You have just given birth. You are tired, sore and probably a little overwhelmed. You have been told that breastfeeding is natural, and then your baby won't latch, or falls asleep at the breast, or cries and turns away.
If that is where you are, please hear this first: it is very common, it is not your fault, and it does not mean breastfeeding won't work for you. Most babies who are slow to latch do get there. They just need a little time and a plan.
Over twenty years as a nurse, neonatal nurse and midwife, I have seen this many times, in hospitals and in living rooms. The families who cope best are not the ones who try hardest. They are the ones who know what to do while they wait. It comes down to three simple principles.
Why some babies don't latch straight away
There are plenty of ordinary reasons, and often it is a mix of them:
A long or difficult birth. Labour is hard work for babies too, and some are simply worn out.
Pain relief in labour. Strong medication, including epidurals, may make some babies sleepier in the first days. The effect varies a lot from baby to baby.
A caesarean birth. This is major surgery. Recovery can make those first feeds harder for you, and some babies are slower to wake up afterwards.
Being born a little early, or having had a rough start.
A baby who just needs longer. Some babies are simply not ready on day one.
None of these mean that your baby doesn't want to breastfeed, or that your body isn't doing its job.
Principle 1: Feed the baby
This is the first priority, and it comes before everything else. Your baby needs to be fed even if they are not latching yet. Regular feeds keep them hydrated, help keep their blood sugar steady and help them gain weight.
As a guide, aim to feed your baby at least every 3 hours, and offer a feed whenever you see feeding cues such as stirring, rooting or hands to mouth. Many newborns feed 8 to 12 times in 24 hours. A sleepy baby often needs to be gently woken to feed.
If your baby isn't latching, you can give your expressed colostrum by spoon, syringe or small cup. This is why I suggest packing a few clean plastic teaspoons in your hospital bag. They are small, cheap and easy to use, and your midwife can also give you syringes.
Small amounts are all they need
Many parents, and sometimes the people advising them, expect a newborn to need big feeds. They don't. A newborn's tummy is tiny, and colostrum comes in just the right amount for it.
Age Typical amount in a feed
First few days A teaspoon or two
End of the first week Usually no more than about 30 to 60 ml (1 to 2 oz)
These are rough guides and every baby is different. But bigger is not better. Too much milk can leave a baby overfull and sleepy, harder to wake for the next feed and feeding less often. That can make things harder, not easier. If someone suggests much larger amounts, ask them why, and check with your midwife or a lactation consultant. If a doctor or midwife has given you a specific amount for your own baby, follow that.
If you need to use a bottle
A bottle is fine if that is your choice, or if your baby needs topping up. In the first few days it is ideal for your baby to practise latching at the breast, so a spoon, cup or syringe is usually the best way to give colostrum. If you do use a bottle, use a paced feeding approach and give only those small, natural amounts rather than overfeeding.
Paced bottle feeding copies the rhythm of breastfeeding and keeps your baby in control:
Hold your baby fairly upright and well supported.
Keep the bottle more level than tipped up, so the milk doesn't rush.
Touch the teat to their top lip and wait for a wide open mouth.
Let them take a few sucks, then lower the bottle slightly for a pause.
Switch sides halfway, as you would at the breast.
Use a slow-flow teat.
Stop when your baby shows they have had enough, and don't coax them to finish.
You can read more about combination feeding and how to make it work on my blog.
Milk flows much faster from a bottle than from the breast, so pacing matters. A feed usually takes 10 to 20 minutes.
Principle 2: Protect your milk supply
Your milk supply is built by milk being removed from your breasts. When a baby is feeding well at the breast, that happens naturally. If your baby isn't feeding well yet, your body doesn't get that signal, so you need to give it, by expressing.
Start early. If your baby hasn't fed, start hand expressing within the first hour or two after birth. Your midwife can show you how, and it helps to have practised beforehand.
Be regular. Express at least 8 times in 24 hours, including once at night, until your baby is feeding well. Keep going until your milk comes in, usually around day 3 to 5.
Then choose what suits you. Once you are seeing larger amounts, you can use a pump if you prefer, or a mix of hand and pump.
Every drop counts. Early, frequent expressing builds your supply for the weeks ahead, and what you collect can be given to your baby.
My step-by-step guide to hand expressing explains the technique and includes free video guides.
In my clinic I often meet mothers who were not shown this early on, and who later worry about low supply. It is far easier to protect your supply from the start than to rebuild it later. If it all feels like too much, that is understandable, and it is exactly the kind of thing support is for.
Principle 3: Keep your baby close
Skin-to-skin contact is one of the simplest and most helpful things you can do. Hold your baby against your bare chest, as often and for as long as feels comfortable. Partners can do this too.
It helps your baby feel calm and safe, and helps keep their temperature and blood sugar steady. It also brings on their natural feeding instincts. Many babies will wriggle their way over to the breast and try to latch on their own, and even if they don't, the time is never wasted.
When you both feel ready, offer the breast calmly. If your baby gets upset, stop and try again later. Feeding should feel relaxed, not like a battle.
Please follow safe sleep guidance. If you are very tired, ask someone to keep a watchful eye on your baby, or place them safely in their cot.
Please be patient with yourselves
Doing all of this on very little sleep is exhausting. You may be feeding, expressing and topping up, round the clock. That is a lot to ask of anyone. Rest when you can, accept help, and let your partner or family take care of everything else.
It may take days rather than hours, and that is okay.
When to ask for help
Please speak to your midwife, public health nurse, GP or a lactation consultant if:
Your baby is very sleepy and hard to wake for feeds
Your baby has fewer wet or dirty nappies than expected, or looks increasingly yellow
Your baby is losing more weight than expected, or isn't gaining
Feeding is painful for you
You feel worried, overwhelmed or unsure
If your baby seems unwell or floppy, or is not feeding at all, seek medical help straight away.
Frequently asked questions
Should I pump if my baby won't latch?
Yes, or hand express. Removing milk is what tells your body to make more, so start within the first hour or two after birth if your baby hasn't fed, and aim for at least 8 times in 24 hours. In the first few days, hand expressing is often easier than a pump, because colostrum comes in very small amounts. What you collect can be given to your baby by spoon, syringe or cup.You can find out how to hand express, step by step, on my blog.
What if my baby won't latch and won't stop crying?
Stop trying for a few minutes. A baby who is already upset finds it very hard to latch, and pushing on only makes you both more distressed. Hold them skin to skin, talk softly and let them settle. If they are hungry, give some expressed colostrum by spoon or syringe to take the edge off, then offer the breast again when you are both calmer. It also helps to offer the breast at the first feeding cues, such as stirring or rooting, before the crying starts.
How long can a newborn go without latching?
Please don't wait and see. Whether or not your baby is latching, they still need to be fed at least every 3 hours, with your expressed milk if you have it. If your baby hasn't fed well at the breast within the first day or so, ask your midwife for a feeding assessment, or contact a lactation consultant, as early help makes a difference.
Can I use a bottle if my baby won't latch?
Yes, if you need to. In the first few days, spoon, cup or syringe is usually the better choice, so your baby can practise latching. If you do use a bottle, use paced feeding and give only small amounts, as described above.
Will my baby ever latch?
Most babies do. Some take a few days and some take longer, and many need just a little extra support with positioning, skin-to-skin time or an assessment of how they suck. If your baby is still struggling after a few days, or you are worried at any point, I would be glad to help.
You don't have to do this alone
offer one-to-one support at my clinic in Listowel, at home across North Kerry, and online. You don't need to wait until things feel desperate. An early conversation can make a real difference. You can book a Breastfeeding Consultation, start with a free introductory call, or email info@bobbidaly.ie. If you are pregnant, my Breastfeeding Preparation Intensive covers all of this before your baby arrives.
