A How-to for new puppies & their owners...not that the puppies read the book, however!
Nursing Healthy Full-term Puppies
By Cindy O'Malley
It never ceases to amaze me the amount of misinformation and old wives tales that abound in dogs. We recently had a litter and unsure if the dam was done (given a history of inertia), took her to the vet. She was apparently done giving birth, and had several healthy puppies at home. The vet then proceeded to tell us we needed to get some supplemental milk since the dam didn't have any yet " duh! " the puppies were only 4-6 hours old! A misconception among veterinarians and breeders is that the dam should IMMEDIATELY have copious quantities of milk to feed her brood, and when this doesn't happen everyone panics. Milk production in all mammals is a supply and demand proposition. First the puppies' demand, then mom supplies! If a human mother can provide for triplets without supplementation (and many have), surely a mother dog can provide for a large litter without it. Her mammary gland system was built for multiple births and will respond given the proper stimulation.
On a long-coated breed, about two weeks before the whelping it helps to trim the nipple area with a #40 surgical clipper blade. This allows enough time for a fine layer of fur to grow back as protection against sharp puppy nails, but the coat is still short enough to allow easy access to the teats. While not necessary, it can make it easier for a newborn puppy to find the teat. Nursing should be allowed as soon as possible after a puppy is born. Nursing will help stimulate the birth of the remaining puppies and help keep the welping moving along. Of course, nursing puppies can be removed while the dam is in active labor and delivering additional puppies. Insert a finger between the puppy's mouth and the teat and gently break the suction before removing the puppy. This early nursing, even before siblings arrive, is very important. If nursing is not started in the first hours, it may take longer and be more difficult to establish a milk supply later.
When healthy, full-term puppies are born, often they are still sleepy and lazy. The sucking reflex may not be very strong. It is the mother's vigorous licking that awakens them and stimulates a reflex to root for a nipple. Often puppies will "root" but can't find the nipple even though it is in front of them. Here they may need a bit of help, or just your patience. A newborn puppy is sensitive to touch on the face, especially the cheek area. A reflex will cause them to turn toward the touch. When they feel a nipple on a cheek, for instance, they will turn toward the nipple. Some puppies are slower than others to the "open mouth" reflex when they turn. Once they find the nipple, and open the mouth, the sucking reflex takes over and the puppy begins to nurse. At this point he is getting little. Just a few drops but ahhh, those few drops are important colostrum, nectar of the gods! Antibodies, concentrated fats, a laxative to expel meconium, and other extremely important nutrients are in those drops. If a puppy is not rooting, sometimes it helps to gently touch his cheek and mouth to a nipple keeping your fingers off his face completely or he will receive conflicting stimuli. Often this is all that's needed to get the puppy to root. If he doesn't, holding the body firmly underneath with your hand, gently use the index finger to gently "pry open" the puppy's mouth. Avoid touching the cheeks. Once open, place the puppy's mouth over the nipple and slip your finger out. Again, avoid touching cheeks or he will root toward your finger instead of the nipple. It may take several tries. Once he latches on, support his body so he can get good suction, and as an extra measure, gently put the front paws on either side of the nipple. In dogs it is necessary for the puppy to "milk" the teat with a pushing action. This stimulates the glands to produce and give milk. He may not do this pumping right away, but it isn't necessary right away. At this point all we are trying to do is get him a few precious drops of colostrum and satisfy what will become a strong sucking need.
For the first 24-48 hours the puppies should be "plugged in" and nursing almost non-stop around the clock. If you attempt to schedule feedings at this point, you will be more likely to fail and need to supplement. If most of the puppies wake and begin nursing, wake the sleepy others and help them find an empty teat. Often a lethargic or sleepy puppy will "forget" to wake up to nurse. A sleepy puppy will need extra stimulation and extra attention to thrive. The first 24-48 hours the puppies will nurse upside down, sideways, piled in total confusion. As long as they are latched on, don't worry about it. Things will get more orderly in a few days. Do NOT give sugar water, supplements, or let the pup suck on fingers for any length of time. In a sensitive puppy, bottle-feeding can interfere with nursing in ways beyond the milk ingested. It takes a different mouth action to nurse from a teat than a bottle. Bottle-feeding is less "work" for the puppy and a puppy can become lazy and ineffectual in his nursing, or what is known as "nipple confused". A nipple confused puppy will not be an effective nurser and may ultimately have to be bottle fed to get enough nourishment. Therefore, do not supplement unless it is absolutely necessary for the survival of the puppy.
All the puppies' sucking needs should come from the dam. If mom won't cooperate, you may have to gently hold her and tell her stay. Many dams won't cooperate immediately. What is happening is the sucking is producing hormonal changes in the mother. She begins producing a hormone called "prolactin" which all mammals produce. It's the mothering hormone responsible for making her love, protect and WANT to feed her babies. It has side benefits in that it helps mom's uterus contract faster and produces a feeling of calm and confidence in taking care of her puppies. A prolactin rush will make the mom sleepy, content and happy. It is important she feels safe and unstressed as well, since stress will ultimately make the milk come in slower. If your dam needs privacy, keep other dogs in the household out of her "puppy room". She needs to relax to have a good milk supply (although it will come in regardless). In the first 24-48 hours most of the sucking is unproductive in the sense that the puppies are only obtaining a few drops, but from a future production standpoint, it makes all the difference. You MUST let them have this unscheduled, uninterrupted sucking for the mother to produce enough milk. If you supplement, the puppies will not suck so vigorously and less milk will come in. It is NORMAL for nursing puppies to lose 1-3 ounces in weight before they begin to gain. It will not hurt them. Some puppies will gain right away, but most do not. They are born with an extra layer of fat in their bodies for this reason, to hold them over till the milk comes in. It is at this point many breeders and vets panic. They feel the mom has not "fed" the puppies for 2 days so must begin supplementing. But colostrum is very rich in nutrients and very concentrated, so they need no more than this. Have faith in nature!
The mother dog should be offered water or a water/milk mixture at least every two hours. She needs lots of liquids and cannot produce milk without them. The skin on her teats will look wrinkly and fragile rather than plump and smooth if she's not getting enough fluids. She will be very thirsty but may not be willing to leave her puppies to get a drink so you should offer her liquids often. When fed (which of course should be more food, more often than usual) add lots of water to the meal. Make it soupy. At every opportunity coax her to drink lots of liquids even if you have to "spike" them with milk or meat broth. We will often crumble up a hard-boiled egg or add yogurt to meals to encourage her to eat or drink. A ready made product is acidophilus that also does the trick. Her nutritional needs are vast at this point and you must feed her a high-quality puppy food. Rather than supplement the puppies, supplement mom with yogurt, cottage cheese, meat, eggs and lots of water.
Listless, lethargic or small puppies should be awakened more and "plugged in" more often, not supplemented! Healthy puppies will grunt and wiggle and root for a nipple. However, healthy puppies may also be sleepy and lethargic (especially true if mom had a c-section). A c-section is not a guarantee of needing to bottle-feed. It just means it will take more effort to wake and "plug in" the puppies until the anesthesia is out of their systems. Do this even if mom is out cold! (Don't forget newborns cannot eliminate without help -- we have a very special grandma dog that takes care of that for us, but if you don't you'll have to do it yourself). If the puppies have been nursing vigorously while mom is "out" the prolactin will help her accept them when she awakens. If they have not nursed, or not nursed much, it will be more difficult, and possibly impossible for her to accept them.
After approx. 48 hours (give or take a bit), mom's milk will come in. It should NOT come in so that she feels hard to the touch! Firm is ok and a good sign, but so is soft and supple. If her mammary glands are hard -- get those puppies nursing before you end up with a full-blown case of mastitis (infection in the glands). Mastitis is often caused by overfull and clogged milk glands or not giving the mom enough liquids. That milk should be in the puppies, not mom. Another misconception is that if the mother is put on any antibiotics the puppies should be pulled off mom. This often compounds problems in that it is not good for her to wean abruptly (mastitis) and the puppies lose the health advantages of natures perfect food. A better option is to find a safer antibiotic and supplement the puppies with yogurt to replace any intestinal flora lost from the antibiotic coming through the milk. If you have LaLeche League in your area, a breastfeeding support group for human moms -- a group leader will have a list of antibiotics that are safe for humans when nursing. With this information, perhaps your vet can prescribe a safer alternative for the nursing dam.
To determine when the milk comes in, watch puppy tails! Soon the brood will be "lining up" at the teats rather than the usual confusion. They will suck for awhile, and suddenly all their tails will rise in unison, straight out! About this time you will also hear some swallowing and gulping noises. The milk is in! Mom will feel very sleepy and often close her eyes and relax. This means the milk is flowing and has "let down". It is important mom is not disturbed or stressed when the pups are beginning to suck or the milk let down will be slower or may not let down at all. The puppies must suck for at least 10-20 minutes after the milk lets down because they need the calorie-intensive "hind milk". If a pup gets sleepy or falls off the nipple too soon, he needs to be stimulated to continue to suck or he will be slow to gain weight. Often the dam will take care of this by cleaning butts, nudging the puppies with her nose and generally annoying them so they stay awake long enough to get the hind milk. If one tail fails to "salute" when all the others do, watch that puppy to be sure it's latched on correctly and sucking efficiently. It may just not have gotten a teat and latched on properly, or may have some other more serious problem such as a cleft palate.
By the 3-4th day mom and pups should be settling in. They'll sleep a little (and more soundly), and eat a little. They'll develop a routine. They will have regained or surpassed their birth weights. Don't disrupt their routine unless you absolutely have to. Let mom finish nursing before you ask her to go out to potty or take her temperature or administer medicine. If you must schedule, work around hers -- not yours! At this point, mom may be willing to go outside for a few seconds to go potty without a bribe. She may be willing to leave the box to eat or drink when the pups are sleeping. If she doesn't, you must continue to monitor her liquid intake. Continue to feed mom well, offer water often and the puppies will thrive. By the 4-5th day they should begin gaining weight. Those few intense first days will pay off with copious amounts of milk, less work supplementing for you, and healthy happy puppies and dam. Enjoy!