When you start breast-feeding, it may seem that the baby is not getting much milk. It's true. A new mother's milk takes a few days to "come in." In the meantime, your baby is getting small amounts of a yellowish white nutritious substance called colostrum. The baby's sucking action will cause your milk to come in. Because breast-feeding is a matter of supply and demand, the more the baby sucks the more milk you will produce. Your milk should come in by about the fourth day after delivery. You'll know when this happens, because your breasts will become larger and harder between feedings, and they'll spontaneously leak or squirt milk.



Breast-feeding is comforting to a newborn baby. So if your baby is crying or fussing, and she hasn't had a feeding in more than an hour, try nursing her-it's usually what she wants. If she seems too sleepy to nurse the second breast, try waking her up by brushing her cheek with your finger or nipple to stimulate the rooting reflex. Or try changing her diaper or clothing to wake her sufficiently to feed on the other breast. Signs of hunger include increased alertness and activity and mouthing or rooting motions. If your baby tends to be sleepy and undemanding, wake her to feed if she hasn't fed in the past 4 hours.

Some babies want to stop nursing for a while to look around or socialize. When this happens, mothers are understandably eager to get them back on the breast. But it's best to be patient, to let her have a break. Research has shown that babies resume nursing sooner when their mothers don't hurry them. Ideally, by the end of the feeding, your baby will empty the second breast-at least partially.

Avoid giving your baby bottles of formula or water during the first 2 or 3 weeks of breast-feeding until your milk production is well established and your baby is nursing well. Infants generally get all the water they need from breast milk. If your baby is not getting sufficient fluids from breast milk, for whatever reason, your doctor may recommend bottles of sterile water or sugar water to avoid dehydration. Ordinarily, a breast-feeding baby won't need bottles at all. However, when breastfeeding is well established-usually in about 3 to 4 weeks-you can introduce a bottle of expressed milk or formula. Introducing it sooner runs the risk of the baby's preferring the bottle to the breast, since she doesn't have to work as hard to get milk from a bottle. The advantage of giving baby an occasional bottle of expressed milk is that the father or a caregiver can feed the baby and give the mother a break.

If your baby is feeding well after regaining her birth weight, she should gain about 1 ounce a day during the first month. If, in the first few days, your baby does not seem to be feeding well, talk to your child's doctor. He may want to see your baby to determine whether she's sucking well and feeding frequently enough. Or, a visiting nurse may come to your home to weigh your baby and assess her feeding. Either doctor or nurse may recommend a lactation consultant or breast-feeding coach for help.