Common Breastfeeding Questions...and Answers!
How often will I breastfeed my baby?
Exclusively breastfed babies typically feed every 2 to 4 hours, up to 8-12 times in a 24 hour period. Some feeding sessions may be long, and others short. Babies will generally take what they need at each feeding and stop eating when they are full.
So how do I know if my baby is getting enough breastmilk?
Clearly breasts don’t have ounce markers on them like a bottle, so it’s hard to know how much milk a baby is getting. We do know that a baby is well-fed how many wet diapers and bowel movements they have, weight gain, and how satisfied they seem. For the first week after birth, babies should have one wet diaper for every day since birth. For example, day 1 after birth, baby should have one wet diaper. On day 2, two wet diapers, etc. A week after birth, a well-fed infant should have 6-8 wet diapers in a 24-hour period.
Other signs that a baby is feeding well:
They feed actively from the breast and are not falling asleep shortly after starting.
Their skin appears well-hydrated.
They have periods of wakefulness.
After your colostrum transitions to mature breast milk (aka your milk “coming in”), a breastfed baby will typically gain 5-7 ounces a week.
A baby who is struggling to feed may:
Appear lethargic,
Have fewer than 6-8 wet diapers in a 24 hour period (for babies at least 1 week old),
Be dehydrated (dry skin, chapped lips, sunken fontanelle on top of their head),
May fall asleep easily at the breast.
If your baby is not gaining weight as expected, let your doula know, talk to your pediatrician and IBCLC. Zipmilk is a great resource to find local breastfeeding professionals.
Do I have a low milk supply? Is my milk supply dropping?
Perceived milk supply is one of the big reasons why people stop breastfeeding. But there’s more to this story than meets the eye. Here’s one version of the story:
You see a baby who is fussy.
Your baby “can’t possibly be hungry again.”
A family member thinks it may be because you’re not providing enough milk.
Here’s another version of the same story:
Your newborn may want to feed 12 or more times in a 24 hour period. In the first six weeks of breastfeeding, the supply/demand process is still getting established. They’re helping establish your supply by demanding more. Every time your baby feeds, they are helping your breasts produce more milk.
Around 6-8 weeks postpartum, the supply/demand process has leveled off and the body knows how much milk to produce. This may cause some people to feel like their breasts are not as full.
Between 6 and 8 weeks, babies hit their peak fussiness. This is normal.
Your baby may be going through a growth spurt. The Kelly Mom website has great evidence-based information on breastfeeding. There, it says, “Common times for growth spurts are during the first few days at home and around 7-10 days, 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months and 9 months (more or less). Babies don’t read calendars, however, so your baby may do things differently.”
Your baby may need more comfort for one of 1,000 reasons.
It is important to know that babies are like us-- some days they're hungrier than others. There may also be times when a baby cluster feeds. This can happen in early evening or during a growth spurt. Cluster feeding is normal and it doesn’t mean your milk supply is decreasing. Your baby has an immature nervous system and has a growing belly. That being said, cluster feeding can be a lot for parents. Remember that it won’t always be like this.
The first story leads a lot of parents to assume they’re not enough. The second story paints a more realistic picture of life with a newborn. If you are concerned about your milk supply, you can:
Reach out to an IBCLC or Infant Feeding Specialist
Do a weighted feed (weighing baby before and right after breastfeeding)
Look for 6 to 8 wet diapers as a sign that baby is getting enough to eat
Help! How can I tell if my baby needs to eat or just wants to breastfeed for comfort? It’s hard to tell the difference and it's really exhausting to be “on demand” like that.
That can be super frustrating. First, non-nutritive sucking is a normal part of infant development too and can happen at breast but also fingers or pacifier. When a baby is feeding for comfort, their pattern of “suck, swallow, breathe” will be less rhythmic and less frequent.
Secondly, it’s helpful to know the early, active and late hunger signs to identify if a baby is hungry.
The best time to bring the baby to the breast is when they’re showing early signs of hunger. They’ll be more calm and likely to get a good, deep latch. Early hunger cues can include licking or smacking their lips, opening and closing their mouth, sucking lips and tongue, turning their head, using their instinctive “rooting reflex.” More active hunger cues include stretching, wiggling, putting their hands to their mouths if they’re not teething.
Late hunger cues (i.e. the baby is hungry and pissed about it), include crying, flailing their arms, and turning red. What are you noticing? If your baby is hungry and pissed, put them in the “reset position,” (head at your heart, close to you) for a few moments to calm them down. You baby can’t get a good latch when they’re crying. Once they calm down, you can try nursing.
How do I know if I’m overfeeding my baby? What if I have an overactive “let down”?
You can’t overfeed a breastfed baby. They will be able to self-regulate at the breast. Feeding at the breast takes work for the baby. It’s not like shotgunning a beer. When they are full, they may turn their head to the side, slow down their sucking, become drowsy.
That being said, some lactating persons have an overactive letdown, where their milk ejection reflex turns on very quickly and forcefully. You may see your baby sputter or cough after getting your let down at the breast. You may even see milk shooting across the room!
There are a few ways to help your baby breastfeed if you have an overactive let down:
Nurse your baby until the let down occurs, and briefly take them off. Have a towel, burp cloth, diaper or Haakaa milk collector ready to catch the forceful flow. Once the forceful let down happens, put your baby back on the breast.
Use breastfeeding positions where the baby’s head is level or slightly above your nipple. This includes side-lying position or laid-back breastfeeding.
For more help navigating the seismic shift into parenthood, reach out to the Boston Area Doulas team.
www.bostonareadoulas.com
