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Is My Baby Getting Enough Milk?
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The following are NOT good ways of judging
Your breasts do not feel full. After the
first few days or weeks, it is usual for most mothers not to feel
full. Your body adjusts to your baby's requirements. This
change may occur quite suddenly. Some mothers breastfeeding
perfectly well never feel engorged or full.
- The baby sleeps through the night. Not
necessarily. A baby who is sleeping through the night at 10
days of age, for example, may, in fact, not be getting enough milk. A
baby who is too sleepy and has to be awakened for feeds or who is "too
good" may not be getting enough milk. There are many
exceptions, but get help quickly.
- The baby cries after feeding. Although
the baby may cry after feeding because of hunger, there are also
many other reasons for crying. See also handout #2
Colic
in the Breastfeeding Baby. Do not limit feeding times. “Finish” the
first side before offering the other.
- The baby feeds often and/or for a long time. For
one mother feeding every three hours or so may be often; for another,
three hours or so may be a long period between feeds. For
one, a feeding that lasts for 30 minutes is a long feeding; for another,
it is a short one. There are no rules how often or for how
long a baby should nurse. It is not true that the
baby gets 90% of the feed in the first 10 minutes. Let the
baby determine his own feeding schedule and things usually come right,
if the baby is suckling and drinking at
the breast and having at least two to three substantial yellow bowel
movements each day. Remember, a baby may be on the breast for two
hours, but if he is actually feeding or drinking (open
wide—pause—close mouth type of sucking) for
only two minutes, he will come off the breast hungry. If the
baby falls asleep quickly at the breast, you can compress
the breast to continue the flow of milk (handout #15, Breast
Compression). Contact the breastfeeding clinic with any concerns,
but wait to start supplementing. If supplementation is truly
necessary, there are ways of supplementing which do not use an artificial
nipple (handout #5, Using a Lactation Aid).
- "I can express only half an ounce of milk". This
means nothing and should not influence you. Therefore, you
should not pump your breasts "just to know". Most
mothers have plenty of milk. The problem usually is that the
baby is not getting the milk that is available, either because he
is latched on poorly, or the suckle is ineffective or both. These
problems can often be fixed easily.
- The baby will take a bottle after feeding. This
does not necessarily mean that the baby is still hungry. This
is not a good test, as bottles may interfere with breastfeeding.
- The five week old is suddenly pulling away from the breast
but still seems hungry. This does not mean your
milk has "dried up" or decreased. During the first
few weeks of life, babies often fall asleep at the breast when
the flow of milk slows down even if they have not had their fill. When
they are older (four to six weeks of age), they no longer are content
to fall asleep, but rather start to pull away or get upset. The
milk supply has not changed; the baby has. Compress the
breast (handout #15, Breast Compression) to increase flow.
Notes on scales and weights
1. Scales are all different. We have documented significant
differences from one scale to another. Weights have often been
written down wrong. A soaked cloth diaper may weigh 250 grams
(half a pound) or more, so babies should be weighed naked or with a
brand new dry diaper.
2. Many rules about weight gain are taken from observations of growth
of formula feeding babies. They do not necessarily apply to
breastfeeding babies. A slow start may be compensated
for later, by fixing the breastfeeding. Growth charts
are guidelines only.
Questions? (416) 813-5757 (option 3) or drjacknewman@sympatico.ca or
my book Dr. Jack Newman’s Guide to Breastfeeding (called The
Ultimate Breastfeeding Book of Answers in the USA)
Handout #4. Is My Baby Getting Enough? Revised
January 2005
Written by Jack Newman, MD, FRCPC. © 2005
This handout may be copied and distributed without further
permission, on the condition that it is not
used in any context in which the WHO code on the marketing of breastmilk substitutes is violated.
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