| Dear Bzee,
You can be confident your baby is getting enough breast milk if:
· He has six to eight really wet diapers a day. For babies under six weeks also look for at least two bowel movements. In an older baby, beyond six weeks of age, the number of bowel movements per day may decrease, and baby may have a bowel movement per day or even every three to four days, but the number of wet diapers continues to signify that he is getting enough milk.
· He is gaining weight at an average of four to seven ounces a week or at least one pound a month (453 grams). Although four to seven ounces per week is an average gain for an average baby, different babies gain at different rates. In addition, some weeks your baby will gain more or less than other weeks, and that’s perfectly normal.
· He is nursing eight to twelve times in a twenty-four hour period. This is an average and some babies may nurse less frequently while others nurse more often. Less frequent nursing is not a problem unless the baby is not gaining well.
· He appears healthy with good skin colour and resilient skin; he is ‘filling out” and growing in length, and is alert and active with good muscle tone.
Sometimes it is easy to think that you don’t have enough milk when actually there is no problem with the supply. If your baby is gaining well and has plenty of wet and soiled diapers there is nothing wrong with your supply even if you baby has the following behaviour patterns:
· Your baby nurses very often. Many babies have a strong need to suck or a need for frequent contact with their mothers. Remember that frequent nursing assures that your baby is getting enough – not that there is a lack of milk.
· Your baby seems hungry soon after being fed. Breast milk digests more quickly than formula does and places less of a strain on a baby’s immature digestive system, so that the breastfed baby needs to be fed more frequently than the formula fed infant.
· Your baby’s nursing habits, weight gain, or sleeping habits don’t compare with other babies you have known. Each baby is an individual, and there is a wide variation within the normal range.
· Your baby suddenly increases the frequency ad/or length of his nursing. Babies go through occasional growth spurts (usually around two weeks, six weeks and three months). During these times they nurse more often than usual to bring in more milk for their expanding needs.
· Your baby suddenly decreases his nursing time, perhaps down to five to ten minutes per breast. He may simply be able to extract the milk more quickly now that he is more experienced at nursing.
· Your baby is fussy. Many babies have a fussy period each day, often at about the same time of the day. Some babies are fussy much of the time. Fussiness can be caused by many things other than hunger, but often there is no discernible reason. If nursing doesn’t seem to help try such things as swaddling the baby in a light blanket, changing the baby’s position, walking him, or rocking him. Keep in mind that whatever the reason for your baby’s fussiness he often needs the comfort of just being held.
· Your breasts leak only a little or not at all. Leaking had no relationship to the amount of milk you are producing and you will probably find that leaking between feedings is no longer a problem once your supply becomes established and regulated to your baby’s needs.
· Your breasts suddenly seem softer. This happens as your production adjusts to your baby’s needs and the initial engorgement subsides.
· Your never feel the let-down sensation or milk-ejection reflex or it does not seem as strong as it did before. This may occur as time goes on. Some mothers do not feel a let-down at all, but they can learn to recognize that it is occurring by watching their baby’s pattern of sucking and swallowing.
If it seems that your supply is not meeting your baby’s needs then it is important to determine what is interfering with your production of milk. The following factors can cause or contribute to lessening milk supply:
· Supplements. They fill the baby up and cause him to wait longer for the next feeding, thereby decreasing his sucking at the breast. The more formula he gets one day, the less milk the mother’s body will make the following day. Supplementing causes a mother’s breasts to produce less, not more.
· Improper positioning of the baby at the breast.
· Nipple confusion. A baby can become confused by a bottle nipple as it requires a different type of sucking. If your baby is not sucking properly at the breast, he will not be able to stimulate your breasts to produce enough milk.
· Pacifiers. Some babies are willing to meet their sucking needs with a pacifier, which may significantly reduce their sucking at the breast and interfere with supply and demand.
· Scheduled feedings. Delaying the baby’s feedings until the clock dictates a certain amount of time has passed can interfere with the supply and demand system of milk production. Feeding when the baby indicates he is hungry usually assures an adequate supply.
· Length of feedings. Long nursings (twenty to forty-five minutes) can help assure an adequate milk supply as well as assuring that your baby gets plenty of milk high in calories. Cutting feedings too short can prevent your supply from increasing as your baby’s needs increase.
· One breast per feeding. After the milk is established, some mothers prefer to nurse at only one breast per feeding. But if you are working to increase your supply, use both breasts. The baby who nurses at only one breast will take in less milk per feeding and each breast will receive less sucking stimulation.
I’m sorry that this information is so long. I tried to cover all possible scenarios. If you are concerned about any of the factors in the last section please contact an IBCLC trained lactation consultant or a La Leche League Leader for help. All these problems can be overcome with the correct information and support.
The local LLL Leaders’ telephone numbers are:
Tanja 2259 3081, Judi 2987 5809, Maggie 2817 7475 and Sarah 2548 7636
Best wishes,
SARAH
La Leche League Leader in Hong Kong  |