Normal Breastfeeding: What to Do and What to Expect
|
Birth-Day 4
|
|---|
|
Feed early and often: at least eight times per 24 hours. Ideally, mothers and babies should be kept skin to skin and the first breastfeeding should be within an hour or two of birth. Babies often act fussy and unsatisfied until milk increases on day three or four. Baby may want to nurse almost continuously, which increases milk supply faster. Supplements are not needed and will only delay the increase in milk.
|
|
Expect a comfortable latch. As you both learn, it may take several tries before baby latches well and begins to feed. When latching, wait until baby opens WIDE and help him/her on FAR--off-center with lower jaw as far as possible from the nipple. No matter what you hear, breastfeeding is not supposed to hurt! If it does, get help.
|
|
"Finish the first breast first" means allowing baby to stay on the first breast until he/she comes off or falls asleep and falls off. Babies normally take one breast at some feedings and both breasts at some feedings.
|
|
If needed, help baby stay active at the breast. (See section below.)
|
|
Diapers: First three days: one to two wet diapers per 24 hours, gradually increasing as the days pass and meconium (green-black tarry) stools. On the third or fourth day, stool color changes to green "transitional stools" and three to four wet disposable diapers per 24 hours.
|
|
Weight: Up to a 7 to 10 percent weight loss by third or fourth day is considered normal. Weight gain starts then.
|
|
After Day 4
|
|---|
|
Breastfeed at least eight to 12 times per 24 hours. The more times per day milk is effectively removed, the more milk is produced. Focus on number of feedings per day NOT the time between feedings (i.e., every two to three hrs). If baby is sleepy and doesn't wake for eight to 12 feedings, you need to wake baby. Start by bringing baby skin to skin.
|
|
Feed on cue. Encourage the baby to nurse whenever he/she shows feeding cues (rooting, hand to mouth, fussing, etc.), even if it has only been a short time since the last nursing. Watch the baby, not the clock!
|
|
Expect "cluster nursing." Irregular intervals between feedings are normal for babies younger than six weeks. Look for eight to 12 feedings that are at least 10 minutes long every 24 hours. One four- to five-hour sleep period (ideally at night!) is fine. Many babies nurse every hour or even half hour for part of the day (usually evenings). As they grow and their stomachs grow bigger, they will take in more milk at a feeding and be content to go longer between feedings. After six weeks, baby will probably start to fall into a more regular, predictable feeding pattern.
|
|
"Finish the first breast first" means letting baby stay on the first breast until he/she comes off or falls asleep and falls off. After the first breast, burp if needed and/or change baby's diaper. Then offer the other breast. Babies normally take one breast at some feedings and both breasts at other feedings. Because fat sticks to the milk ducts in the breast, as baby continues to nurse, the fat content of the milk increases. Allowing baby to finish one breast before offering the other insures baby gets both the watery, low-fat foremilk, which he/she needs for fluids, and richer, high-fat hindmilk, which he/she needs to gain weight. (The hindmilk produces stools.)
|
|
If needed, help baby stay active at the breast. Average feeding time for a newborn is 20 to 40 min., but to count, a feeding should last at least 10 minutes long. (As babies grow, they tend to get faster and more efficient.) Look for movement near ear/temple area (some pausing is normal). If baby consistently falls asleep or stops sucking actively before 10 minutes, make sure baby is not too warm (dress down to diaper). If baby pauses for long stretches, compress the breast firmly to increase milk flow. (Don't release pressure until baby stops sucking actively.) Each time you compress, move your hand about an inch to compress a slightly different area of the breast.
|
|
Diapers: When breastfeeding is going well, babies typically have at least three to four yellow stools (the size of a quarter or larger) by around day five and at least five to six wet disposable diapers/24 hours. If too few stools, check baby's weight.
|
|
Keep a written record of number of feedings at least 10 minutes long and number of stools per 24 hours. Goal: at least eight to 12 feedings and at least three to four stools per day. You can have too few, but you cannot have too many!
|
|
Weight: For the first four months, a thriving baby typically gains at least 3/4-1 oz per day or at least 1 1/2 to 2 lbs per month. Weight gain is the "acid test of how a baby is doing. If baby is gaining well on breast alone, your milk supply is fine.
|