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How Do I Know My Baby Is Getting Enough Milk?
You can't see exactly how much milk your
baby takes while nursing. However, you can tell whether
breast-feeding is off to a good start if you know what to
look for. The following patterns are typical of
well-nourished, breast-fed babies during the first month of
life.
- You start
producing milk abundantly 2 to 4 days after your baby is
born.
If your baby seems hungry after most
nursings or you do not think your milk has come in by 5
days after delivery, tell your baby's doctor and have
your baby weighed.
- Your baby
latches on to your breast correctly and sucks
rhythmically for at least 10 to 15 minutes at each
feeding.
Your baby may pause sometimes while
breast-feeding. However, he should nurse vigorously
during most of the feeding. You should hear your baby
swallow regularly while breast-feeding.
Allow your baby to remain at the first
breast until it is well drained, so he will receive the
rich, high-fat hind milk. When your baby starts to suck
less vigorously, swallows less, or begins to doze off,
you can burp him, change his diaper and arouse him to
take the second breast. Generally, babies get more milk
at a feeding by nursing at both breasts. Since the first
breast gets drained better, begin each feeding on a
different side. This way, both breasts will get about
the same stimulation and emptying.
- Your newborn
nurses at least 8 times every 24 hours.
Nurse your baby as often as she shows
hunger cues, such as waking from sleep, becoming alert,
bringing a hand to her mouth, turning her head, or
moving her mouth or tongue. Remember that crying is a
late sign of hunger and a baby may not nurse well after
crying too long. For the first few weeks, you can expect
your baby to want food about every 1 1/2 to 3 hours,
with a single longer stretch (up to 5 hours) between
feedings at night. Newborns that feed fewer than 8 times
in 24 hours or sleep through the night are not likely to
get enough milk. At times you may need to awaken your
baby to nurse. Some babies just don't demand to be fed
as often as they should, especially in the first few
weeks of life.
- Your baby
appears satisfied after nursings and may fall asleep at
the second breast.
Breast-fed infants who appear hungry
after most feedings -- who cry, chew their hands, or
often need a pacifier after nursing -- may not be
getting enough milk.
- Your breasts
feel full before each feeding and softer after your baby
has nursed.
One breast may drip milk while your baby
nurses on the other side. After the longest time between
feedings at night, your breasts should feel particularly
full.
- Your baby's
bowel movements look like cottage cheese and mustard by
the 4th or 5th day of life.
Bowel movements that look like cottage
cheese and mustard are called "milk stools." If your
baby is still having dark meconium, green, or brown
stools by 5 days of age, you should have your baby
weighed to see if he is getting enough milk.
- Your baby
urinates 6 or more times a day once your milk has come
in.
The urine should be colorless, not
yellow. If it looks like the diaper has reddish brick
dust on it after your baby is older than 3 days, your
baby's urine probably is too concentrated and your baby
may not be getting enough milk.
- Your baby has
4 or more good-sized bowel movements each day.
Many breast-fed babies have a bowel
movement every time they nurse during their first 3 to 4
weeks of life. If your newborn is having fewer than 4
bowel movements each day, you should have your baby
weighed to see if he is getting enough milk.
- Your nipples
may be a little tender for the first several days of
nursing, especially at the beginning of feedings. The
discomfort should be gone by the end of the first week
of breast-feeding.
Nipple pain that is severe, lasts
throughout a feeding, or continues more than 1 week
after birth probably means your baby is nursing
incorrectly. If your baby doesn't latch on properly to
nurse, your infant may not be getting enough milk. If
you do have very sore nipples, ask your infant's doctor
to check your baby's weight and to refer you to a
lactation consultant who can look at how your baby is
nursing.
- Two or three
weeks after delivery you may notice the sensations
associated with the milk ejection, or milk let-down,
reflex.
Breast-feeding causes the release of the
hormone oxytocin. This hormone causes the uterus to
cramp. These "after-pains" with breast-feeding are more
noticeable than any early breast sensations. They
usually go away 7 to 10 days after the birth of your
baby.
The sensations of the milk ejection
reflex are a tingling, pins-and-needles, or tightening
feeling in your breasts as milk begins to flow. When
your milk let-down occurs, your baby may start to gulp
milk. Milk may drip or spray from the other breast. You
may find that just hearing your baby cry causes your
milk to let down, even before your baby starts nursing.
If you don't notice any signs of milk let-down, your
milk supply may be low.
- Once your milk
comes in, your breast-fed baby should gain weight
rapidly -- at least 1 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 your
baby weighed regularly. If your baby is not gaining
enough weight, your milk supply may be low or your baby
may not be nursing effectively. Such breast-feeding
difficulties are easier to overcome if you recognize and
treat them early. Your baby's doctor can help develop a
feeding plan tailored for you and your baby or can refer
you to a lactation consultant.
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Written by Marianne Neifert, MD, and the clinical staff of The Lactation
Program, Rose Medical Center, Denver, CO. 303-377-3016.
Copyright © 2006 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved.
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© 2008 Texas Children's Hospital
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