How do I know if my baby is getting enough milk?

Your baby is getting enough if they have 6 or more wet diapers per day (after day 5), light-colored urine, adequate weight gain at pediatric checkups, and are alert when awake.

When should I seek professional help for breastfeeding?

Seek help if you experience intense pain that does not improve, bleeding or infected nipple cracks, baby not gaining weight, fewer than 6 wet diapers per day, fever, or symptoms of mastitis.

When does breast milk come in after birth?

The milk typically comes in between day 2 and day 5 after birth. Before that, the baby feeds on colostrum — a yellowish fluid rich in antibodies and perfectly suited for the first days of life.

What is the best breastfeeding position for a newborn?

There is no single best position — it depends on your comfort and your baby. Try the cradle hold, football hold, side-lying, and laid-back positions. The football hold is especially good after a cesarean section as it avoids pressure on the abdomen.

Breastfeeding in the First Days: 7 Essential Tips for New Mothers

The first days of breastfeeding can be challenging, but with the right guidance, you and your baby will adapt quickly. In this guide, I share 7 practical tips that make a real difference. If you are an expat family in Sao Paulo, know that breastfeeding support is readily available — and your first pediatric appointment is the perfect time to address any concerns.

A Word from a Mother and Pediatrician

As a mother myself, I know the first days are not easy. There are moments of doubt, pain, and even wanting to give up. But I also know that with proper support, breastfeeding becomes lighter and more natural. You are not alone in this journey! If you are new to Brazil, our expat guide to pediatric care can help you navigate the healthcare system.

1. Correct Latch Is Everything

An incorrect latch is the number one cause of pain, nipple cracks, and low milk supply. A correct latch looks like this:

The baby should take in not just the nipple, but the entire areola (the darker area around the nipple)
The lower lip should be turned outward (like a “fish mouth”)
The baby's chin should touch the breast
You should hear the baby swallowing (not just sucking)

If It Hurts, Something Is Wrong

Breastfeeding should not hurt. Mild discomfort in the first days can be normal, but intense pain indicates an incorrect latch. Gently break the suction (insert your finger in the corner of the baby's mouth) and try again.

2. Positions That Make Breastfeeding Easier

There are several breastfeeding positions. Try them until you find the most comfortable one for you:

Cradle Hold (Traditional)

Baby lies on their side, tummy to tummy with you. Your hand supports their head. This is the most common position, but not always the easiest for newborns.

Football Hold

Baby is tucked under your arm, body alongside you. Great after a cesarean section (no pressure on the abdomen) and for mothers of twins.

Side-Lying

Mother and baby lie on their sides, facing each other. Perfect for nighttime feeds and postpartum recovery (you rest while feeding). See our complete guide to baby sleep for more tips on nighttime routines.

Laid-Back (Biological Nurturing)

You recline semi-upright, baby rests on your chest. This lets the baby's natural reflexes guide them. Great for babies who swallow a lot of air and may develop colic.

Need help with breastfeeding?

Dr. Paula offers personalized breastfeeding guidance to make nursing smoother and more comfortable.

Talk to the Pediatrician

3. Feeding Frequency: On-Demand Is the Rule

In the first days, forget clocks and rigid schedules. Your baby should feed whenever they want, usually every 2-3 hours (or more often). In Brazil, pediatricians strongly advocate for on-demand feeding — this is standard practice you will hear from any English-speaking pediatrician in Sao Paulo.

Hunger Cues (Before Crying!)

• Bringing hands to mouth
• Turning head side to side (rooting reflex)
• Making sucking motions
• Becoming restless and fidgety
• Crying is a late hunger sign! Offer the breast before that

4. Milk Supply: How to Know if It Is Enough

Many mothers worry about whether their baby is getting enough milk. You can feel reassured if:

6 or more wet diapers per day (after day 5)
Light-colored urine (dark, concentrated urine may indicate dehydration)
Adequate weight gain (monitored at your pediatric checkups)
Baby is active and alert when awake

5. Nipple Cracks: Prevention and Treatment

Nipple cracks are painful fissures, usually caused by an incorrect latch.

Prevention

• Ensure correct latch
• Vary positions
• Do not use soap on nipples
• Let nipples air-dry after feeding
• Apply your own breast milk as a natural healer

Treatment

• Pure lanolin after each feed
• Silicone breast shells for protection
• Breast milk compresses
• If very painful: temporary pumping
• See your pediatrician if it worsens

6. When the Milk Comes In (Engorgement)

The “milk coming in” typically happens between day 2 and day 5 after birth. Before that, your baby feeds on colostrum — a yellowish fluid rich in antibodies and perfectly suited for the first days. In Brazil, exclusive breastfeeding until 6 months is strongly recommended before starting any complementary guidance.

When the Milk Comes In

Your breasts will become fuller, warmer, and more sensitive. This is normal and temporary. To ease discomfort:

• Feed frequently
• Warm compresses before feeding (helps milk flow)
• Cold compresses after feeding (reduces swelling)
• Gentle massage
• If needed, express a small amount to relieve pressure

7. Ask for Help When You Need It

Breastfeeding is natural, but it is not instinctive. Many mothers need support, and that is completely normal.

When to Seek Professional Help:

• Intense pain that does not improve
• Bleeding or infected nipple cracks
• Baby not gaining weight adequately
• Fewer than 6 wet diapers per day (after day 5)
• Fever, chills, or symptoms of mastitis
• Feelings of helplessness or deep sadness

A Note for Expat Families in Sao Paulo

If you have recently moved to Brazil, know that breastfeeding support is excellent here. Brazilian pediatricians are trained in lactation counseling, and most private consultations include breastfeeding evaluation as standard. International health insurance typically covers these visits — Dr. Paula provides English invoices for reimbursement.

Remember: the first days are the hardest. But they pass. In most cases, after 2-3 weeks, mother and baby are in sync and breastfeeding flows naturally. Keeping your baby's vaccinations up to date is just as important as nutrition. Be kind to yourself — you are doing an incredible job!