Newborn Feeding in the First 48 Hours (UK): Cues, Colostrum & Nappies

Feeding & Nutrition
Written By Victoria

Those first two days are tiny volumes, frequent feeds, and lots of learning — for both of you. This guide shows what “responsive” feeding looks like, what’s normal for nappies, when to try hand expression, how to store expressed milk safely, and when to ask for help. It’s written for UK families and signposts practical support.

Quick note: This article is information, not medical advice. If you’re worried about your baby or yourself, contact your midwife, health visitor, GP, or NHS 111.

Where you’ll be: In the UK, many families go home within 6–24 hours after an uncomplicated vaginal birth (often longer after a caesarean). Services don’t wait for “milk to come in” or for the first poo in every case. Your team will check you’re both well, observe a feed, arrange newborn checks (by 72 hours), and set up community follow-up.

What “responsive” looks like on Day 0–2

  • Expect frequent, small feeds. Colostrum comes in modest amounts that match a newborn’s tiny tummy.

  • Keep baby close. Skin-to-skin helps babies rouse and latch, regulates temperature and sugars, and supports bonding.

  • Comfort matters. If latch feels pinchy or sharp, pause and try again with better support or a different position.

  • Partners can lead the set-up. Positioning, snacks/water, watching for early cues, and protecting your rest all help.

Tiny tummy, tiny volumes

Your newborn’s stomach is about the size of a marble on Day 1. Colostrum is thick, golden, and immunologically rich — tiny amounts are exactly what’s designed. Frequent feeds signal your body to make more milk over the coming days.

Typical pattern (ranges, not targets):

  • Day 0–1: many short feeds; some babies are sleepy after birth.

  • Day 2: feeds often pick up and may cluster (several close together).

  • By Day 3–5: milk volume rises (“milk coming in”); nappies and swallowing usually increase too.

Nappies dashboard

Think of nappies as your friendly dashboard. Trends over days matter more than any single feed.

  • Day 0–1
    1–2 wet nappies in total. Poos are meconium (black, tarry). Wee can be hard to spot in disposables — an unused nappy moistened with 2–4 tbsp of water shows the feel of “wet”.

  • Day 2
    2–3 wet nappies. Poos usually start to lighten (dark green/brown) as meconium clears.

  • Preview: by Day 5
    6+ heavy wets in 24 hours. Poos are yellow and soft/seedy most days (formula-fed: usually smoother/pastier, tan–brown, a bit firmer; combination-fed: typically in-between).

If nappies are consistently fewer than expected and baby is very sleepy or struggling to latch, get hands-on support the same day.

Hand expression in 60 seconds

Hand expression is a simple, low-tech way to collect drops of colostrum and to stimulate supply if latching is tricky. It’s not a waste — you catch every drop and offer it to your baby.

  1. Warm up: 5–10 minutes of skin-to-skin and gentle breast massage.

  2. Hand shape: thumb and forefinger opposite each other about 3 cm back from the nipple (on the darker skin).

  3. Motion: press back towards the chest wall, then roll fingers together in a rhythmic squeeze-release. Avoid sliding on the skin.

  4. Collect & feed: catch drops in a clean spoon/cup/syringe and feed straight away. A few minutes, a few times a day is plenty.

When to use: right away if baby is too sleepy or struggling to latch, or if you feel very full/firm — expressing a little before latching can soften the areola for a deeper, more comfortable latch.

Storing colostrum & expressed milk (UK)

Containers & labels — Use sterilised containers or breast-milk storage bags; label with date/time (and name if for hospital).

How long you can keep it

  • Fridge (4 °C or colder): up to 8 days (if unsure your fridge is ≤4 °C, use within 3 days). Store at the back, not the door.

  • Ice compartment of a fridge: up to 2 weeks.

  • Freezer (−18 °C or colder): up to 6 months.

  • Carrying chilled milk: cool bag with ice packs for up to 24 hours.

Defrosting & warming — Thaw in the fridge or gently in warm water. Never microwave. Once defrosted, use immediately and don’t refreeze. If baby has started a bottle, use within 1 hour, then discard leftovers.

Combining small amounts — You may add newly expressed milk to already chilled milk once the new milk has been cooled first (don’t pour warm onto cold).

“If you’re using bottles” (quick callout)

Using bottles? Follow responsive bottle feeding (upright baby, horizontal bottle, pause often, stop on fullness cues). For safe formula preparation (≥70 °C water), sterilising up to 12 months, storage times, and common FAQs, see our full guide: Bottle Feeding & Sterilising (UK Safety Essentials).

Is baby getting enough?

  • Cues & rhythm: baby feeds at early cues, often 8–12+ times in 24 hours in the early days. Cluster feeding can be normal.

  • Swallowing: during active sucking you’ll see slow, rhythmic sucks with pauses and occasional swallows.

  • Post-feed state: many babies look relaxed with soft hands and a dozy “milk-drunk” face after a good feed.

  • Nappies: follow the dashboard above.

  • Weight: routine checks are done by your care team. Ask for extra support if weight loss is greater than expected or if you’re worried.

When feeding hurts: immediate steps

  • Pause and relatch. Tummy-to-tummy; nose to nipple; wait for a wide gape; bring baby on quickly and close.

  • Change position. Laid-back, underarm/rugby, koala hold, or side-lying.

  • Soften first. Hand-express a little if very full.

  • Protect your skin. Expressed milk and air-drying can soothe; change damp pads regularly.

  • Get hands-on help early. Persistent pain or nipple damage needs skilled support.

Red flags & who to contact (UK)

Seek same-day support from your midwife/health visitor/GP or NHS 111 if you notice any of the following:

  • Fewer than 2 wet nappies in the first 24–48 hours, or no wee/poo, or very dark concentrated urine after Day 3

  • Very sleepy baby who doesn’t wake for feeds or can’t stay on to drink

  • Ongoing sharp pain with feeds that doesn’t improve after a deeper latch

  • Signs of dehydration (dry mouth, listlessness, fewer nappies)

  • You’re worried — trust your instincts

Helplines and directories:

  • National Breastfeeding Helpline (24/7): 0300 100 0212

  • Local infant-feeding team / midwife / health visitor (ask your unit)

  • Find an IBCLC (UK): Lactation Consultants of Great Britain directory

  • International directory: ILCA “Find a Lactation Consultant”

FAQs

How often should my newborn feed in the first 48 hours?
Very often. Many babies feed 8–12+ times in 24 hours, sometimes in clusters. Offer at early cues rather than waiting for the clock or for crying.

My baby is very sleepy after birth — is that normal?
Common on Day 0–1. Keep baby skin-to-skin, watch for subtle cues, and offer frequent opportunities to latch. If baby won’t rouse to feed or can’t stay on to drink, get hands-on help the same day.

How do I know they’re getting enough before my milk “comes in”?
Look for early cues and frequent feeds, some swallows, and nappies matching the dashboard for Day 0–2. Comfortably softer breasts after feeds can also reassure.

Can I use bottles and still breastfeed/chestfeed?
Yes. Use paced, responsive bottle feeding; keep baby upright; pause often; stop on fullness cues. Maintain skin-to-skin and frequent offers to support supply. See our Bottle Feeding & Sterilising guide for safety details.

When does milk “come in”?
Colostrum is there from birth. The bigger increase in milk (lactogenesis II) usually happens around Day 2–4.

Is antenatal colostrum harvesting necessary?
Not for most families. It’s optional and usually suggested from 36–37 weeks when there’s a specific reason for early top-ups (e.g., diabetes, planned caesarean, expected feeding challenges). Ask your midwife first.

Victoria