As doulas, we often see new mums come home from the hospital bewildered and confused about breastfeeding. The common experience is that women have received conflicting advice by different midwives and other care providers in the hospital, and often head home feeling unsure about what to do and who to listen to.

This, according to midwife and IBCLC Amy Sherer, is because ‘current research can take years to filter down to institutional level where it is passed on to parents, hence the common experience of conflicting advice in maternity care.’

Another thing we notice consistently with new mums is their surprise at how frequently newborns want to feed. This one doesn’t discriminate. No matter how your baby was born or what level of support you have, newborns are demanding and most of them don’t adhere to the schedules of the modern parent. 

We aren’t saying any of this to scare you, but rather to encourage you to arm yourself with information and support so that you have the knowledge and confidence you need to embark on a successful breastfeeding journey. 

The following Breastfeeding Timeline is an excerpt from our book Life After Birth which we hope can shed some light on what to expect in your first days and weeks of breastfeeding.

A Typical Breastfeeding Timeline - From Life After Birth

PREGNANCY:

Breast tissue grows only two times in your life: puberty and pregnancy, the latter being when the most significant changes occur. You will notice not only a change in breast size, but also in the colour and shape of your areola and nipples (they get darker which helps baby to find them) and your veins may become more prominent. It's important to note the degree of changes have minimal to no bearing on the outcome of your milk production.

Colostrum production begins from around 16 weeks of pregnancy. Colostrum is a low-volume nutrient-dense substance that may appear thick like honey or be watery and even different colours from one person to the next. Colostrum is tailored to your baby's specific needs and contains the immune blueprint for your baby's lifetime.

You may wish to discuss the advantages of antenatal hand expressing with your healthcare provider. Antenatal expression can be especially beneficial for those who develop gestational diabetes or who have pre-existing diabetes. A good place to start with general information on this topic is via the Australian Breastfeeding ASSOCIatIon. We recommend their article Antenatal Expression of Colostrum'. When seeking advice on this topic it is important to ensure your health practitioner is up to date with the latest advice and research and is also qualified to advise you on whether it is safe for you to hand express under your specific circumstances.

BIRTH TO 8 HOURS AFTER BIRTH:

In ideal circumstances, baby should be placed skin-to-SkIn on vour chest immediately after birth. it this is not possible - such as after neonatal or obstetric emergencies - aim to initiate skin-to-skin contact as soon as vou are able. Ask your care provider to assist you if this is not something you feel confident with.

Babies are often very alert in the first hour following birth; this is the prime circumstance for a baby to perform the breast crawl before nursing for the first time.

8 TO 24 HOURS AFTER BIRTH:

Your baby may be very sleepy during this period. It is not necessary to wake them for a feed unless it has been more than 6 hours, or it is medically indicated to do so (such as with premature, very small babies, or those requiring blood sugar monitoring)

24 TO 48 HOURS AFTER BIRTH:

From around 24 hours it is important to feed your baby more frequently.

Some feeds may occur in clusters or very close together, or they may be longer with lots of swapping or 'switch feeding' (swapping from one breast to the other). It is important to remember that some feeds will be to satiate hunger while others will be for comfort and security as the baby seeks to regulate their nervous system following their own transition from foetus to baby. Babies have no concept that they are separate from you at this early stage and require loads of reassurance. Allowing your baby to suckle as often as they need to will comfort them and stimulate your breasts to produce milk. Suckling also provides babies with exercises that support brain development and oral development.

2 TO 3 DAYS AFTER BIRTH:

Your baby may feed in longer, more regular blocks of time, or have long stretches of fussing and/or feeding constantly or around the clock as they bring in your milk Your colostrum may become more watery as it increases in volume, water, lactose (milk sugar) and fat. This is sometimes called 'transitional milk'. Everything you've read will have told you that breastfeeding isn't painful and it shouldn't hurt, but your nipples may feel sensitive from all the sudden action they are experiencing. This will pass, but if you notice any cracks, blisters, bleeding or bruises, it's important to ensure babys latch is correct, to mitigate further damage and other associated problems. If your nipples are becoming damaged it is likely because baby is not latching well. This may mean they aren't receiving enough milk, which will also affect your supply. There is only so much that can be communicated through a book or the internet, so if your intuition tells you that your latch isn't correct, see a lactation consultant immediately. One breastfeeding problem can lead to a cascade of issues, so it is important to seek help and nip any small issues in the bud.

3 TO 5 DAYS AFTER BIRTH:

Your baby may continue to want to nurse around the clock. This is around the time where they become more motivated by hunger rather than just the need to suckle.  This is often coined 'cluster feeding' and if you aren't expecting it, it may cause you to question your supply. Hang in there, and know that your baby is doing exactly what they are supposed to.

Once your milk comes in, your breasts may feel rock hard or become engorged. If baby is having trouble latching due to engorgement, it is important to express a little before feeding, to make it easier for your baby to latch and to prevent nipple damage. Milk may remain yellow for another week or so it it still contains colostrum.

Once your milk is in, your baby may continue to enjoy frequent and lengthy feeds, especially in the first two to four weeks. This is biologically normal and is a continuation of the baby's adjustment to the world - they are feeding for comfort as well as nutrition. Your baby may often fall asleep at the breast due to the presence of melatonin in your milk and because sucking switches on the parasympathetic (rest and digest) nervous system. While once believed to be 'bad habit' forming, science is now showing that falling asleep at the breast is a biological norm, and another case of your baby doing exactly what they are supposed to do.

5 DAYS TO 6 MONTHS AFTER BIRTH:

As your breasts relax you may wonder if your supply has reduced, but worry not, breast fullness is not a reliable measure of milk supply, nor is leakage! If your baby appears satisfied after a feed and has consistent wee and poo nappies, this is usually a sign that your supply is as it should be.

It's also important to note that the amount you pump is not a reliable indicator of milk supply. Babies are much more efficient at removing milk from breasts than machines are, as pumps don t stimulate the neuro-hormonal reactions in your breasts and brain that your baby does, therefore the amount you are able to pump isn’t necessarily indicative of how much your baby is getting.

The number one most reliable sign of milk transfer is hearing regular, audible swallows at the breast; this is easier to hear once your supply increases and you may need a trained professional to held you identity it.

Given that you have the right support, adequate nutrition and rest, and drink plenty of water and herbal teas, your body will continue to be the sole source of food for your baby until they are around six months of age, as it contains all the nutrients and building blocks they need for optimal development. Pretty amazing huh? As they get older, they will continue to nurse not only due to hunger but also for comfort, pain relief through teething and sickness. connection and sleep. It is important to know that your milk remains nutritious beyond six months and adjusts composition alongside baby's needs for their age.

Breastmilk is a living substance and your body produces different milk at different times of the day. At night, your breastmilk contains more melatonin (the sleep hormone, and during the day it contains more cortisol (the waking hormone). You will notice that a boob in the mouth is the best solution to any major or minor incident, from vaccinations to falling over at the playground and everything in between.

6 MONTHS ONWARD:

Your baby will begin to explore solids alongside breastmilk, as you slowly increase the amount of food they eat and reduce the amount of milk they drink.

Your body will continue to make milk that is customised to your baby's needs, based on the miracle that is the backwash effect' (absorption of saliva by the areola) and our innate desire to cover our babies in kisses.

When it's time to introduce solids, check out the book Milk to Meals by Luka McCabe and Carley Mendes, and the Solid Starts app.

To finish off - and to keep morale high when the going gets tough - we want to share one of our favourite quotes about breastfeeding, by Carley Mendes of Oh Baby Nutrition.

"When your baby breastfeeds, a vacuum is created and their saliva is sucked back into your nipple along with important information about their personal immune status. It travels "upstream" to the receptors in your mammary glands, which rapidly respond by producing specific antibodies to meet your baby's unique need. These antibodies are then delivered back to your baby via new made-to-order milk. It means that if you or your baby have picked up a virus or some pathogenic bacteria, their saliva will inform your memory gland receptors to create the specific antibodies required to help fight them.

The antibodies then travel through your breastmilk to your baby. Not only that, but by kissing your baby, you pick up and consume viruses or pathogenic bacteria your baby has come in contact with. Your body then creates antibodies to fight those pathogens, which the baby receives directly through your breastmilk. Writing up and delivering the perfect prescription."

CARLEY MENDES, OH BABY SCHOOL OF HOLISTIC NUTRITION