Scene 1: The Hospital. You have just delivered a beautiful, perfect baby. He sleeps like an angel in the nursery, in your room. You gloat to all friends and family about your wonderful feeder and sleeper. A few days later, you are discharged and take him home.
Scene 2: Home, Day 3. The honeymoon is over...Your baby is feeding frequently and for long periods of time. His sleep patterns have miraculously changed and he is awake all night, crying more often. You feel, "What have I done wrong? He was so perfect in the hospital!" The answer is: Absolutely nothing! This is, fortunately or unfortunately, normal.
What to Generally Expect at This Stage
Whether a baby is exhausted from the long journey into this world, sleeping heavily because of the hum of activity in the nursery or because he is being held against your warm body, babies generally sleep well in the hospital. (Moms who have had C-sections are often more realistic in their expectations once they go home because they are in the hospital a bit longer, which means that their babies "wake up" while they're in the hospital.) Once they come home, everything changes: Feedings are much more frequent and last longer and sleep patterns adjust because of the new schedule. Some babies feed for what may seem like hours and then sleep for many hours. Once the milk comes in, patterns change yet again!
Common Issues For Mother at This Stage
Aside from physical exhaustion kicking in, sore nipples continue to be the most common issue in the first three days postpartum. At this stage, even with a properly latched baby, nipple sensitivity is still prevalent because of postpartum hormonal changes. However, if nipples are cracked, bleeding, or blistering, the latch-on needs help. Contact a lactation consultant immediately.
Some moms also find that their milk has started to transition from colostrum to transitional milk by Day 3. They often feel a heaviness to their breasts, which indicates that their milk is starting to "come in." Feeding frequently will combat any discomfort.
Common Issues For Baby at This Stage
Jaundice is common in breastfed babies. However, by breastfeeding frequently (at least 8 to 10 times a day) in the first 3 days of life, you can greatly reduce the chances that your baby will require higher intervention, such as phototherapy (going under bilirubin lights.)
Sleepiness may also prevail...
Waking Up A Sleepy Baby
Your body is in the process of building a milk supply that will fully sustain your baby and your baby needs frequent feedings for her growth and development. It is essential for both the establishment of your milk supply and the baby's nutrition to continue to wake the baby if he is not waking himself. Some people or books may tell you that you should never wake a sleeping baby. While that may be true later -- after your milk supply is established and the baby is showing all signs of feeding well -- at this stage it is very important.
Establishing A Milk Supply
At this stage, you will notice your breasts becoming fuller and heavier. Your milk is "coming in!" Your milk is changing from colostrum to transitional milk and you will notice the color changing from a clear, yellowish fluid (colostrum) to a thicker white (transitional milk). Continue to breastfeed (or, if necessary, pump) every 2 to 3 hours to stimulate supply.
If you haven't seen any physical changes in supply at this point, don't stress. Monitor the baby's output and continue to feed frequently and stimulate every 2 to 3 hours. You should see changes in the next few days. If not, you should be seen by a lactation consultant to assess the situation.
Very important! Mothers who have had breast reduction or other nipple surgery should be aware that they may never establish a full milk supply. There are methods to maximize what they can make, but the promise of a full supply cannot be made.
Keep plugging away! Sore nipples, sleepy babies -- it will all subside within the next week if you're consistent about proper latch-ons and frequent feedings.
Some breast discomfort will probably make its appearance as your milk comes in. However, with frequent feedings you can avoid severe engorgement. So try your best to be persistent and consistent to avoid the problem.