The first week of breastfeeding is mostly small, frequent feeds. For the first few days you make colostrum, and the NHS guide to the first few days says about a teaspoon per feed is enough. Expect at least 8 to 12 feeds in 24 hours, and fuller breasts around day 2 to 4 as your milk comes in. Nappies are your best everyday sign that feeding is working: wet nappies build from 2 or 3 in the first 48 hours to at least 6 heavy ones a day from day 5.
Below is what each part of the week usually looks like, how to handle engorgement and a sleepy baby, how to stay safe if you doze off during night feeds, and which signs need help the same day or straight away.
What is colostrum, and is it enough?
Colostrum is your first milk. The NHS describes it as usually thick and golden yellow, and so concentrated that a newborn needs only about a teaspoon at each feed. Seeing only drops when you hand express is normal and doesn't mean you're running low.
Your baby's job in these days is to feed often. The Australian Breastfeeding Association's first-week guide says supply builds when your baby can feed at the breast as often as they want, and that formula top-ups can make supply harder to establish. If a top-up is suggested for a medical reason, ask your midwife how to protect your supply while you use it, for example by hand expressing.
For some mothers colostrum changes to more plentiful milk a little later, or more gradually. That can still lead to a full supply, but it's worth having feeds checked if nappies aren't building as expected.
How often should a newborn breastfeed?
Often, and on cue rather than by the clock. The NHS gives a rough guide of at least 8 to 12 feeds, or more, every 24 hours in the first few weeks, with feeds every 1 to 3 hours in the first days. The CDC's guide to how much and how often to breastfeed says the same, and adds that some babies feed as often as every hour for a stretch, which is often called cluster feeding.
Offer the breast at early hunger cues, before crying:
- stirring, restlessness and murmuring
- rooting (turning towards your breast or a touch on the cheek)
- sucking on fists or fingers.
The NHS notes you can't overfeed a breastfed baby, so feed on demand. Offering both breasts at each feed may help with fullness, according to the Australian Breastfeeding Association. For more on reading your baby's signals, see hunger cues; for long evening feeding sessions, see cluster feeding.
When does your milk come in, and how do you ease engorgement?
The NHS says many people notice fuller breasts around 2 to 4 days after birth, and the Australian Breastfeeding Association's engorgement page gives day 2 to 5. Some people then get engorgement: breasts that feel hard, swollen and tender, and nipples that flatten so latching is harder. Others never do, and that isn't a sign of low supply.
What helps engorgement
- Feed often, whenever your baby wants, and wake your baby for a feed if your breasts are very full, especially overnight.
- Keep your bra very loose or take it off.
- Before feeds, use gentle warmth or very light strokes towards the nipple.
- If your baby can't latch because the areola is tight, try reverse pressure softening: press your fingertips in around the nipple and hold for 1 to 3 minutes, or longer, until the tissue softens.
- Between feeds, use a covered cool pack to ease swelling.
- Hand express only for comfort. The NHS advises expressing only enough to feel comfortable so you don't overstimulate supply.
- Ask your midwife, doctor or pharmacist which pain relief is suitable while breastfeeding.
If engorgement is severe and these steps don't help, see your midwife or a lactation consultant. A hard, red, painful area with fever or flu-like symptoms is a different problem — see mastitis.
How many wet and dirty nappies should a newborn have?
You can't see how much milk goes in, so count what comes out. This table combines the NHS signs your baby is getting enough milk and the AAP guide to telling if your breastfed baby is getting enough.
| Baby's age | Wet nappies in 24 h | Poo |
|---|---|---|
| Days 1–2 | 2 or 3 in the first 48 hours | 1 or 2 a day, black and tarry (meconium) |
| Days 3–4 | More each day | At least 2, turning greenish to yellow |
| Days 5–7 | At least 6 heavy, pale urine | Yellow and loose; AAP: 3 to 4 or more a day |
The NHS looks for at least 2 soft yellow poos a day from day 4 for the first few weeks. The Australian Breastfeeding Association uses a slightly different count: by 5 days old, at least 5 wet disposable nappies or 6 very wet cloth nappies, with clear or pale wee. These sources agree on the direction; if your baby is under any of these counts, get feeding checked.
Disposable nappies can be hard to judge. The NHS suggests pouring 2 to 4 tablespoons of water into a clean, dry nappy so you know what a properly wet one feels like.
How much weight do breastfed babies lose in the first week?
Some weight loss in the first few days is normal. The AAP says a well-fed breastfed newborn loses no more than 8% to 10% of their birth weight before starting to gain again, and the NHS expects steady gain after the first 3 to 4 days.
The AAP's warning signs of breastfeeding problems include a baby who is still below birth weight at 2 weeks. Your midwife or GP or child-health nurse will weigh your baby in the first days and weeks; if you're worried between checks, ask for an extra weigh rather than waiting.
What if your newborn is too sleepy to feed?
Many newborns are sleepy in the first days. The AAP advises waking a newborn who sleeps more than 4 hours at night and encouraging a feed. The CDC suggests patting, stroking, undressing your baby or changing their nappy to help them wake.
If your baby keeps falling asleep before the long, deep swallowing part of a feed, the NHS says they may not be well attached, so ask a midwife or breastfeeding supporter to watch a feed. See latch and positioning for what a good latch looks like.
Sleepiness also matters because of jaundice. The NHS jaundice page recommends feeding around 8 to 12 times a day and waking a sleepy baby for feeds. A baby who is sleepier than normal, hard to wake or not feeding needs emergency help (see below). There's more in newborn jaundice.
Is it safe to doze off while breastfeeding?
Night feeds in the first week are tiring, and falling asleep while feeding is very common. The safest plan is to expect it might happen.
- Sofas and armchairs: The Lullaby Trust says never to fall asleep on a sofa or armchair with your baby, and to put your baby down somewhere safer first if you think you might. The AAP's safe sleep guide says the risk of sleep-related death is up to 67 times higher when babies sleep with someone on a couch or soft armchair.
- Preparing the bed: The AAP says that if there's any chance you might fall asleep with your baby in bed, move pillows and blankets away from your baby, and put them back in their own sleep space as soon as you wake. The Australian Breastfeeding Association's co-sleeping page adds a firm, flat mattress and bedding that can't cover your baby's face.
- When not to share a sleep surface at all: if anyone in the bed smokes, has had alcohol or drugs that make them drowsy, or if your baby was premature or small at birth. In these cases, always return your baby to their own cot.
Your baby's own sleep space should be a firm, flat cot or bassinet with nothing soft or loose in it, and your baby always goes down on their back. The AAP recommends room sharing (not bed sharing) for at least the first 6 months. See safe sleep and bed sharing.
When should you get help with breastfeeding in the first week?
These emergency signs come from the NHS jaundice page and the NHS guide to whether your baby is seriously ill.
Contact your midwife, GP or a health advice line (Pregnancy, Birth and Baby on 1800 882 436 in Australia, NHS 111 in the UK, your pediatrician's after-hours line in the US) the same day if:
- your baby is over 24 hours old and looks yellow, or the yellow is spreading or not improving
- wee is dark yellow or brown, or poo is pale, creamy or chalky
- your baby has fewer wet or dirty nappies than the table above, or still has dark poo by day 7
- your breasts haven't started to feel fuller by day 5 — the AAP advises getting your baby weighed promptly
- your baby seems hungry after most feeds, or you can't hear or see swallowing once your milk is in.
Get feeding support soon — from your midwife, a lactation consultant or a breastfeeding helpline (the Australian Breastfeeding Association on 1800 686 268 in Australia, the National Breastfeeding Helpline on 0300 100 0212 in the UK) — if feeds hurt, your nipples are cracked or bleeding (see sore nipples), engorgement isn't easing, or you simply feel unsure. Early help usually makes the next weeks easier.
What to note down this week
A simple tally of feeds, wet nappies and dirty nappies (with poo colour) for each 24 hours helps you see whether output is rising day by day. Bring it to your midwife or child-health checks, along with any times your baby was hard to wake or feeds hurt.
