One of the most common and frequently asked question to health care providers is “How do I know my baby is eating enough?” In today's society we have adapted the thought that everything needs to be measured. This can be very nerve-wracking to a new parent because you can not see how much milk your breasts are making and how much the baby is actually eating. This can also be intimidating to some, after all you can look at the side of a bottle and read measurements of how many ounces your baby is drinking. First take a deep breath, I am going to explain what we look for when determining sufficient intake and what you can monitor at home to ease your worry.
First thing is Diapers…
Honestly, this is the main thing to focus on in the first few weeks. A baby should be stooling and having wet diapers daily! You’ll know your breasts are starting to produce colostrum when your newborn starts to poop. You should notice your baby's stools changing in color and consistency. Days 1-2 of life it will look greenish-black tarry which is meconium. Days 3-5 baby should have at least 3 greenish transitional stools. Days 5+ at least 3-5 yellow, unformed stools the size of a quarter or larger. Days 6+ possibly less frequent stools but still 4-5 times a day but larger in size and yellow seedy in color. When counting wet diapers, these should be very frequent and by day 5 of life always 6-8 or more heavy wet diapers a day.
Weight Gain Expectations….
The expectation for weight gain is to get your newborn back to birth weight by 2 weeks of age. Newborns often lose 7-10% of their birth weight in the first few days and this does require close monitoring by your pediatrician and Lactation Consultant. Once a mothers milk production increases, usually by days 3-4, we tend to see babies begin to regain weight. We strive to have babies gain 5.5-7 oz per week and maintain their growth curve. All babies will grow at their own rate, but a growth chart can be a good tool to indicate how well they are feeding. If it is noticed that a baby is dropping off their growth charts we may suggest supplementation of breastmilk or formula to help increase caloric intake. T
Following babies feeding cues….
The first thing we tend to suggest to a parent is do not watch the clock and stress, watch the baby. Some newborns prefer to eat routinely and others choose to graze feed. Frequent nursing is normal because your baby’s tummy is tiny and breastmilk is quickly digested so they tend to need more frequent feeds to stay satisfied and grow properly. According to the AAP, it is recommended that a newborn eat every 2-3 hours but some will eat every 1-2 hours. Both are completely normal, do not let the baby go past 3 hours; they need 8-12 feedings in a 24 hour period. A few hunger cues you can watch for are * lip smacking, * rooting around looking for the nipple, *hands brought to the mouth, * and crying is the last stage of them telling you they are hungry. When a baby is satiated they should finish the feeding in a calm and alert stage, or be "milk drunk." They should be able to hang out for 1-2.5hrs or so before they get fussy and start showing hunger signs again. Baby's who come off the breast fussy may still be hungry.
When to see a Lactation consultant….
At Feed Well want to make sure you and your baby are off to a great start. Some recommendations are to do a prenatal visit to ensure all concerns and questions prior to birth are addressed then we’d like to see you 3-5 days postpartum to make sure latch and feedings are starting off well. The earlier we can troubleshoot issues the more successful and enjoyable breastfeeding can be.
If you have any concerns about your baby's weight please contact your pediatrician or schedule an appt with us!