Episode #22: Struggling to Breastfeed in the Hospital? Do THIS in the First 48 Hours

By Meaghan Selki, MS, IBCLC
Welcoming a newborn into your life can be both exhilarating and overwhelming. Whether you’re tuning in from a hospital room or settling in at home after delivery, navigating those first 24 to 48 hours can be challenging without the right resources. In this week’s episode, we walk through a comprehensive overview to help you begin your early breastfeeding journey with confidence and clarity.

What You’ll Learn in This Episode

  1. The physiology behind early milk production and cluster feeding
  2. What’s normal and what’s not when it comes to latch, soreness, and supply
  3. Comfort and positioning strategies you can use immediately
  4. How to promote and protect your milk supply in those first critical days
  5. When and how to reach out for lactation help so you don’t wait too long

1. Understanding Early Breastfeeding Physiology

As soon as your placenta delivers, your body begins a hormonal transition that triggers milk production, known as lactogenesis II. In the first few days you’ll produce colostrum. Around days three to five, mature milk typically arrives. During this time your baby may cluster feed, meaning very frequent short feeds. This is normal and important for establishing supply.

2. Pain and Latching: What’s Normal?

Breastfeeding should not be inherently painful. Some soreness (around 2 to 3 on a pain scale of 10) is common, especially for first-time mothers, but more intense or persistent pain is a sign that something needs adjustment. Shallow latch is often the culprit. A deep latch helps both comfort and effective milk transfer.

3. Comfort Strategies for Moms

  • Deep latch first: Focus on positioning and latch quality instead of tolerating discomfort.
  • Nipple care: Use expressed breast milk, coconut oil, or nipple balms if soreness occurs, and allow nipples to air dry.
  • Positioning and posture: Bring your baby to the breast, not the breast to your baby. Keep baby’s ears, shoulders, and hips aligned.
  • Over-the-counter relief: Ibuprofen is often safe during breastfeeding and can help with uterine contractions and breast discomfort.

4. Promoting Your Milk Supply and Protecting Your Milk Supply

Frequent milk removal is essential. Aim for feeding at least every 2 to 3 hours, or more often if your baby shows feeding cues. If your baby is sleepy or slow to start, gentle hand expression or a few drops of milk on their lips may help stimulate sucking. Setting the tone early with responsive, frequent nursing protects your supply long-term.

If your baby isn’t feeding effectively after the first 24 hours, or if you’re separated due to NICU care or health issues, hand expression is a valuable tool. A pump can also be helpful but should be used with guidance. The goal is stimulation and milk removal since milk out means milk in.

5. Seeking Help When Needed

If you’re experiencing any of the following, it’s time to reach out for support:

  • Persistent or worsening nipple or breast pain
  • A baby who is not latching or transferring milk and has few wet diapers
  • No increase in milk volume by day 5
  • Any signs of infection such as redness, warmth, or fever

Before hospital discharge, ask about seeing a lactation consultant and identify and schedule a follow-up once you’re home. Help early and often prevents complications and improves your experience.

Key Takeaway

Your first two days postpartum can be foundational for your breastfeeding journey. Frequent feeding, comfortable latch, and early attention to discomfort can dramatically improve your experience and help you build lasting confidence. Don’t wait while things escalate. Reach out early, lean into support, and trust that your body and your baby are learning together.

FAQs

  1. What if my milk hasn’t come in by day 5?
    It can take up to day 5 for your mature milk to appear, especially after a cesarean birth or complicated delivery. Continue frequent feedings or expressions, and consult a lactation specialist if needed.
  2. Is it normal for my baby to lose weight at first?
    Yes. Most newborns lose up to 7 percent of birth weight in the first few days. A loss greater than 10 percent requires evaluation and possibly temporary supplementation.
  3. Can I take pain medication while breastfeeding?
    Yes. Ibuprofen and acetaminophen are generally considered safe. Avoid aspirin. Always check with your healthcare provider for individual recommendations.
  4. Should I pump to build supply in the first few days?
    If your baby is feeding well and frequently, you do not need to pump. If your baby is sleepy, separated, or not transferring milk effectively, pumping or hand expression every 2 to 3 hours can help maintain supply.
  5. When should I see a lactation consultant?
    Seek help right away if you have nipple pain, cracks, or bleeding; if your baby has few wet diapers; if latch or positioning feels off; or if your baby hasn’t regained birth weight by two weeks.

Related References

Connect with Us

For more evidence-based breastfeeding insights and support, follow @themilkproduction on Instagram, Facebook, and YouTube.

Important Note: This podcast and blog are for educational purposes only and do not replace personalized medical advice. Always consult your pediatrician, OB, IBCLC, or another qualified provider for concerns about your or your baby’s health or feeding.

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