Guest Post by Bethany Lovern, MS, CCC-SLP, CBC

If you have worked with Mackenzie, you already know she is someone who shows up for the realest, most unguarded hours of your life. She is in the room before you have cleaned up, before the announcement, before the world descends. She sees what actually happens.

And what actually happens in those first 48 hours with nursing is something most mamas are not prepared for.

Not because it has to be hard. But because the gap between what you were told to expect and what those first feedings actually feel like can catch you off guard, even when everything is going right.

Nursing in the first 48 hours does not have to be perfect. But it does matter, and I want you to know what to watch for before you go home.

The First Hour Sets the Tone

The golden hour is real.

In the first hour after an uncomplicated birth, your baby is in a uniquely alert, calm state. This is the window when a baby placed skin to skin on mama’s chest will often begin rooting, push with their feet against your body, and make their way toward the breast on their own. It is instinctive. It is built in.

What helps: skin to skin immediately, a quiet space, and time. Routine newborn procedures like weighing and measuring can often wait. Ask your provider in advance about delaying the newborn exam until after that first nursing attempt.

What works against it: separating baby from mama too quickly, bathing baby before the first feeding, or a bright and busy room with a lot of hands. If something feels rushed in those first moments, you are allowed to slow it down.

Mackenzie sees this window happen with beauty when no one interrupts it. The mama exhales. The baby settles. And the beginning of a feeding relationship starts quietly, before anyone has said a single word about technique.

What Nursing First 48 Hours Actually Looks Like

Here is the most important thing most mamas are not told before they leave the hospital:

Your milk is not in yet. And that is completely normal.

What your baby receives in those first feedings is colostrum, a thick, concentrated, golden fluid your body has been producing since the second trimester. Colostrum comes in very small amounts because your baby’s stomach is the size of a marble. Small and frequent feedings are not a sign that something is wrong. They are exactly right.

Here is what normal looks like in those first 48 hours:

Your baby may cluster feed, nursing frequently and wanting to be at the breast almost constantly. This is not evidence that you do not have enough milk. Cluster feeding is how your baby signals your body to establish supply. Let it happen.

Some nipple tenderness in the earliest days is common as your body adjusts. Pain that is sharp, toe-curling, or makes you dread the next feeding is not something to push through in silence. It is information worth acting on.

Your baby will likely lose a little weight. A loss of up to 7 to 10 percent of birth weight in the first few days is expected. The two-week pediatric appointment should show your baby back to or near birth weight.

Your baby should have at least one wet diaper and one dirty diaper in the first 24 hours, increasing from there. Stools will be dark and tarry at first, transitioning to yellow and seedy by day four or five when your milk comes in.

What to Ask For at the Hospital

Hospital stays are short. Knowing what to ask for in advance means you are less likely to go home with questions no one answered.

Ask for a lactation consultant visit before you are discharged. Most hospitals have one on staff and you are entitled to request a visit even if no one offers. Ask specifically to have someone watch a full feeding, not just a quick check at the beginning of a session.

Ask about rooming in. Keeping your baby in the room with you around the clock supports frequent feeding, skin to skin time, and helps you learn your baby’s early hunger cues before they escalate to crying.

Ask before accepting a nipple shield. A nipple shield can be a helpful tool in specific situations with proper follow-up. When one is handed over quickly without a clear clinical reason or a plan, it often creates more questions than it answers.

Ask before supplementing with formula. If supplementation is medically recommended, that is a real conversation worth having. If it is being offered because your baby seems hungry and the formula samples are right there, it is worth slowing down and asking questions first.

I want to be honest with you about something. When my son Daniel was born, I called for the lactation consultant. And then I called again. And again. Nobody came.

This was not a small community hospital without resources. But I left without anyone ever watching a full feeding, even though I knew in my gut that something was not right. On day three of his life, I packed up my newborn and my postpartum body that was still moving so slowly, and my mother drove me to a private lactation consultant so I could get a weighted feed and a real answer.

It was a lot. It should not have been necessary. And the reason I built my practice around home visits is specifically because I do not want you to have to do what I did. You should not have to load up a three-day-old and get yourself somewhere when you are barely moving. Someone should come to you.

If you find yourself in the hospital calling for support and no one is coming, you are not being dramatic. You are right that you deserve an answer before you go home. There is a real difference between what hospital protocols allow and what a private lactation specialist can offer you, and this post explains why those gaps exist so you can advocate for yourself more effectively.

What I Watch For as a Lactation Specialist

As a Speech Language Pathologist and Certified Breastfeeding Counselor, I look at feeding from a clinical angle that is a little different from a standard latch check. My training covers oral motor function, which means the mechanics of how a baby’s tongue, jaw, and mouth work together during a feeding.

Here is what I watch for in the first 48 hours that does not always get named before a mama goes home:

A latch that looks fine on the outside but causes real pain throughout the feeding. This can point to a shallow latch, oral tension from the birth process, or a tongue-tie that has not been identified.

A baby who works very hard for a small amount of milk. Fatigue at the breast in the first day or two can look like normal newborn sleepiness. A baby who consistently falls asleep within a few minutes, comes off unsatisfied, and wants to feed again very soon is worth watching more closely.

Clicking sounds during nursing. Clicking means your baby is losing suction repeatedly and is almost never just a positioning issue.

A strong preference for one side. A baby who latches well on one breast but fights the other may be carrying tension from birth that is affecting how they turn or position their head.

The hospital will not always name these things. If something feels off before you go home, reaching out for a feeding evaluation does not have to wait until the two-week appointment. Your gut is data. Trust it.

A full in-home feeding assessment is exactly the kind of evaluation that looks at everything together: not a two-minute latch check, but a full feeding session where I can see what is actually happening and give you real answers before anything gets harder.

If tongue-tie has come up or you are wondering whether it might be part of the picture, my free guide Why Does Feeding Feel So Hard is a good place to start before you even leave the building.

Before You Go Home

Before discharge, here is what I want every mama to have:

A clear picture of how much weight your baby has lost and what the two-week appointment expectation is.

A name and number for someone you can actually call if feeding is not going well at home. Not a general hospital line. A real person.

At least one witnessed, full feeding where a provider watched the whole session and gave you specific feedback, not just a reassurance that everything looks fine.

An understanding of when to call before your scheduled appointment. If your baby is not having adequate wet and dirty diapers, if pain is not improving, if your baby is not trending back toward birth weight, or if something just does not feel right, those are reasons to reach out before you wait another week.

You were not meant to figure this out alone. Mackenzie is there for the moments that deserve to be held and witnessed. When the feeding piece needs someone who can actually watch, assess, and give you a plan, that is where I come in.

Book a feeding consult with Bethany 

 Learn about in-home lactation visits 

Download Why Does Feeding Feel So Hard 

 FSA and HSA funds can be used for lactation support

Rooting for you,

Bethany

About Bethany Lovern

Bethany Lovern is a Speech Language Pathologist with a master’s degree and a Certified Breastfeeding Counselor. She provides in home breastfeeding support, tongue-tie evaluation, and oral motor feeding assessments for families in Brownsburg, Avon, Plainfield, Zionsville, Danville, and the westside of Indianapolis.

Website: bethanylovern.com

Frequently Asked Questions

What should happen with nursing in the first 48 hours after birth?

In the first 48 hours, a baby should nurse frequently, 8 to 12 times in a 24 hour period, receiving colostrum in small amounts. Skin to skin contact supports the feeding relationship and helps stimulate supply. Some nipple tenderness is common but persistent sharp pain during feedings is not. A baby should have at least one wet and one dirty diaper in the first 24 hours, increasing daily. Weight loss of up to 7 to 10 percent in the first few days is expected.

When should I ask for a lactation consultant at the hospital?

Ask for a lactation consultant visit before you are discharged, even if no one offers. Request that someone watch a full feeding, not just the first minute. If anything about the feeding feels off, if you are in significant pain, if your baby seems to work very hard without transferring well, or if tongue-tie has been mentioned, ask for that evaluation before you leave.

What is the golden hour after birth?

The golden hour refers to the first hour after birth, when a baby is typically alert, calm, and primed to nurse for the first time. Placing baby skin to skin on mama’s chest and allowing time for baby to find the breast instinctively supports the first latch. Routine newborn procedures can often be delayed until after this window when medically safe to do so.

Is it normal for a baby to lose weight in the first 48 hours?

Yes. A weight loss of up to 7 to 10 percent of birth weight in the first few days is considered normal. Babies should begin regaining weight once milk comes in, typically by day three to five, and should be back to or near birth weight by the two-week pediatric appointment.

How do I know if something is wrong with breastfeeding before I leave the hospital?

Signs worth having evaluated before discharge include pain that does not improve between feedings, a nipple that comes out creased or flat after nursing, clicking sounds during feeding, a baby who falls asleep within a few minutes and wants to feed again very soon, and a strong preference for one side. A gut feeling that something is not quite right is also worth naming to your care team before you go home.