I didn't breastfeed immediately after birth; is it too late ?

My baby was born two weeks ago. At the time I decided not to breastfeed because of an illness. Now that I'm better, I'm having second thoughts. Is it too late to establish a milk supply for the baby, and will he receive the same benefits from breast milk produced now?

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Although it is easier to establish breastfeeding from the beginning, this may not be possible in some circumstances. The first step in establishing breastfeeding is offering your breast. If you have not already done so, review information about proper positioning and latch-on. Read more on help for latch-on difficulties.

Get started as soon as possible, but choose a time when you and your baby are in a relaxed state. Offer your baby the breast before a diaper change, for example. If your baby latches and suckles, observe his feeding behavior. Within a minute of latching on, his pattern should change from a rapid, shallow sucking to a slow, deep suck-swallow rhythm. Get more information in our guide to breastfeeding.

Allow your baby to stay on the breast as long as you are confident he is feeding well. When he begins to pause more or swallow less frequently, burp him and relatch. When your baby will not resume the good suck-swallow pattern on the first breast, even after burping, offer the second breast. Most babies will take both breasts when increasing their mothers' milk supply. Keep relatching your baby to the second breast unless he won't resume the good suck-swallow pattern or becomes impatient at the breast. At this point, offer expressed mother's milk or formula to complete the feeding.

You may be able to move your baby from bottles to breastfeeding by gradually reducing your baby's reliance on formula supplementation as you and he improve and increase breastfeeding. Offering the breast at each feeding and keeping a written log to monitor your progress can help this transition to move along quickly. At two weeks postpartum, this process may be as short as several days or take as long as one month. Either way, once your baby begins to receive any amount of breast milk, he will benefit.

If you have any difficulty, an international board-certified lactation consultant can guide you through the transition from bottle-feeding to breastfeeding. Some babies are reluctant to latch on after a period of bottle-feeding. Some mothers are not confident that their baby is feeding well on the breast. Causes for initial reluctance include the unfamiliarity of breastfeeding, not a baby's aversion or dislike of breastfeeding.

A gradual introduction with expert guidance can enable a stress-free transition. If your baby appears to dislike the taste of your milk, regular breast draining (every 3 to 4 hours for a 24-hour period) by hand-expressing milk or pumping alters the breast milk composition, which improves the taste. Many strategies are available to help you achieve your goal, regardless of the obstacles you may encounter.

Mothers often wonder about milk quality when they have not initiated breastfeeding immediately after delivery. The early milk that you produced during your pregnancy (colostrum) is probably still present in your breasts two weeks after childbirth. Even if the transition to mature milk began without the benefit of the stimulation caused by the withdrawal of milk, all the components of the colostrum will be present although mixed into what we call transitional milk. Lack of breast drainage causes other modifications in milk composition. See more on making the decision to breastfeed.

Therefore, your milk may be more concentrated than would be appropriate for your baby's needs at two weeks of age if you offered your breast exclusively without any supplementation from the very first day of breastfeeding. With this in mind, you should plan to offer some supplementation on day one, regardless of how effective and satisfied your baby appears. Use urine output and the moistness of your baby's lips as loose guidelines to determine what the minimum supplementation should be if your baby appears to be breastfeeding like a pro from the start. Your baby should pass clear urine at every feeding (at least 8 times each 24 hours), and his lips should not be dry after feedings or appear chapped at any time.

With your improved health and your obvious desire to meet the needs of your baby to the best of your ability, I'm confident you will go on to have a rewarding breastfeeding experience. I wish you good luck.

More: Tips to help you get the best start in breastfeeding and making sure your baby is getting enough milk

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