Tips for effective breastfeeding and good milk intake in a newborn baby

During the first week of life, healthy babies should nurse when showing signs of hunger, which usually occurs 8 to 12 times in 24 hours. By four weeks after delivery, nursing usually decreases to 7 to 9 times per day. By the 5th day of life, babies with adequate milk intake have at least six to eight wet diapers daily and have three or more pale yellow and seedy bowel movements daily. In the first few days, adequate milk intake can be reassured by seeing that the baby should have at least one wet diaper per day of age and at least one bowel movement per day of age. Newborns typically lose weight in the first three to five days with an average of about 7% weight loss from their birth weight. They typically are back to birth weight by one or two weeks. The mother’s breasts become full with milk during days three to five, and weight loss should not continue. It would be important to meet with a lactation specialist if weight loss has continued after this time period or the baby is at 10% weight loss from birth weight.

Parents should be watching for normal feeding behaviors that are frequent in those first few weeks. Frequent feedings and effective breastfeeding can help to build a good milk supply for the future. Baby should nurse within the first two hours after birth. The best way to promote this first breastfeeding experience is to be skin-to-skin with the baby immediately after the birth and as much as possible those first 24-48 hours. The infant’s frequent nursing sessions are encouraged to be around 10-12 times in 24 hours. Listening for good swallows during feedings shows that the baby is able to remove the milk from the breast. As the milk supply increases in the parent, the newborn will start to swallow after each suck and is a good sign there is more milk! Baby should nurse on each breast until he/she unlatches and is in a relaxed state.

During the first weeks after birth, an important marker of making milk is the timing of Lactogenesis II. This is the transition from making concentrated drops of colostrum to larger amounts (ounces) of breast milk; this transition typically occurs by 72 hours postpartum. There is a small percentage of women who this process does not happen by day three or four. In most cases, it would be important to seek help from a lactation specialist to work to problem solve by working on certain breastfeeding techniques like how the baby is being latched to breast, increasing how much baby is going to the breast or parent is pumping, and making sure the milk is removed from the breast to stimulate milk production.

A reassuring sign of effective breastfeeding is that the mother is not having nipple pain or compressed or crease in nipple after feeding is over. And seeing milk in the baby's mouth or when expressing by hand. If the baby is not able to nurse, is preterm, or inconsistently nurses at breast, then it is important for good milk production to remove milk by hand or a breast pump at least 8-10 times in 24 hours. Some parents become concerned if the baby seems hungrier than the previous feeding pattern and wants to eat more frequently. It may seem like the baby is not getting enough milk, but if your baby is having normal diapers as usual, and baby is gaining weight, then the likely cause of the increased eating pattern is a growth spurt. Parents can expect these growth spurts to occur typically at two to four weeks, six weeks, three months, and six months of age.