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The Pregnant Community
The Early Days of Breastfeeding 
30th-Apr-2008 09:30 am [breastfeeding, recommended reading]
I am the adopt_a_mom Mentee Coordinator, which means I am the one who coordinates the pairing of new moms with our experienced breastfeeding mentors. I wanted to take a moment to address a few common concerns that I see in applications. Hopefully this information will help you avoid a few of the common breastfeeding-related stressors in the first weeks of your baby's life!

The following image is a representation of how much liquid an infant's stomach can hold at one day, three days, one week, and one month of life. The blue liquid in the bottles represents the maximum stomach capacity of the newborn. As you can see from the image, the amount of sustenance needed per feeding in the first few days is tiny!





This image demonstrates stomach size in a slightly different way:




This is an important thing to be aware of, because women are often told in the hospital that their colostrum is not enough and that their babies need additional milk. That is simply not true for the vast majority of infants! A newborn does not need two ounces of formula, though the natural sucking instinct means the baby will continue to suckle at the bottle, even after s/he is full. The tiny amount of colostrum your breasts produce in the first few days is more than enough to meet the nutritional needs of a newborn, and is a superior was to raise blood sugar, help your baby pass the meconium (first poop), and flush out jaundice.

Don't worry about your baby overeating at the breast, though. While a baby can be overfed by a bottle, this is because the baby cannot control the flow of the bottle. S/he does have control over the flow at the breast and can learn a non-nutritive suckling pattern that causes very little milk to be transmitted. Comfort suckling at the breast is a good thing for both mother and baby, so don't limit your baby's time at the breast out of fear that s/he will over eat. Direct-breast feeding will not lead to a baby overeating!

How do you know your baby is getting enough milk? What goes in must come out. In other words, if your baby is making enough wet or dirty diapers, you know your baby is getting enough to eat. A normal diaper output is one sopping wet diaper (about 3 tablespoons of liquid) per day of life until baby is a week old, and then 6+ sopping wet diapers a day from then on. Disposable diapers are so absorbent that it can be hard to tell how wet they are, so if you or your doctor are concerned about your baby's diaper output, consider using cloth diapers for a few days, as they show wetness better. Poopy diapers also can mask a wet diaper, so most experts say to count a large poop as a wet diaper as well.

Breastfed babies usually regain their birthweight within two weeks, not the one week that most doctors expect from formula fed infants. As long as baby is making good wet/dirty diapers and is showing a steady gain, your baby is getting enough to eat. Once your milk comes in, baby's weight gain will average 6oz a week (this is just an average, some gain more or slightly less). If you or your doctor are concerned about your baby's weight gain, talk to an IBCLC* to troubleshoot common problems like bad latch before turning to supplementation, as most weight gain issues are correctable through proper latch and positioning.

The most important thing is to feed your baby often, as often as s/he indicates hunger -- feeding your baby when s/he shows early hunger cues will make breastfeeding easier for both you and your baby. Early hunger cues include smacking/licking lips, sucking on hands, opening and closing mouth (baby fish lips). Crying is a late hunger cue!

Some babies are sleepy (especially if they have jaundice) and need to be woken to eat. If your baby isn't eating every 2 hours, isn't making enough wet diapers, isn't showing a consistent growth pattern, or has jaundice, make sure you wake your baby to feed every two hours, then continue to feed him/her on demand as s/he becomes more alert.

Newborns should be fed at least every two hours in the first weeks of life, but some will need to be fed more often. This doesn't mean your milk supply isn't sufficient or that your milk isn't satisfying enough. Quite the opposite! Breastmilk's nutrients are highly biolavailable, meaning that your baby can quickly and easily absorb all the nutrients and digest the milk -- this means more frequent feedings. Overfilling your baby with a bottle of formula may make him or her go longer between feedings, but that isn't a good thing -- frequent nursing makes baby more comfortable, makes mom more comfortable (avoids engorgement), helps establish milk supply, and keeps baby's stomach from being stretched beyond capacity.

Your baby will have frequent growth spurts in the first few weeks of life, during which time s/he will want to nurse more frequently. This is normal, though it can be frustrating or stressful for a first time mom. It doesn't mean your supply is dwindling. It just means your baby needs to eat more to support the massive growth that s/he is undergoing! If you allow your baby to nurse on demand, your supply will continue to meet his/her needs.

This great article by Kelly Bonyata, IBCLC*, covers the biological basics of how milk production works. Remember that milk supply is largely an issue of supply and demand. The more you nurse your baby, the more milk you will make.



breastfeeding is an active community for breastfeeding moms on LiveJournal. The ladies in this community are very fast to respond to questions or concerns. boobie_bootcamp is another good community for first-time breastfeeding moms.

Kellymom is an excellent resource for answering all your breastfeeding related questions.

Dr. Jack Newman, who is one of the foremost lactation experts, has a wonderful series of handouts and videos covers common breastfeeding questions and concerns, including videos on latch.

Dr. Thomas Hale, an expert in medications and their interaction with lactation, publishes a book called Medications and Mothers' Milk that is searchable on Amazon.com and includes research on the safety of various medications while breastfeeding. Most medications are compatible with breastfeeding or have a breastfeeding-safe alternative. For medications not included in this book, Dr. Hale also has a forum where he will answer questions or address concerns.




If you would like to be paired with an adopt_a_mom mentor for more information and breastfeeding support, you can do so at any during during pregnancy or post-partum. Pregnant moms can apply in this post and moms who have already had their babies can apply in this post. All comments/applications are screened for privacy. None of your personal information (including your status as an AAM mentor) will be divulged without your permission outside of the closed adopt_a_mom community (which is for mentors only).



Hopefully you have found some of the information helpful, or at least interesting. Good luck breastfeeding your new babies!




*IBCLC stands for "Internationally Board Certified Lactation Consultant." These highly trained professionals have thousands of hours of training and in-the-field experience in the area of human lactation. If you do find yourself encountering a breastfeeding problem, an IBCLC is the best resource for answering your questions and helping you find a solution. You can search for an IBCLC in your area through this page.
Comments 
30th-Apr-2008 02:31 pm (UTC)
Thanks for sharing this. I am going to print it out and save it for when I'm at the hospital for my mother... cause I know she's going to totally be like "OMG YOU'RE STARVING THE BABY, IT'S LOSING WEIGHT, SHE NEEDS FORMULA!!!" I have full confidence in my breastfeeding abilities (my 3 yr old son is proof of it :) but she is gonna freak dealing with me bf'ing instead of using formula.
30th-Apr-2008 02:51 pm (UTC)
Kellymom and Dr. Newman both have some additional handouts that would be good to show your mother, too.
30th-Apr-2008 02:32 pm (UTC)
Fabulous!
30th-Apr-2008 02:39 pm (UTC) - Ferris Bueller you're my hero


I <3 you.
30th-Apr-2008 02:52 pm (UTC)
Adopt a Mom all the way, baby. I've never learned so much in my life as I have from working with my fellow mentors!
30th-Apr-2008 02:40 pm (UTC)
this is stellar! thanks for posting.
30th-Apr-2008 02:52 pm (UTC)
You're welcome!
30th-Apr-2008 02:51 pm (UTC)
Thank you SO much for posting this. It's going in my favorites.
30th-Apr-2008 02:57 pm (UTC)
awesome. invaluable information. thanks HEAPS for posting this. :)
30th-Apr-2008 03:00 pm (UTC)
You're welcome!
30th-Apr-2008 03:10 pm (UTC)
Thanks so much for posting this. It's really informative.

And sorry if this is off-topic but...I applied for the adopt_a_mom thing several days ago and I haven't heard anything. How long does it typically take to pair up?

Edited at 2008-04-30 03:11 pm (UTC)
30th-Apr-2008 03:20 pm (UTC)
It usually takes about a week. Your application was mixed in with some urgent ones, so those usually get address more quickly. I'm going to be making another adoption post this afternoon to list the moms who are applying today in response to this post, so I'll make sure you're at the top of our list!
30th-Apr-2008 03:25 pm (UTC)
Great stuff here :)
30th-Apr-2008 03:39 pm (UTC)
Thank you for posting this!
30th-Apr-2008 03:40 pm (UTC)
Thank you for this. I knew babies only ate a little, but I didnt know it was that little now I can tell my SIL to stfu about starving my child.
30th-Apr-2008 03:45 pm (UTC)
Thanks for sharing this!

I remember that about a week and a half after my son was born and I was so tired, averaging about two hours' sleep in every 24 hours, that the midwife told me to "pump what you can...even if it's only an ounce or two, it'll keep him full long enough for someone ELSE to feed him so that you can nap!"

Did that twice and it was the best advice anyone ever gave me - before that I'd had *no* idea how tiny a newborn's stomach was!
30th-Apr-2008 06:42 pm (UTC)
There is a danger in supplemental feeding in the early weeks, though. Feeding a baby a bottle early on can lead to nipple confusion, so it's important that if there is a case where baby absolutely must be given EBM, that it's given via a cup or syringe feeder, not a bottle.
30th-Apr-2008 03:55 pm (UTC)
This is a great write up. My daughter had jaundice and she ate every 3 hours but she always woke up to eat and her diaper put out was good so we didn't have any problems.
30th-Apr-2008 07:12 pm (UTC)
If she was growing, making good diapers, and eating at least 8-12 times in a 2 hour period, then 3 hours was just her normal feeding period. Some mamas get lucky and have a baby who likes to space it out. Other mamas get cluster feeders who eat every 30 minutes for half the day. ;)

You were aware of the important signs of a healthy baby, so you were able to trust that she would eat when she needed to, and that your milk was doing the job it needed to do. Sounds like you were really good at following her cues!
30th-Apr-2008 04:22 pm (UTC)
Thank you for this GREAT post!
30th-Apr-2008 04:51 pm (UTC)
Thank you so much for this. I'm planning to breastfeed my first when she comes (about 8 weeks off) and this will definitely come in useful!
30th-Apr-2008 05:24 pm (UTC)
excellent post! i added it to the community memories :)
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