How To Tell Your Baby Is Getting Enough to Eat

BABY

• Nurses 8 to 12 times every 24 hours
• Swallows at the breast
• Has 6 or more wet diapers every 24 hours by day six
• Has 3 or more yellow bowel movements every 24 hours by day six
• Regains birth weight by two weeks
• Is satisfied after most feedings

MOTHER

• Notices engorgement, or swelling of the breasts, by day five
• Does not have extremely sore nipples

The newly delivered mother has “milk” in her breasts in just the right amount to meet the needs of her baby. The first days after delivery, your baby will suckle frequently to feed on your early, high-powered milk called “colostrum.” This is the perfect food for your newborn infant. Unlimited access to the breast these first days gets breastfeeding off to a positive start. Your milk volume will continue to increase over subsequent days in response to frequent feeding. Your baby does not need supplemental bottles of formula or glucose water at this time.

Your baby should rapidly progress to at least 8 to 12 feedings/24 hours. Infants occasionally have to be awakened for feedings during the first days or weeks. Once your baby’s weight gain is established, waking should not be necessary. The length of feedings will vary greatly. Typically, babies have one 3-4 hour stretch of sleep and one 3-hour stretch of wakeful, fussy behavior (the marathon feed) every 24 hours. Initially, your baby may feed for only a few minutes, or linger as long as thirty minutes per breast. Let your baby set the pace; he/she will suck strongly with pauses between suckling bursts. Gradually suckling will slow down. Some babies need to use both breasts at feedings, while others are full after feeding on one breast. Alternate which breast you start on to equalize your milk production.

Between the third and fifth day, the volume of milk produced by a breastfeeding mother increases dramatically. At this time you will begin to perceive the filling of your breasts as the welcomed sign of “engorgement.” This is due to an increase in the volume of your breast milk, as well as body fluids within your breast tissue. Your breasts may become hot, firm and uncomfortable with the onset of engorgement and you may feel body aches. This condition lasts only 24-48 hours, providing the baby is nursing well. Although the amount of engorgement varies from woman to woman, frequent nursing (every 2-3 hours or more) from birth helps reduce the swelling and tenderness. The more your baby nurses, the less engorgement you will experience. You can tell your baby is removing milk from your breast when you hear swallowing during feeding, and your breasts feel softer and less full after feeding.

Your baby’s urine should be clear. Urine increases incrementally from 1 to 2 wet diapers on day one, to 6 or more wet diapers by day six. Although normal for the first two days, a reddish “brick dust” in the diaper after the second day may indicate that your baby is not getting enough milk. After day three, your baby’s stool will change from dark meconium to green/brown, then to mustard yellow. Yellow breast milk stools are loose and contain seedy curds. Your baby will progress from 1 to 4 stools a day for the first five days, moving to 3 or more stools every 24 hours from day six on.

Most babies lose 5 to 10% of their birth weight during the first days of life. This is normal and is due to the elimination of birth fluids and meconium. As your milk volume increases, your baby should start to gain 3/4 to 1 ounce every day and regain his/her birth weight by the end of the first two weeks. This weight gain pattern of 4 to 7 ounces per week should continue over the next 2 to 3 months.

Mild nipple tenderness at the beginning of each feed for a few days is normal. Severe pain or scabbed, bleeding nipples indicate your baby is not latched on correctly and may not be able to properly compress the areola (the dark area surrounding your nipple) to obtain milk. When properly latched on to your breast and compressing the areola, your baby should be taking enough milk.

Human babies are designed to feed frequently. Breast milk is easily digested and can pass through your baby’s tiny stomach within 48 to 90 minutes. Watch for indicators of hunger: hand-to-mouth movements, wiggling, stretching, tongue movements, noises and light sleep. Crying is a very late feeding cue, so don’t wait for your baby to cry to let you know he/she is hungry. Feed frequently, as often as your baby desires. This assures adequate feeding and helps build up your supply. If you are still concerned, see your baby’s doctor or bring your baby to The Pump Station for a lactation consultation and weight check.

Sample Breastfeeding Record