Making Plenty of Milk

Here’s how you’ll know your baby is getting plenty of milk:

Build a good milk supply

First, to ensure a good milk supply: feed frequently, never limit feeding times, make sure baby is latched on well, and that you hear swallowing as he suckles. Spend lots of time in skin-to-skin contact. Avoid supplemental bottles or pacifiers for the first 3- 4 weeks.

Look for signs of satisfaction

At the end of the feed, a baby should look full and satisfied. (Video of full cues.) Before the feed, she was showing hunger cues like rooting, sucking, tongue thrusts, and searching for the breast. After the feed, she is relaxed, sleepy, and content.

Also, mom’s breast will be softer. Before the feed, your breasts will feel full and firm. At the end of the feed, they are soft. (Note: after you’ve been nursing for a few months, you may no longer notice this effect – they may be soft all the time.

Diaper Counts

To know if enough is going in to a baby, look at what’s coming out.

In the first five days, expect to see at least 1 wet or dirty diaper per day old. For example, a three day old baby would have at least three dirty diapers, as a minimum. Some babies may have much more, depending on how much meconium they eliminate in those early days.

After day 6, you should see a total of 8 – 10 diapers a day, and at least three of those should include stool / poop. (Newborns may have a bowel movement with every feeding. That’s fine too.)

Urine should be clear to pale yellow. Bowel movements are yellowish and loose: may be the consistency of mustard, may look seedy, may contain white curds, like cottage cheese. By 3 months, babies have larger b.m.’s less often, and may go several days between.

Weight Gain

In the final weeks of pregnancy, babies stock up on extra fluids to ease their passage through the birth canal, and to help them through the first few days.

It is normal and expected for newborns to lose up to 7% of their body weight in the first few days as they shed this extra fluid. If they lose more than 7 – 10%, the baby’s doctor may want to monitor breastfeeding more closely. It generally isn’t necessary to supplement. A 10% weight loss definitely calls for some attention to make sure mom’s milk supply is developing and nursing is going well. It’s not a cause for panic, and it doesn’t mean nursing will never go well. It just means we want to pay a little extra attention right now. (Note: if mom had IV fluids during labor, this may make a 10% weight loss more likely, as baby pees off the extra fluid he absorbed.)

Babies should regain their birth weight by the end of two weeks, then gain consistently from then on, doubling their birth weight by 4 months, and tripling by one year.

When to Be Concerned

If baby is gaining weight, developing well, and is peeing and pooping as described above, you can be reassured that all is well.

However, in the rare circumstance where you see any of these signs, you should contact baby’s doctor: less than 6 diapers a day or less than one bowel movement a day (after day 5), dark yellow urine, urine with a reddish “dust” in it, a sunken fontanel, a dry mouth, or jaundice – a yellow tinge to skin below the chest line, or yellowness in the “whites” of baby’s eyes. Or if baby seldom seems to be content after feedings, is lethargic, or uninterested in feeding.

Growth Spurts and Nursing Strikes

Expect your baby to have growth spurts at around 2 weeks, 6 weeks, 3 months, and 6 months. At these times, he will be unusually fussy, and will nurse longer and more frequently than usual. This is normal – just increase the length and frequency of feedings. This will only last a few days.

Nursing strikes: Sometimes babies will go through periods of not wanting to nurse as often as you’re used to. Possible causes are teething pain, over-stimulation, reaction to a change in the routine, flavor differences in the breastmilk, or normal developmental stages. This will typically only last for a short while, and need not be interpreted as a sign that baby is ready to wean.

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