By Emily Nusbaum, RN, IBCLC, Boone Family Birthplace
Breastfeeding is a normal and natural part of delivering a baby. Our bodies produce breastmilk as a result of hormones and continue to produce as our babies nurse. New parents are often surprised to learn that breastfeeding can be confusing or hard – shouldn’t things that are normal and natural be easy? Not necessarily! So, what is normal for a newborn?
WHAT’S THE BEST WAY TO START BREASTFEEDING?
Skin to skin: When a baby is born, the best place to transition to the outside world is on their mother’s chest, skin to skin. Ideally, they will stay there for 2 or more hours. The baby may begin to show signs of hunger by opening their mouth, turning their head from side to side (a behavior called rooting), and putting their hand in their mouth. A baby can latch on the breast right away or they may need time to figure it out. Babies can breastfeed for a few minutes or for an hour. Often babies are awake and active for the first hour or two before they get sleepy.
HOW OFTEN SHOULD MY NEWBORN FEED?
8 to 12 times in 24 hours: Babies need to eat 8 to 12 times in 24 hours to get the nutrients they need – and breasts need stimulation at the same time to get the message they need to continue producing milk.
It’s best and most effective to feed your baby when they show signs of hunger like opening their mouth, putting their hands in their mouth, and rooting. If your baby hasn’t eaten for 2 to 3 hours, undress your baby and change their diaper. Hold your baby skin to skin again so they can feel, hear and smell you, and they may begin to show hunger signs.
Sometimes a baby who had a great first breastfeed will go into a sleepy state and will not wake for a feeding until a few hours later. Babies don’t have to be wide awake to eat, but they do need to be awake enough to participate. Try to wake your baby by undressing him, changing his diaper and holding him skin to skin. If your baby won’t wake for feeding, then you can hand-express milk.
WHAT IS COLOSTRUM AND WHY IS IT IMPORTANT?
Colostrum is the first milk your breast produce. It’s produced in smaller quantities than mature milk and is full of amazing nutrients for babies. Colostrum is also the best possible substance to make up your baby’s gut microbiome for a healthy gut. But sometimes it’s necessary for newborns to get formula as a supplement.
If your baby has low blood sugar, high bilirubin, or is losing too much weight (7 to 10% of their birth weight), your pediatrician or nurse may suggest using formula –but that shouldn’t stop you from breastfeeding, too. If your baby needs supplemental nutrition, it’s recommended that you still put your baby to the breast or use a pump or hand expression to stimulate the breast. Firstdroplets. com has helpful information, including videos, on how to hand-express and the importance of stimulating the breast to give your baby as much colostrum as possible in their first few days of life.
In the first few days of life, a healthy, full-term newborn will get approximately 2 to 10 milliliters (mL) – about ½ to 2 teaspoons – of colostrum at a feeding. If your baby has medical issues or is preterm, their needs may be different. Your baby’s doctor will discuss these needs with you.
If you set an alarm to wake or remind you to feed your baby, they can go for a longer stretch at night without eating, but not longer than 4 hours. You can begin to observe your baby’s pattern after a few days.
By day 3 of your baby’s life, they should eat 10-30 mL – about 2 teaspoons to 2 tablespoons – per feeding and by day 10 up to 1.5 ounces or 3 tablespoons. (Since we can’t precisely measure how much breastmilk a baby receives while nursing, these are estimates.)
HOW DO I KNOW MY BABY IS GETTING ENOUGH?
Wet and dirty diapers: You can make sure your baby is getting enough at feedings but counting how many times they eat, their weight, and how many wet and dirty diapers they have each day:
• Day 1: Your baby should have at least 1 wet diaper and 1 stool in the first 24 hours.
• Day 2: 2 wet and 2 dirty diapers
• Day 3: 3 wet and 3 dirty diapers changing from black meconium to brown
• Day 4: 4 wet and 2 to 3 dirty diapers with a yellow, seedy consistency
• Day 5: 5 wet and 1 to 5 dirty diapers
• Day 6 and beyond: At least 6 wet diapers and 1 to 6 stools each day
WHAT IF I’M STILL UNSURE?
If your baby has 8 to 12 feedings a day, the expected amount of wet and dirty diapers, and is not losing too much weight when she is weighed in the hospital or your pediatrician’s office, rest assured that you are doing what you can to ensure your baby gets the nutrition they need. If you have any questions or concerns, call your pediatrician’s office or lactation consultant.
DID YOU KNOW?
Boone Health Labor and Delivery provides lactation consultant support to new mothers while in the hospital and after returning home. For more information, call 573.815.6290.