It’s common to worry that your baby may not be getting enough milk when you breastfeed, as you cannot measure the quantity the way you would if feeding from a bottle or cup. However, there are other ways to tell – and if you may need support.
Signs baby is feeding well
• Baby is actively sucking, you can hear them swallow, and they release your breast on their own, falling asleep contentedly afterwards. “Their hands, often balled into fists before a feed, are relaxed and open,” says Sister Francoise van der Westhuizen, a registered nurse and certified lactation consultant at Melkbekkies Breastfeeding Clinic, East Rand.
• Your breasts feel significantly softer after feeding.
• Baby produces 6-8 nappies heavy with pale or clear urine a day after day five. (They tend to pass little urine on the first day, have about 2 wet nappies over 24 hours, and 3 wet nappies or more by day three or four.)
• They produce 3-4 stools a day by day 4, and these change from black or dark green (meconium, composed of amniotic fluid, mucus, skin cells, and lanugo, built up in the intestines during gestation), to yellow with a loose, seedy texture by day 5.
• They gain around 180-280g a week in the first few months.
• When awake, they are alert and active, and they meet their developmental milestones, says Sister Van der Westhuizen.
Signs you may have feeding issues and should seek support
• Baby produces fewer than 6 wet nappies a day after day five.
• They lose more than the usual 7-10% of their birthweight newborns lose when they shed the excess fluid they are born with, and they fail to regain it by week 2.
• They seem frustrated during feeds, pulling off your breast, arching or crying. They may be finding it hard to feed or to get enough milk.
• They fall asleep soon after starting a feed, or they take more than an hour for a feed – they may not be getting enough milk at each session due to poor latch or low milk transfer. (A shallow latch can cause milk flow to be too slow, leading to fatigue, while a sleepy baby may not feed often enough.) “About 30-40 minutes for a feed is normal for some babies,” says Sister Van der Westhuizen. “I usually advise a maximum of 30 minutes per breast of active feeding – so a maximum of 60 minutes of active feeding per session.”
• They are lethargic, regularly sleeping 4 or more hours at a time, and are difficult to wake for feeds, or constantly irritable or unsettled after feeding. “This can indicate dehydration, low blood sugar or infection, so consult your healthcare provider or clinic sister straight away – especially if their fontanelle (the soft spot on their head) looks sunken,” she says.
• They cause you breast pain when they latch, make clicking sounds (a sign that they are losing suction), or feed without active swallowing. This can signal latching problems or other issues such as tongue tie – a common congenital condition where a band of tissue ties the tip of their tongue to the floor of their mouth, limiting its movement.
• They produce fewer than 6 heavily wet nappies in 24 hours after day 5, and fewer than three or more dirty nappies.
• They don’t gain about 180-280g a week.
• You feel anxious about feeding or overwhelmed. “Always trust your instinct,” says Sister Van der Westhuizen. “Getting reassurance and support from a professional lactation consultant or clinic sister can make all the difference, the earlier the better. They can identify any underlying problems and work with you to support you and your baby.”
New Clicks Clinic Service: Lactation support and Consultation
Selected Clicks Clinics now offer Lactation support and Consultation. Find out more and book an appointment: https://bookings.clicks.co.za/
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