodes, vous devez sevrer bébé. Ces plantes doivent être utilisées si vous souhaitez arrêter la montée de lait, et non pas juste pour diminuer la production de lait tout en allaitant en parallèle. 

La consommation de persil est traditionnellement recommandée également [16] en décoction.

Les premiers jours de l’allaitement sont des moments privilégiés et inoubliables avec votre bébé. Écoutez-vous et écoutez votre bébé, vous en êtes capable. 

Si vous rencontrez la moindre difficulté, ou tout simplement pour être bien préparée, n’hésitez pas à faire appel à une consultante en lactation IBCLC, qui est formée et saura vous aider dans cette nouvelle aventure. Si besoin, elle pourra vous recommander le meilleur complément alimentaire allaitement adapté pour vous. 

Take care mama