The other day, a husband & wife came in with their 3 day old infant. The infant was not latching well & the mother’s experience with the hospital’s CLE (Certified Lactation Educator) and her words to the new parents did not help the situation much either. Actually, her words probably made things worse. The new mother came in crying, frustrated, and ready to offer her baby formula after leaving the hospital the day before still without the infant latched. The only thing that had been going through the new-mother’s mind had been the last thing the CLE kept telling her before she left the hospital she had given birth in, “you’re doing it wrong! You’re doing it wrong! YOU ARE DOING IT WRONG!” I asked her if I could give her a hand & proceeded to help the new parents latch their infant. I reminded them about these few important things to keep in mind when it comes to the first few days of an infant’s life:

1. An infant’s stomach is the size of a marble and can only hold, at most, 1/6 – ¼ oz in the first day of life. Frequent feedings, 10-12 feedings, per day is completely normal and expected. This is why skin-to-skin with mother and baby is so important, especially, in the first few days of life so that the infant can have access to the breast as much as possible.

2. Day three is around the size of a Ping-Pong ball which at most is around 1 oz and frequent feedings should still continue; 10-12 feedings.

3. By day ten, the infant’s stomach has grown to be able to hold around 2-3 oz and by that time your breastmilk might be completely established and hopefully the baby is latched and is drinking like a true-professional.

Skin-to-skin contact (as discussed in a previous post) is super important for the mom & baby during this time. Women have receptors in their breasts & during the first month, the more skin-to-skin contact & breastfeeding that occurs actually “stimulates” these receptors & triggers the most production of milk to be made for the baby. Think of it like your baby is “calling ahead” to “Brest Restaurant in town” & wanting to “put in an order” of how much milk the baby will be wanting to drink from here-on-out until s/he slowly starts age & texture appropriate solid foods at 6 months of age.

Another important thing to remember is how breastmilk is made.

1. Cuddling, nuzzling, skin-to-skin time w/baby increases Oxytocin (the hormone of calm, love, and healing)
2. Oxytocin increases Prolactin (the mothering or nesting hormone) – Pro Lactin, means for milk in Latin.
3. Prolactin is released by the pituitary gland during pregnancy and lactation and causes the alveoli & mammary ducts to mature & proliferate, and then start producing milk.

In other words, just like the woman explained above in her story, if the new mother is stressed out because she “thinks” she is not making “enough” milk in the first couple days or weeks or months (or if she thinks she is a bad mother or not doing something right), the oxytocin hormone will go down, causing prolactin to decrease, causing less milk to be made. And the cycle continues…She will become even more stressed due to less milk being made, she will stimulate even less oxytocin to become released, leading to even less prolactin. Just as I told the new-mommy in the story above: relax, be calm, say a prayer, put on your favorite movie or music, eat your favorite food, have your husband give you a foot massage, smile, and most importantly, nuzzle, cuddle, smell, kiss, and love your baby…this can create a wave of oxytocin →increase prolactin → increase milk let-down.

And lastly, in any profession where you are helping somebody out, use motivational interviewing. Use positive, helpful, and healing words. For example, “Great job New-Mommy, but let’s see if the baby will latch better this way, or that way. You’re doing a wonderful job and getting the baby to latch can take a few days, keep up the good work.” Be positive and uplifting to the new mother; she deserves all the praise & love she can get from everyone around her.

During pregnancy, don’t spend all your time picking out the baby’s nursery & which maternity outfit you’ll look best in. Learn, discover, grow (no pun intended) and become educated so that you’ll be on your way to making your own decisions about the birth & breastfeeding experience you were meant to have

Katie O’Mara, RD
The Diet Doula

Resources: Gaskin, Ina May. Ina May’s Guide to Breastfeeding. New York: Bantam Books, 2009.