How to Start Breastfeeding: Complete Beginner's Guide

The First Hour (Golden Hour)

The first hour after birth is magical for breastfeeding initiation.

What Happens

Baby is alert: Most newborns are wide awake right after birth
Instincts kick in: Babies naturally root and seek the breast
Hormones peak: Oxytocin flowing for bonding and milk release
Colostrum ready: Your first milk is already there

What to Do

Request immediate skin-to-skin: Baby on your bare chest
Delay routine procedures: Weighing, measuring can wait
Let baby find the breast: The "breast crawl" is instinctive
Don't force it: Let baby root and latch when ready
Ask for help: Hospital lactation support if needed

If You Can't Do Skin-to-Skin Immediately

C-sections, NICU admissions, or other circumstances may delay this—that's okay:

Partner can do skin-to-skin
Start as soon as medically possible
Express colostrum by hand if baby can't nurse
Breastfeeding can still be successful

Understanding the Latch

A good latch is the foundation of comfortable, effective breastfeeding.

Signs of a Good Latch

Wide mouth: Baby's mouth opens wide, like a yawn
Flanged lips: Lips curl outward like fish lips
Asymmetric: More areola visible above baby's top lip than below
Chin touching breast: Nose free or barely touching
Rounded cheeks: Not dimpling or sucking in
Audible swallowing: You can hear soft "kuh" sounds
No pain: Initial tenderness okay, but not toe-curling pain

How to Get a Good Latch

Position baby: Nose to nipple, body close and aligned
Support your breast: C-hold (thumb on top) or U-hold (thumb on side)
Tease the lip: Tickle baby's upper lip with nipple
Wait for gape: Baby needs to open WIDE, like a yawn
Bring baby to breast: Quick motion, aim nipple to roof of mouth
Check the latch: Lips flanged, chin in, asymmetric

If It Hurts

Break the latch: Insert finger in corner of mouth to release suction
Try again: Don't suffer through—relatch
Adjust position: Try pulling baby's body closer
Check for tongue tie: If pain persists, ask for evaluation

The First Day

What to Expect

Baby is sleepy: After initial alert period, lots of sleep
Colostrum: Thick, yellow, small amounts (teaspoons, not ounces)
Frequent feeding attempts: Every 1-3 hours is normal
Short feeds: May only nurse a few minutes

Colostrum: Liquid Gold

Small but mighty: Baby's stomach is marble-sized (5-7ml)
Packed with antibodies: Baby's first immunization
Laxative effect: Helps baby pass meconium
Perfect amount: Don't worry about "not enough"

Your Goals for Day 1

Breastfeed at least 8 times (attempt, even if baby sleepy)
Practice skin-to-skin as much as possible
Learn to hand express colostrum
Get help from hospital lactation consultant

The First Week

Day 2-3: Increased Feeding

Baby wakes up and wants to eat constantly
This is normal—cluster feeding helps bring milk in
May feel like baby is never satisfied
Keep feeding—demand creates supply

Day 3-5: Milk "Coming In"

Breasts become full, firm: Engorgement is common
Milk changes: Colostrum → transitional milk (thinner, more volume)
Can feel uncomfortable: Warmth, fullness, heaviness
Keep feeding: Best way to relieve engorgement

Managing Engorgement

Feed frequently (every 2-3 hours)
Warm compress before feeding helps milk flow
Cold compress after feeding reduces swelling
Hand express a little before latching if very full
Cabbage leaves (sounds weird, but many swear by it)

Day 5-7: Finding Rhythm

Milk becomes mature (thinner, bluish-white)
Baby should be back to birth weight by day 10-14
Feedings may become slightly more predictable
Still feeding 8-12 times per 24 hours

How Often to Feed

General Guidelines

Newborns: 8-12 times per 24 hours (every 1.5-3 hours)
1-2 months: 7-9 times per 24 hours
3-6 months: 6-8 times per 24 hours
Feed on demand: Watch baby, not the clock

Hunger Cues

Feed when you see these (before crying):

Rooting (turning head, opening mouth)
Hand to mouth
Smacking lips
Stirring, squirming
Rapid eye movement under closed lids

How Long Per Feed?

Newborns: 10-20 minutes per side (or until satisfied)
Older babies: May get more efficient (5-10 minutes)
Let baby decide: Baby will release when done
Offer second side: Baby may or may not want it

One Breast or Two?

Let baby finish first breast (until they release or slow down)
Offer second breast—baby may take it or not
Start next feed on opposite side
Use a hair tie or app to remember which side

Signs Baby Is Getting Enough

Diaper Output

Day	Wet Diapers	Dirty Diapers
Day 1	1+	1+ (meconium—black)
Day 2	2+	1-2 (transitioning)
Day 3-4	3-4+	2-3+ (greenish → yellow)
Day 5+	6+	3+ (yellow, seedy)

Weight

Normal to lose: Up to 7-10% of birth weight in first days
Should regain: Birth weight by day 10-14
After that: Gain 5-7 oz per week (first 3 months)

Behavior

Content after feeds (most of the time)
Alert and active when awake
Good skin tone, lips moist
Audible swallowing during feeds

Common Early Challenges

Sore Nipples

Cause: Usually shallow latch
Prevention: Focus on deep latch
Treatment: Expressed milk on nipples, lanolin, air dry
Not normal: Cracked, bleeding, or severe pain needs attention

Sleepy Baby

Common in first 24-48 hours
Wake baby every 2-3 hours to feed
Skin-to-skin helps
Change diaper mid-feed to wake
Tickle feet, blow on face gently

Cluster Feeding

Baby wants to eat constantly (usually evenings)
Normal behavior, especially in early weeks
Not a sign of low supply
Helps build supply—go with it

Feeling Like "Not Enough Milk"

Very common fear—usually unfounded
Focus on output (diapers) and weight gain
Frequent feeding is normal, not a sign of low supply
True low supply is rare—see IBCLC if concerned

Engorgement

Peaks around day 3-5
Feed frequently to relieve
Hand express a little before latching if too firm
Ice packs between feeds
Reverse pressure softening to help latch

What's Normal (But No One Tells You)

Physical Sensations

Uterine cramping: Breastfeeding triggers uterus to contract—normal and good
Letdown sensation: Tingling, pins and needles when milk releases
Leaking: One breast leaks while nursing other—wear pads
Thirst: Intense thirst while nursing—keep water nearby
Drowsiness: Hormones make you sleepy—normal

Baby Behaviors

Bobbing head: Baby naturally searches for nipple
Pulling off and on: During letdown or gas
Falling asleep at breast: Very common, especially newborns
Comfort nursing: Not always hungry—may want comfort
Fighting the breast: Overtired, overstimulated, or frustration

Emotional Aspects

Bonding takes time: Instant love isn't universal—it can grow
D-MER: Sudden dysphoria at letdown—real and treatable
Breastfeeding aversion: Touched out feeling is real
Grief if it's hard: Okay to mourn expectations

When to Get Help

Call a Lactation Consultant If:

Persistent pain that doesn't improve with latch adjustment
Cracked, bleeding, or blistered nipples
Baby not gaining weight or losing more than 10%
Fewer than expected wet/dirty diapers
Feeding taking more than 45-60 minutes consistently
Baby never seems satisfied
You suspect tongue or lip tie

Call Your Doctor If:

Fever with breast pain (could be mastitis)
Red, hot, painful area on breast
Baby is jaundiced (yellowing of skin/eyes)
Baby is lethargic, hard to wake

Where to Find Help

IBCLC: International Board Certified Lactation Consultant (gold standard)
Hospital lactation services: Often free for recent births
WIC: Provides free breastfeeding support
La Leche League: Peer support groups
Online: Telehealth lactation consults available

Setting Yourself Up for Success

Before Birth

Take a breastfeeding class
Have an IBCLC's contact saved
Set up a nursing station (water, snacks, pillow, phone charger)
Line up support for household tasks

In the Hospital

Request skin-to-skin immediately
Ask for lactation help before discharge
Practice hand expression
Room-in with baby for practice

At Home

Focus on feeding baby—let others handle everything else
Sleep when baby sleeps (yes, really)
Stay hydrated and fed
Limit visitors if overwhelming
Don't watch the clock obsessively

Mindset

Give yourself grace—it's new for both of you
Days 2-7 are often the hardest—it gets better
Fed is best—your mental health matters too
Asking for help is strength, not failure

The Bottom Line

Starting breastfeeding is a learning curve for both you and baby. The first two weeks are often the hardest—you're both figuring it out. Focus on skin-to-skin, frequent feeding, and getting the deepest latch possible. If something doesn't feel right, get help early. And remember: however you feed your baby, you're doing a great job.

References: Academy of Breastfeeding Medicine protocols, WHO/UNICEF Baby-Friendly guidelines, La Leche League International.