Baby Care Within First 24 Hours

Delivering life’s greatest gift is a journey you will always remember. You made it! But the first 24 hours of your baby’s life might come as a shock. You have been through a lot, and there is much to keep in mind – from rest and recovery to the breastfeeding essentials that ensure your newborn’s ability to make the transition to this new and wonderful world.

Breastfeeding complications are more likely in mothers who experience stress and anxiety. It is important to trust that the baby knows what he or she needs, including how to find the nipple. The first 24 hours following delivery are your most critical time. If you have concerns at any time during your stay, it is best to ask before something goes wrong.

The First Few Hours

If you have recently given birth to a new baby, or have a baby less than one week old, it can be quite intimidating trying to figure out how to breastfeed your infant. The first few days after birth are called the quiet time or the critical period and this is when the mother should gain confidence about breastfeeding her child.

As your baby waits patiently in the hospital’s special-care nursery, you may be asking yourself, “When is my baby going to eat? Do I have enough breast milk for her? Will the nurses look down on me for breastfeeding?” The good news is that the first few hours of life are crucial. Nursing within the hour after birth can improve your baby’s survival rates, make breastfeeding easier in the future, and save you (and your baby) years of frustration due to painful and unsuccessful breastfeeding experiences.

When it comes time to breastfeed, do not be surprised if your baby is awake and alert during one of the first few hours after birth (for most babies, this is during the first two hours). Many newborns have been able to suck effectively right after being born, and when you are recovering from a vaginal delivery or an epidural, your milk has already begun flowing. You can help make breastfeeding easier by using the techniques in this section until your milk “comes in” about 24-72 hours after the baby’s birth.

Establishing Your Milk Supply

If you have had a vaginal delivery, it is normal for your milk to come in about 2 to 3 days after birth. This is known as “milk supply establishment” and can be an exhausting process. Whether you are breastfeeding or using pumped breast milk, give your baby as much skin-to-skin contact as possible.

Establishing your milk supply is a crucial part of the breastfeeding process. In the first few days after birth, your body will respond to the baby’s hunger cues by making an adjustment in hormone levels that contributes to a higher level of prolactin. High levels of prolactin are necessary for establishing and maintaining a healthy milk supply. Because latching on and drinking from the breast stimulates prolactin release and production, it becomes very important that you wake up and feed your baby often enough during this stage. Even if you are not producing any noticeable amounts of breastmilk yet, frequent feedings will help to establish your breasts as sources of food while also helping your body make the adjustments it needs to produce breastmilk.

If you are having difficulty establishing your milk supply and want to try pumping, the recommendation is to wait at least 12 hours after birth before beginning. To get the longest use out of your pump, find a place that is quiet, comfortable, and familiar so you can relax. For example, this is where you would be if you were feeding a baby at the breast.

Common Issues

Most new mothers experience nipple soreness—also known as nipple trauma—when they begin breastfeeding. The nipples are often more sensitive during the early weeks of breastfeeding because the baby is latching on, or grabbing hold of your nipple, with their gums; this is not painful for the baby with a proper latch and with time, the sensitivity in your nipples should decrease. Use warm compresses to decrease pain and swelling.

As a new mother, you may experience some challenges in the first 24 hours after delivery—in particular, positioning your baby and breastfeeding. A certified lactation consultant will help start breastfeeding on the right track by helping you stay comfortable and positioning your baby in a way that is most likely to succeed.

Your doctor or midwife will learn about your medications, including prescription and over-the-counter drugs, so they can discuss any special issues with you. You will also be asked to make sure your prenatal records include information about any medications you take regularly.

Tips for the First 24 Hours

In the first 24 hours after birth, before the mother and baby leave the hospital, she may be most comfortable lying in bed with the baby next to her. Make sure she is set up for breastfeeding, with pillows for her back and head. She may need help positioning the breast for the baby. It is best if dad visits after mom and baby are settled at home.

• Comfort measures are essential to helping your baby breastfeed and bond with you right after delivery. Many breastfeeding measures can be provided by the hospital staff before you go home. These include: “Try to breastfeed within the first hour of life. Your baby is more likely to be awake and take the breast while he is most susceptible to learning how at this time. “
• Newborns do not need to eat very often in the first week or so. Your baby may not take a full meal for the first few days. He may breastfeed only every two hours. This is normal. Keep offering your breast.
• Babies benefit when placed directly on their mother’s chest during the first few weeks of breastfeeding because it allows them to breathe similar air and stay in close, skin-to-skin contact with her.
• It is important to not give your baby a pacifier. A baby that uses a pacifier will not be able to effectively suckle at the breast, delaying breastfeeding and making it more challenging to get your baby to latch on properly and begin nursing. If your baby is crying or looks interested in sucking, put them to the breast instead, even if they have already been pacified.
• At least once a day in the first few weeks, try to get your baby to breastfeed. Even if she falls asleep before latching on, wake her up, put her to the breast, and she’ll probably start feeding more vigorously. Once you have your baby mastered breastfeeding and it is becoming a habit for the two of you, your baby may feed longer between feedings and may sleep longer in between. But even then, you should wake her up when it is time to breastfeed since newborn babies need to eat frequently.
• During the first few days postpartum, you may be concerned that your baby is not getting enough to eat. Your colostrum, which is produced for the first three days after giving birth, is all your baby needs. If your breasts fill up with milk by about the third day postpartum and start leaking, this indicates enough milk production.
• While it may seem like your newborn is not getting enough to eat the first few days, that is completely normal. Colostrum is a rich, yellowish fluid that you produce in your breasts during the first few days after delivery. Even though the amount of colostrum you make may seem small, it contains all the nutrients your baby needs during this initial period.

Other Concerns

If your child is born prematurely and/or has breathing issues or heart-rate problems, they may go to the Neonatal Intensive Care Unit (NICU) for observation, monitoring, and treatment. Use Medela’s Supplemental Nursing System (SNS) with premature infants in the NICU. The SNS provides nutrition and comfort through a small tube that connects the bottle of supplement to a specially designed SNS teat. SNS small teats are designed to fit the mouths of premature and sick babies whose own sucking action may be weak.

Do not give up if your child needs a little help. Just ask for a breast pump. A breast pump can make it easier to start breastfeeding. And, in time, breastfeeding will become routine. A breast pump can be used to remove the excess breast milk until the child begins to breastfeed. As soon as your child can breastfeed, put them at the breast immediately.