Human milk is specifically designed for humans. Colostrum, the first breastmilk for a heathly newborn, is low in volume and fat, but high in carbohydrates and protein so is the perfect food for an immature digestive system and a newborn who is still learning how to take their nourishment from the breast. It is also rich in antibodies which provides protection from infection and nutrition.
Breastmilk gradually increases in volume, in the first weeks, and the quantities of antibodies, carbohydrates, proteins, enzymes (and many more constituents) alter to meet your growing and developing child's needs. It remains perfectly balanced therefore is easily and fully digested. It also provides a high level of protection from infection. Your milk supply is regulated by the frequency of feeds and the degree to which the breast is drained. Following your baby's cues usually produces a good supply of milk.
With your baby correctly positioned and attached to the breast you should not have sore nipples. Sore and/or cracked nipples are NOT normal. Seek help as soon as you experience soreness.
Your baby is perfectly nourished if he is being fed regularly, is generally alert, appears healthy, with smooth skin, has 6-8 very wet nappies and more than 2 bowel movements in 24 hours for at least 6 weeks and has a continual weight gain. If your baby feeds less than 8-12 times in 24 hours, check the number of nappies and weight gains. So long as he is still wetting and stooling a good number of nappies in 24 hours and is gaining weight, then usually all is well. Please note in the first few days expect to have less wet and stooled nappies - at least until your milk supply increases.
Other things to consider:
Offer the second breast after your baby has given you definite signs of having finished on the first breast e.g. baby has long pauses and a few little sucks (no rhythmic continuous sucking as at start of feed).
If baby takes the second breast again watch baby's cues to know when your baby has finished feeding - long pauses between suckles, goes to sleep.
Listen for audible swallows during the breastfeed.
Check your breasts before the feed and note whether they feel softer after the feed.
Check that baby is not jaundiced - seek medical help if baby's skin becomes more yellow, if baby is not waking for feeds or seems lethargic.
Rather than a strict time interval between feeds consider how many feeds the baby is having in 24 hours. Even as adults we don't have a strict timeframe between our mealtimes. The best option is to watch your baby's cues for early signs of hunger. Sometimes babies will cluster their feeds with shorter intervals (1-2 hours) and then they may have a long stretch before one or more feeds (3 or more hours) this is normal and will still achieve a similar number of feeds in 24 hours. Aim for approximately 7-8 or more feeds in 24 hours rather than sticking to a rigid time interval like three hours. If your baby is sick, premature, jaundiced or otherwise compromised then you may need to wake your baby for feeds but even then aim to be a little flexible because babies woken from a very deep sleep often don't feed well - discuss this with your health care professional. Every woman has a different storage capacity in her breasts and every baby will transfer differing quantities of milk. Some babies can manage to gain weight but feed less than 7-8 times in 24 hours perhaps this is due to their ability to take enough volume of milk and the mother has a large enough storage capacity to supply a large amount at any one feed. Other babies transfer smaller volumes and/or the mother has a smaller storage capacity which means the baby will need to feed more frequently than 8 times in 24 hours. Remember every mother and baby pair are unique and all combinations of frequency and volume are normal as long as baby is developing normally and gaining weight appropriately.
This is also called 'demand feeding' which means breastfeeding to suit both the baby's and mother's needs. At times you may need to feed your baby more e.g. during hot weather. Your breasts may feel very full and need your baby to feed. You may also need to feed your baby regularly when he/she isn't regularly giving you feeding cues, for example when very sleepy or jaundiced.
Although sometimes called 'growth spurts' this behaviour has not been proven to be linked with increased milk intake by babies. Despite this your baby may seem more hungry and unsatisfied for a few days and you may doubt your milk supply. If you breastfeed more often, by following the baby's lead, then your baby will normally become less unsettled and baby will settle back to a more normal pattern. This behaviour can precede a baby's illness but your milk will provide your baby with many protective factors so don't stop breastfeeding, follow your baby's cues and seek medical advice if you are concerned.
At approximately 6 months of age, babies may attempt to sit by themselves, lose the tongue-thrust reflex, attempt to put everything to their own mouths and show a great interest when you are eating. Follow your baby's cues.
Links to breastfeeding general information and FAQ website pages: ABA, LLLI, Dr Jack Newman