When to Start
Ideally, babies will nurse for the first time within about one hour after birth. In that first hour, babies tend to be very awake and alert. After that, they may fall asleep for a period of two to six hours, during which it’s hard to rouse them for a feeding.
Some babies are ready to feed immediately after birth, some may not be ready till almost the end of the first hour, and trying to push breastfeeding before that may only lead to frustration for all involved.
First Feeding – the Breast Crawl
Many experts recommend the following process for initiating breastfeeding. Immediately after birth, mom is in a semi-reclining position, and the baby is placed skin-to-skin on mom’s belly. (Naked baby on mom’s bare belly/chest, with a blanket over both of you to keep baby warm). It is best not to wash baby’s hands before doing this; if his hands smell like amniotic fluid, that helps him to recognize mom’s smell.
Baby is then allowed to nuzzle against mom; he may touch her belly and breasts, may sniff or lick or mouth at her skin. (Learn more about hunger cues.) He may “crawl” and wiggle his way up to her breast on his own, eventually. If placed near her nipple, he may begin bobbing his head up and down, or turning his head from side to side. He may find the nipple on his own, then may latch onto the breast on his own. (Click here for a video of this, or go to YouTube and search for “breast crawl” to see lots of babies making this journey.)
Research indicates that it may take a baby up to 50 minutes to latch on his own, but if allowed to do so, the baby generally will have a good latch from then on, and generally mom will have less problem with sore nipples and other breastfeeding challenges. Mothers who breastfeed in the first hour tend to breastfeed their babies longer than those who did not feed shortly after birth. Skin-to-skin and early breastfeeding is also important after cesarean.
However, some babies do not latch on by themselves. If mom had pain medication during labor, self-attachment is less likely. If by 45 minutes or so after birth, the baby isn’t seeming interested in feeding, try expressing a little colostrum, and rubbing it on baby’s lips. This may stimulate his hunger.
If by 50 minutes after birth baby has not yet latched on and nursed, then mom will want to follow the steps described under position and latch, to help her baby learn to nurse.
Early Days of Breastfeeding
At the hospital (or at home), the baby will typically stay in the room with you to allow you to nurse as frequently as possible: at least 8 times a day, but 12 or 16 would be fine. The more you nurse, the sooner your mature milk will come in, the sooner baby will start gaining weight, and the less likely that baby will develop jaundice. The nurses at the hospital (or your midwife) can help you with position and latch.
In the first few days, you may feel cramping when baby nurses: this is a positive sign that your uterus is returning to its pre-pregnancy size. Rest assured, cramping is temporary.