One of the reasons I recommend checking in with a lactation consultant is because newborns and breastfeeding change… by the week… by the day… by the hour! I don’t expect someone to be able to pick up on all the little details and remember the changes for that day. Those details often are exactly what the lactation consultant is looking for to determine if breastfeeding is going super smooth or if it could use some tweaks. Day 1 and day 2 of your newborn’s life are great examples of this. Already, in Breastfeeding the First Week: Day 1 we talked about baby changing the way they act and the way they breastfeed just in the first few hours of life. Now, they’re going to change again. So, let’s talk about how to excel at baby’s first week: day 2.
Baby’s behavior day 2
I hope you took as many naps as possible on day 1. At some point on day 2, your baby is going to feel rested enough from delivery to wake up. When he does, he’ll realize the only thing familiar is you! Definitely not the bassinet. The bassinet does not smell familiar, it’s not warm, it doesn’t make any of the sounds that have been constant in his life over the past 9 months. He can’t suckle on it and it doesn’t have milk. His instincts tell him he needs to get to where it is familiar. Your little one knows he can survive and thrive if he gets to where it is warm and where it smells and sounds normal.
This can manifest in a few ways. When a baby nurses frequently, it is called cluster feeding. Most often, cluster feeding happens at night. It may be that he nurses once an hour for four hours. It may be that he nurses really well and then you lay him down. 20 minutes later, he is awake again and either crying or showing feeding cues. This behavior leads many parents to think their baby is hungry and that mom doesn’t have enough milk for him. That’s an understandable reaction but that’s not what’s going on. He’s not starving. He just wants to be where he can thrive.
This intense nighttime cluster feeding is most common on the second night. It’s also expected night three or the first night home. (Also when they’re sick or have had a busy, stimulating day like a baptism.) It can be normal for a baby to cluster feed longer than days 2 and 3, but it’s worth getting a lactation evaluation to make sure your baby is transferring milk well if they continue to have intense cluster feedings.
How do you know your baby is getting enough milk day 2?
Your baby’s goals on day 2:
- 2 or more wet diapers
- 2 or more dirty diapers
- Breastfeed at least 8 times
Is your baby meeting those goals? Terrific! A feeding/diaper log can really help. You can use a paper print out or an app. If you love to document all the things, feel free to do that. If you’d rather document the minimum, that’s great, too! You can tailor this to your personality. Jot down when your baby nurses and when you change his diaper. Keep in mind a dirty diaper may also have urine in it, check before you toss it.
What you want to know: is my baby on track to nurse at least 8 times today? For example, if you’re going to say your day starts at midnight, then by noon, baby should have nursed at least 4 times. If he has, wonderful! Keep following his feeding cues. If by noon, he has nursed 3 or fewer times, now you know he’s not on track to meet his goal and you can be proactive. Place him skin to skin every 2-3 hours and offer him the breast to help him reach his nursing goal.
You can decide when his day starts for the purpose of counting feedings. You may choose to start it at the time he was born, at midnight, or when you wake up in the morning and consider it the start of the day.
A few other things to consider on day 2
- How do you feel baby is nursing? Does he latch deeply and have large jaw movements while he suckles? Or does he make tiny, fast, jaw movements that may indicate he’s asleep or not transferring much milk? This baby below has a decent looking latch but you can see by her small jaw movements (and her limp hand) that she is falling asleep. She’s probably not transferring much milk anymore. Practice listening for swallowing sounds to help you determine if babe is actively nursing or sleeping.
- Your baby will be weighed about every 24 hours you are in the hospital. We expect baby to lose weight after they are born! 10% weight loss and below is the standard for normal but there are a lot of factors and weight is only one piece of the puzzle. Another reason to have a lactation consult. Furthermore, a weight on day 2 usually doesn’t tell us much because we don’t have enough to compare it to. If we simply have 2 weights, it’s too easy for one of those weights to be off and skew the whole comparison. By the 3rd weight, at least you can start to see the trend, which is the whole point of the weights. It’s not about a specific number it’s about the curve of their weight loss… is their weight loss becoming more drastic or is it slowing down?
- I’m a huge fan of Global Health Media’s breastfeeding videos. Here is one titled “Is Your Baby Getting Enough Milk”.
What do you do to excel on day 2?
- When baby shows feeding cues, and at least 8-12 times per day, place him skin to skin on your chest. Offer him your breast. Hand express to make the smell and taste more pronounced so he can find the breast and latch on better. (It will also help your milk supply.) Practice getting him latched as deeply as you can. Be picky and try to only keep the deep latches so you don’t end up with super sore nipples. It can take time and practice for him to learn how to latch deeply so don’t stress if that’s the case. Check out this article and the videos and just keep trying. He’ll get it!
- Keep holding him skin to skin as much as you can. Remember, his instincts tell him he’ll survive and thrive when he’s skin to skin with you. You smell familiar (the glands on your breast remind him of amniotic fluid), you are warm, you have milk, you sounds familiar (heart, stomach, breathing). Holding him skin to skin will help:
- his temperature, respiratory rate, and blood sugar stabilize
- him to cry less
- him latch better
- you make more milk
- you and dad to bond with him (it actually changes your brains!)
- Continue to rest as much as you can. I like to tell friends who are new moms that naps are not optional! I strongly encourage a supper time nap so that you don’t feel like a crazy person when your baby wants to cluster feed that night. That can lead you to feel like a failure, like your baby hates you, or that you have to give a bottle. (I am not making up these examples.) Being more rested helps everything! You can tend to your baby’s frequent awakenings with a calmer head and reach your goals!
What should you avoid with breastfeeding on day 2?
There are very few babies who need more than their own mother’s milk. Adding in formula not only changes your baby’s gut (forever!) but it can cause a load of hurdles to breastfeeding. If your baby needs more milk, there are a lot of things we can tweak with breastfeeding, before we consider adding formula. Check out this video (password lactation) to learn a few tools.
If baby is still tired day 2
If baby is still sleepy day 2, no worries, but you will want to start helping him with his intake by:
- Any time he shows feeding cues, place him skin to skin. Sleepy babies or early babies may just go back to sleep if no one responds to their feeding cues.
- If he doesn’t show feeding cues, place him skin to skin every 2-2.5 hours (starting before 3 hours gives him time to wake up).
- Talk to him and rub his back for about 20 minutes to try to catch a different part of his sleep cycle.
- If he doesn’t wake and latch, hand express milk and place any drops in his mouth.
- If he still doesn’t wake and latch
- lay him down or hand him to dad
- hand express more milk into a cup or a spoon
- spoon feed, cup feed, or finger feed the milk to him
- The milk may help him to wake, so place him skin to skin again and offer the breast. If he doesn’t nurse, you still expressed milk from yourself and got it in to him to continue moving in the right direction.
- Repeat with feeding cues and at least 8-12 times per day
Who needs to learn how to excel on baby’s first week, day 2? Share this with them! What was most helpful for you on day 2? Comment below!