Question of the day

pexels-photo-356079.jpegQuestion: My baby is 2 days old and has lost weight. Is this normal?

Answer: Most babies lose weight until mom’s milk comes in on day 3. If your baby is breastfeeding well on day 1 and 2, the weight loss probably won’t exceed about 7% of baby’s birth weight. Weight loss greater than 7% may indicate that baby isn’t breastfeeding effectively yet.

A Lactation Consultant can assess the situation, determine if there is a concern, and assist, as needed. Once your milk is in, your baby should not lose any additional weight, and should begin to gain about 1 ounce per day or 5 ounces per week during the next 3-4 months.

Question of the day

 

pexels-photo-356079.jpegQuestion: When will my milk come in?

Answer: Your body begins producing colostrum about halfway through your pregnancy and that’s what your baby will eat during the first 2-3 days. You should notice your breasts are fuller and heavier on day 3. If you do not notice a difference in the way your breasts look and feel by 72 hours after delivery, contact your Lactation Consultant.

How much milk will I pump?

Expect to pump more milk on Monday than on Friday and,

Expect to pump more in the morning than in the afternoon

    Also, you will probably notice that one breast produces more milk than the other breast; this is normal. As long as you have enough milk from both breasts combined, that’s all that matters.

Nights and weekends

    Babies are pretty smart! They realize they are breastfeeding fewer times during the day, so they make up for it at night and on the weekends. This is actually very good for your milk supply. Don’t worry, after your baby adjusts to the new schedule, he will sleep again.

Question of the day

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Question: How often should I feed my baby?

Answer: Babies should breastfeed 8-12 times per day. Some of those feedings will be close together and others will be more spaced out (hopefully at night). It is best to watch for feeding cues as a sign to feed rather than watching the clock.

 

Question of the day

pexels-photo-356079.jpegQuestion: How do I know my baby is getting enough to eat?

Answer: Babies who are eating enough will pee, poop, and gain weight. It is normal for babies to lose weight in the 1st 3 days, but once mom’s milk is in, babies will begin gaining about 1oz per day (or 5 oz per week) during the 1st 4 months. They will double their birth weight by 4-6 months and will triple their birth weight by the time they are 1 year old. Additionally, babies who are eating enough will show feeding interest and will feed 8-12 times per day.

Limiting hospital visitors

A new baby! What could be more exciting? After months of anticipation, the big day has finally arrived…. along with family, friends, and co-workers. What most people don’t realize, including the new parents, is that visitors in the first couple of days can interfere with breastfeeding success.

A newborn babyI see it daily at the hospital. A waiting room full of people anxiously listening for that very first cry, followed by an endless stream of visitors in and out of the room to see the new family. I also see baby passed from grandparents, to aunts and uncles, brothers and sisters. The baby doesn’t seem to mind, he sleeps through it all.

But what if I told you the baby does mind. Being away from mom is stressful for a newborn baby and decreases breastfeeding interest. During the first couple of days, stressed-out newborns don’t cry when they are passed around by their loving family and friends; they sleep. This means they show fewer “feeding cues” and miss opportunities practice breastfeeding.  When baby is left skin to skin with mom, he relaxes and communicates with her. He puts his hands in his mouth and turns his head to let her know he’s ready to try.

Babies who miss feeding opportunities during the 1st couple of days may have greater weight loss and an increased risk for jaundice. They are also more likely to wean early. Their moms are more likely to experience breastfeeding difficulties, too, such as engorgement or an insufficient milk supply.

Hospital visitors should be limited. I know, easier said than done! And, I also know that new moms and dads want the love and support of their family and friends during this special time.  My best advice, as a Lactation Consultant who spends day after day (and night after night) with families during the first days of their baby’s life, is to talk honestly about the importance of establishing breastfeeding before the baby arrives. Limit visitors to only those that mom feels most comfortable learning to breastfeed in front of, or those that she is comfortable asking to step out on a moments notice. And, be selfish; I give you permission. Keep baby skin to skin and don’t allow others to hold him until he’s learned to breastfeed.

LRM

Question of the day

pexels-photo-356079.jpegQuestion: Can I breastfeed my baby too much?

Answer: No, you don’t need to worry about overfeeding your breastfed baby. Babies are smart. They can suckle to remove milk when they are hungry (nutritive suckling) and they can suckle for comfort (non-nutritive suckling). Both nutritive and non-nutritive suckling are beneficial and important for moms and babies.

 

Day 2

Colostrum is enough

Moms begin making colostrum about halfway through their pregnancy. Some moms don’t notice colostrum, but it’s there. Colostrum is very thick and concentrated. Babies only need a small amount at a time because their tummy is so small.

If baby is latching to mom’s breast and suckling, he is able to remove colostrum. Babies are much better at removing colostrum than moms or pumps. A couple spoonfuls of colostrum will fill the baby’s tummy on the 2nd day.

Babies who are getting enough colostrum will poop! Colostrum is like a laxative. One poop on the 1st day, and 2 poops on the 2nd day indicates that baby is getting colostrum from mom’s breast.

Babies who are not latching well on the 2nd day need to be given mom’s colostrum. Mom should hand express and offer colostrum using a small spoon or syringe after each time baby tries to breastfeed.  The hospital Lactation Consultant or nurse can teach moms how to hand express, if needed.

Mom’s milk comes in on day 3, just when baby’s tummy is big enough for it. Giving baby too much milk on the 1st and 2nd day is unhealthy for baby and increases his risk of obesity later.

tummysize

 

 

Day 3

Infant weight loss

All babies lose weight until mom’s milk comes in on day 3. If baby is breastfeeding well on day 1 and 2, the weight loss probably won’t exceed about 7% of baby’s birth weight.

Weight loss greater than 7% may indicate that baby isn’t breastfeeding effectively yet. A Lactation Consultant can access the situation, determine if there is a concern, and assist, as needed.

Babies should have a weight check on day 4 if there are any concerns with weight loss on day 3. Once mom’s milk is in, baby should not lose any additional weight, and should begin to gain about 1 ounce per day or 5 ounces per week during the next 3-4 months.

The milk comes in

Mom’s will notice their breasts are heavier and fuller on day 3, sometimes even before then. Moms who don’t experience breast changes by 72 hours after delivery should consult with their Lactation Consultant.

Gulping milk

Once mom’s milk is in, she will begin hearing her baby swallow milk. The baby will probably breast feed just as often as he did on day 2, but some of the feedings may be shorter because of the increase in mom’s milk volume.

Pumping for comfort

Mom may notice that there is more milk in her breast than the baby needs. If mom is uncomfortable between breast feedings, she can pump her breasts for just long enough to feel comfortable.

 

 

The first 24 hours

IMG_5540 2Breastfeeding during the 1st 24 hours of your baby’s life will be different than the days to  come. Parents who are not aware of this often spend the 1st 24 hours worrying rather than resting.

Baby’s gestational age, whether baby is born vaginally or by c-section, and even the length of mom’s labor can affect the baby’s eagerness, or lack thereof, to breastfeed on day 1.

What most parents experience is a very eager baby in the 1st hour or two after delivery,  followed by sporadic or very little interest in breastfeeding. This is because babies have a rush of adrenaline when they are born. During the first hour, they are awake and alert, and are amazing breastfeeders! They don’t usually need my help for the first feeding, and typically, neither does mom.

Oh, but what happens after a rush of adrenaline? Yep, you guessed it. They sleep. And, they sleep. And, they sleep. This is normal. Healthy, full-term babies, in the absence of illness, don’t have to be fed routinely. They were fed very well right up until the minute their umbilical cord was cut.

During the 1st 24 hours, healthy, full-term babies should be kept skin to skin with their mom as much as possible and fed when they show interest in eating. This may be often, but it may not be at all. They should not be bathed right away, and they should not be passed around for all the family to hold, as these things will make the baby less likely to show feeding interest and feed on-demand.

Labor and delivery are tiring and stressful for both mom and baby. Don’t worry if baby isn’t a champion breast feeder in the 1st 24 hours. He will make up for it on day 2, or should I say, night 2! Mom and baby both need time to rest and recover. Unless baby is premature or sick, he does not need to be supplemented with formula during the first 24 hours if he’s not feeding. Giving formula is unhealthy and actually interferes with learning to breastfeed. It also increases a mom’s risk of engorgement and/or an insufficient supply of milk later.