The First Post-Natal Week And What To Expect

The First 24 Hours – Day 1

Your Breasts

Your breasts will still feel soft at this stage.

Your Milk

You will be producing colostrum, which is thick and may be clear or yellow in colour. It will be small in volume but high in calories and protein for your baby. The average amount a baby receives in the first 24–48 hours is 5–15 ml per feed. It is perfectly suited to meet baby’s needs.

Your Baby

After the birth, skin to skin contact with your baby is very important. Your baby will usually look for a feed within an hour of birth. Baby is initially alert and likely to feed well and then may have a long sleep. Some babies are sleepy and may only want a few feeds in the first 24 hours – others are more wakeful and want to feed frequently. Baby may feed for a short time, from around 5–10 minutes or even 20–30 minutes on one or both sides.

Baby’s Nappy

Within the first 24 hours expect one or two wet nappies. You may need to pull disposable nappies apart to check that they are wet, because disposable nappies pull the urine away from the baby’s skin and lock it away in crystals. Your baby will also pass meconium – a thick, sticky black/green stool. This will happen at least once in 24 hours but may be more.

Asking for Advice

Do not feel anxious or embarrassed to ask for advice and assistance with attachment, or for help to get you and your baby feeling comfortable. The more help you have initially, the sooner you will gain confidence.

Correct positioning and attachment are very important. Check the shape of your nipples each time the baby comes off the breast. Your nipples should look round and should not look squashed, pinched, flattened, ridged or distorted in shape. If this occurs, ask for assistance with your next feed.

Remember – breastfeeding is a natural thing to do – but it is a learned skill and you and your baby are learning together.

24–48 Hours After Birth – Day 2

Your Breasts

They will probably feel soft and comfortable at this point, but may begin to feel fuller and heavier towards 48 hours after birth.

Your Nipples

Some discomfort (pulling or stretching) is common when baby first attaches to the breast, as your nipple and breast tissue are drawn to the back of baby’s mouth. This settles after a few minutes and should not be painful.

Your Milk

You are still producing colostrum, with the volume increasing a little. It is still perfect for your baby’s needs.

Your Baby

Baby is waking up and becoming more alert. Her or she may seem quite unsettled and need to feed more frequently, for up to 30 minutes on each breast. Your baby may need 10–12 feeds in 24 hours, day and night, but should have at least six feeds in 24 hours. Your baby’s sucking should be deep and rhythmic.

Baby may need lots of cuddling time between feeds while he/she gets used to life outside your uterus.

Baby’s Nappy

There should be one or more wet nappies in this 24-hour period. Again, you may need to tear the nappy open and check the inside. There will still be some meconium; at least one dirty nappy and perhaps more. It may be less thick and becoming brown in colour.

Advice For Mum

Check your nipple shape after feeds. Ask for help whenever you need it for feeding or with settling your baby. You might be very tired today, rest when your baby rests to help you cope with sleep disturbances at night.

48–72 Hours After Birth – Day 3

Your Breasts

Your breasts may still be soft or beginning to feel heavier and fuller. They also be warmer to touch.

Your Nipples

Some women experience increased sensitivity in their nipples over the first 72 hours. It settles down once milk volume increases.

Your Milk

Colostrum changes to transitional milk; it looks thinner and yellow to creamy white. Volume is increasing slowly, responding to baby’s needs.

Your Baby

Your baby is ‘programmed’ to know what he/she needs to do to ‘bring milk in’. He/she may want to feed very frequently, for example, a cluster of 4-5 or more feeds close together and then may settle for a little longer. This is normal as long as the attachment and positioning is correct and he/she is sucking correctly.

Your baby likes to stay in your arms and will often settle better when being cuddled. You may also notice your baby studying your face. Your baby’s eyes can focus best on objects about 50–60cm away. This is about the distance between your face and your baby’s when feeding. Your baby has been hearing you talk to him/her for a few months and now wants to get to know the person who has been making all those sweet noises.

Baby’s Nappy

Output increases as milk flow increases. Two to three nappies in this 24 hours. Stools are brown to khaki green in colour.

Advice For Mum

You may feel tired and emotional, so make sure you sleep or rest when baby rests.

It is recommended to keep visitors to a minimum on day 2 and 3, to allow you and your partner to get the chance to rest or watch educational videos – and to get to know your new baby!

72 Hours Plus After Birth – Day 3–4

Your Breasts

Your breasts may feel full, heaver and firmer and may be tender or uncomfortable.

Your Milk

Milk becomes thinner and whiter in colour and more plentiful, often known as the milk ‘coming in’.

Your Baby

Your baby may continue to be wakeful and feed frequently. It is still normal to have 6–12 feeds in a 24-hour period. You should be able to hear baby swallowing after each suck. Feeds may not take as long now. Allow unrestricted time at the first breast, then, when baby finishes one breast and is feeling comfortable, offer the second breast. Sometimes baby will take it and sometimes he/she won’t. If a feed lasts longer than an hour, ask for help.

Your Nipples

Any tenderness or sensitivity of the previous days should be reduced. If nipples are tender or painful throughout the feed take baby off the breast and reattach, and/or ask for help.

Baby’s Nappy

Expect more frequent wet nappies (4–6 in 24 hours) and paler coloured urine. Stools usually become a yellow/mustard colour, often quite loose with small lumps.

Advice For Mum

Each breastfeed has a three stage sucking pattern.

First stage: A burst of short sucking to draw the nipple back to the soft palate and to release the milk. This shallow non-nutritive sucking may last for a few seconds or a few minutes, until milk is released or ‘let-down’.

Second stage: A pause in sucking then long, strong deep sucking with short pauses. Swallowing can be heard. Mostly one suck per swallow ratio.

Third stage: Dreamy phase with long pauses and shorter bursts of deep sucking before coming off the breast.

Days 4–6 After Birth

Your Breasts

You will still be full before feed, but noticeably less full after feeds. You may notice your other breast leaking while you are feeding. You may need to express a little milk before a feed (only if your breasts are very full) to make attachment easier. It is important that you are shown how to do this before going home.

Your Milk

White in colour and flowing well.

Your Baby

Your baby needs at least six feeds in 24 hours. Some feeds will be clustered close together and others will be further apart. Baby is generally more settled between feeds, looks content after feeds, settles better but will have some unsettles wakeful periods. He/she may be lonely, uncomfortable or insecure and may need extra cuddles. You may have been told that picking your baby up too often will ‘spoil him/her’. This is absolutely not true. Your baby has recently been removed from a place that is dark, warm and relatively quiet to a world that is noisy, cold and with harsh bright lights. Your baby wants comfort and reassurance, and what better way to get this than snuggling up close to mum.

Baby’s Nappy

Stools remain loose with curds and yellow to yellow/green in colour. Can have several in one day.

NOTE: After about six weeks of age some fully breastfed babies may not have a bowel action every day in fact they may go for several days without a motion. This is normal for breastfed babies providing that, the stools are not constipated but still soft and loose.

Written by BellyBelly Midwife, Alan Rooney, who you can often catch in the BellyBelly Forums.