From Hospital to Home

For families who are pumping and/or supplementing

I strongly recommend that you read (1) and (2) Basic Principles, but if you are too exhausted, feel free to skip ahead to (3) Step-by-Step Plan for now. Don't worry about (4) until you are well rested and making more milk.

1. Basic Principles of Milk Production

1. Removing milk from your breasts increases milk supply.

2. Letting your breasts stay full reduces milk supply.

3. Your body starts figuring out how much milk your baby needs in the first 5-7 days; as time goes on, it becomes harder to increase the milk supply, and in some cases, impossible.

   1. Breasts must be emptied about 8x/day (a well-latched and energetic baby, or a pump, can do this)

   2. Emptying the breasts should be a higher priority than other problems like poor latching.

   3. A full supply is about 17 or more ounces per day by Day 7, and 27 ounces or more by Day 14 (if you are directly breastfeeding, your baby will be gaining 1 oz/day).

2. Basic Principles of Baby Learning to Breastfeed

1. Baby must be fed until full at every feeding, for their health and to have the energy to breastfeed.

2. Latching problems are not urgent; as long as baby is eating enough and breasts are being emptied, there is plenty of time to figure latching out.

3. Baby must have good experiences at the breast; no fighting/pressuring them to latch.

4. It can take time, even weeks, but babies usually figure it out. Your job is only to give them opportunities to practice.

3. Step-by-Step Plan for Breastfeeding Problems in the First Week

Daytime

Every 3 hours:

1. Breastfeed (or try to) for about 10 min per side...

   1. or until baby stops swallowing, whichever comes first.

   2. if you are too exhausted, you can skip this breastfeed and proceed to step 2.

2. Other parent or support person bottle-feeds baby until they're full. (Here is a calculator to figure out how much milk your baby is likely to need.)

3. Mother pumps her breasts about 15 minutes or until mostly empty.

Nighttime

1. Mother sleeps for one 5-hour stretch, while father feeds baby when needed.

2. Continue emptying breasts by whatever way is quickest and easiest (usually pumping).

3. Make sure one of these emptyings is between the hours of 12 and 6 a.m.
   

On Day 7 after birth, if your baby is still needing formula, start "power pumping" when you wake up (20 minutes pumping, 10 min rest, 10 min pumping, 10 min rest, 10 min pumping). More tips here.

4. Transitioning to Exclusive Breastfeeding

This is very individual, but basically as baby does better with breastfeeding, pumping and supplementing can be stopped. Sometimes you can stop as soon as your milk comes in, and sometimes you must do this gradually. Do not rush. Baby must be able to successfully get full from breastfeeding alone to proceed. Breast compressions can be helpful if baby is sleepy or impatient. Again, this is very individual, so you may need personalized advice.