Monday, October 17, 2011

Baby Getting Enough Breast Milk?

Breastfeeding requires a lot of trust. Trust in your baby, trust in your body and trust in the process. Moms often ask me: "If I can't see how much milk my baby is drinking, how can I know that she is getting enough?" Wouldn't it just be easier if our breasts had an indicator on them to know how much milk the baby took at each feeding? The good news is that there are some easy ways to tell if your baby is getting enough milk. Also, most moms are able to produce enough milk for their baby, assuming the baby is given the opportunity to nurse frequently. Moms of multiples can make supplies that nourish their children and help them grow, too!

Some signs that the baby is getting enough milk include:

Weight loss less than 10% in the first 3 daysGaining weight after day 3Adequate urine and stool outputRegained birth weight by 2 weeksBaby has periods of alert, awake and happy times

While your child's practitioner will be the person to help you determine if your child's weight is meeting appropriate goals, there are things you can monitor at home to make sure your child is getting enough milk. Do you notice that your child is awake and alert, noticing things around him? Is she meeting her milestones? Does she have both happy and unhappy times (a typical baby is rarely happy all of the time or sad all of the time)?

Another great indicator is the baby's urine and stool output. This is because if you put food into the baby, it has to come back out. After the first few weeks the baby may become very efficient with his stools and it is normal for a breastfed baby to go several days without stooling. In the first few weeks, however, these guidelines can help you monitor output:

Your baby should have:

1 urine and 1 stool on day 12 each on day 23 each on day 3at least 3 stools and 5 urines each day following

Any stool the size of a quarter or larger can be counted towards the total. The wet diapers should be soaking and families who use cloth diapers should increase minimum wet diapers by one to two diapers a day, since they tend to need changing more frequently. Some babies will just meet these goals and some children will stool with every feeding. Both are completely normal.

The first few days your infant will have stools that are thick, black and tarry. This first stool is called meconium. After the first couple of days your infant's stools should be mustard colored, seedy and loose. The stools will stay this way until you add in complimentary foods at your baby's six-month birthday.

If you notice that your child is not meeting one of the above guidelines, it's important to talk to your child's pediatrician and a qualified lactation professional. The earlier you get help, the more likely it is that the problem will be remedied. A good lactation professional can help you assess your milk supply, assess the baby's feeding and help weed out any problems that you may experience. If you do have an issue, giving supplements via a bottle may only complicate the problem. It's best to let an expert help you determine the cause and the best solution if you run into bumps in the road.

Judging milk intake by the fullness of your breasts or by how much baby sleeps will not give you a good indication of whether baby is getting enough. Breast size is not a good indication of ability to make a milk supply, either. Moms with large breasts can make milk and moms with small breasts can make milk. Frequency of milk removal is the main factor in milk supply, so be sure that you are giving your baby lots of opportunities to nurse. Your infant should nurse at least 8-10 times in 24 hours.

Sources:

Riordan, J, K Gill-Hopple, and J Angeron. "Indicators of Effective Breastfeeding and Estimates of Breast Milk Intake." Journal of Human Lactation. 21.4 (2005): 406-412. Print.

Adams, D, and S Hewell. "Maternal and Professional Assessment of Breastfeeding." Journal of Human Lactation. 13.4 (1997): 279-283. Print.


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