Breast Feeding Your Infant

"HOW DO I KNOW MY BABY IS GETTING ENOUGH MILK?"

Even though a breast-feeding mother can't see exactly how much milk her baby takes while nursing, observant parents can tell whether breast-feeding is off to a good start, provided they know what to look for. The following patterns are typical of well nourished breast-fed babies during the first month of life (after a mother's milk comes in).

Your milk should "come in" at 2-4 days after delivery. If your baby seems hungry after most nursing and you do not think your milk has "come in" by 5 days post partum,you should have your baby weighed.

Your baby should urinate 6 or more times a day. The urine should be colorless, not yellow. A red or pink "brick dust" appearance on the diaper suggests your baby is not getting enough milk.

Your baby's bowel movements should look like cottage cheese and mustard by the 4th or 5th day of life. These are called "milk stools". If you baby is still having dark meconium or green or brown "transition" stools by 5 days of age, he or she may not be getting enough milk.

Your baby should have 4 or more bowel movements each day. Many breast fed infants pass a stool with every nursing during the first 3-4 weeks of life. If your newborn baby is having fewer than four stools each day, it might mean he or she is not getting enough milk.

Your newborn baby should nurse approximately 8 times each 24 hours. This will be accomplished if you nurse every two to three hours, with a single 5 hour stretch at night. Time the feedings from the beginning of one nursing to the beginning of the next. Very few breast fed babies will gain adequate weight if nursed only 6 times each 24 hours. It is not uncommon to need to awaken your baby to nurse. Some babies just don't demand as often as they should.

Your baby should latch on correctly to your nipple and suck rhythmically for at least 5 minutes at each breast (at least 10 minutes per breast is preferred). He or she may pause periodically, but should nurse vigorously throughout most of the feeding. A baby usually gets more milk from nursing at both breasts than nursing from one side only. If your baby typically falls asleep and will not take the second breast, it is best to divide the baby's effective suckling time between the two breasts. For example, a sleepy baby will obtain more milk by nursing 5 minutes at each breast than 10 minutes at one. Alternate the side on which you start feedings, so both breasts receive comparable stimulation and emptying.

Your baby should appear satisfied after nursing and will probably fall asleep at the second breast Breastfed infants who appear hungry after most feedings, who chew their hands after nursing, and who often require a pacifier may not be getting enough milk.

Your nipples might be mildly tender for the first several days of nursing. Tenderness usually is present only at the beginning of the feedings, and discomfort is typically gone by the end of the first week. Severe nipple pain, pain that lasts throughout a feeding, or pain persisting beyond one week probably means your baby is nursing incorrectly. If your baby isn't latched on properly to nurse, not only will your nipples hurt, but your baby may not obtain enough milk. Thus, if you have severe sore nipples, your baby's doctor should evaluate your infant's nursing technique and check your baby's weight.

Your breasts should feel full before each feeding and softer after your baby has nursed. You should hear your baby swallow regularly while breast4eeding. One breast may drip milk while your baby nurses on the other side. After your longest night interval, your breasts should feel particularly full

After 2 or 3 weeks. you might be aware of the sensations associated with the milk ejection. or milk let-down. reflex. This is a "tingling", "pins-and-needles" or "tightening" sensation in your breasts as milk begins to flow. When your milk "let-down" occurs, your baby may start to gulp milk, and milk may drip or spray from the other breast. Just hearing your baby cry can cause your milk to "let-down", even before your baby latches on.

Once your milk has come in, your breastfed baby should gain about one ounce each day for the first couple months of life. The only way to be absolutely certain that your baby is getting enough milk is to have him or her weighed regularly. If your baby is not gaining weight appropriately, it is possible that your milk supply is low or that your baby is not nursing effectively. Such breastfeeding difficulties are easier to remedy if they are recognized and treated early. Your baby's doctor can help develop a feeding plan tailored for you and your baby.