Fox Chase Pediatrics is updating its parenting information sheets. Below is the first in a series of updates.
The American Academy of Pediatrics recommends exclusive breastfeeding for the first 4-6 months of life. Breast milk is rich in maternal antibodies and disease fighting cells that help protect the baby from infection. Continued breastfeeding acts as an extension of the mother’s immune system; viruses and bacteria in the baby’s environment get recognized by the mother’s immune system and it responds by making protective antibodies that transfer over to shield the baby. Additional benefits of breastfeeding include a lower risk of allergies and a reduced risk of obesity, diabetes and certain cancers. Breastfeeding is not an “all or nothing” decision and even if you need to supplement with formula, continuing breastfeeding, even partially, still has benefits.
Breastfeeding works as a supply and demand process. The more milk is “demanded” and emptied from the breasts, the more milk the body will produce. In other words, you have to move milk out to make milk. That is why it is so important to nurse your baby often in the first weeks. This is when the milk supply gets established and the baby learns to breastfeed effectively.
In order for breastfeeding to be effective, the baby must have a good latch-on and positioning. Your baby’s head and body should be in a straight line and their tummy should touch yours; your baby should not have to turn his head to latch. Pull your baby close to you, supporting his back, while his mouth is wide open. The goal is to get enough of the breast into the mouth so that the nipple is drawn to the back of the baby’s mouth, and his gums and tongue are compressing the areola, covering about an inch or two of the areola from the base of the nipple. Getting a good, deep latch will help the baby get more milk out and prevent nipple discomfort. Breastfeeding takes practice for both the mom and the baby and will get easier and faster with time, but if you are having any issues, please see a lactation consultant or call us for advice.
While older children benefit from having a schedule, newborns grow and thrive best when fed on demand in response to their hunger cues. Look for signs such your baby bringing her hands close to her mouth, looking around or turning head side to side, opening her mouth or making sucking motions, clenching her hands over her chest and belly or flexing her arms and legs. Crying is a late hunger cue and some babies might need to be calmed in other ways before they are ready to feed even if the cry is from hunger. It is normal for a newborn to nurse 8-12 times in a 24 hour period and to cluster their feeding sessions at some parts of the day or night. For example, your baby might want to cluster-feed, or nurse every hour or so in the evening in preparation for a longer sleep stretch or be more hungry after a long nap. Most newborns are also nocturnal feeders and to help reverse this pattern, feed more frequently during the day. While you are feeding on demand, avoid allowing your newborn to go more than 3 hours without eating during the day, waking her up if needed. Also, until we are sure that your baby’s weight gain is good, avoid having your baby go more than 4 hours without a feeding at night.
How will you know that a breastfed baby is getting enough? During a feeding, listen for active swallowing that sounds like gulps. As the baby becomes full, his body will become more relaxed, the arms might move down away from the face or breast and the clenched hands open. Some babies will have a happy, satisfied “milk-drunk” look on their face as they are dozing off to sleep. Your newborn might also unlatch on her own. This is a good time to burp, and try to offer a little more, as most babies are still hungry for a few more sips. Some babies get sleepy easily and will need to be woken up several times before they finish a feed. As you get to know your new baby, you will find what works best for him or her.
Pay attention to your baby’s diapers, since that tells us a lot if she is getting enough milk. By the time the baby is 5 days old, she should have at least 6 wet diapers and a few stools each day. By two months of age, some breastfed babies will have fewer stools as they become more efficient at digesting milk. Another way to evaluate if your baby is getting enough is to see how he is growing. Most newborns lose weight in the first few days of life but should be back at their birth weight by 10-14 days of life. After that, they should gain about 2/3 to an ounce per day until 4 months of age, when the weight gain slows down. If we are concerned about your baby’s weight, we’ll have you come in for a weight check. Also, you can ask for a weight check any time you are concerned about your baby’s feeding and feel free to call with any questions.
Breastfeeding Resource Center – Abington Office (1355 Old York Rd, Suite 101, Abington, PA 19001 or 215-886-2433) breastfeedingresourcecenter.org
Healthychildren.org – a website from the American Academy of Pediatrics, type in “breastfeeding” in the search bar www.healthychildren.org
La Leche League of Montgomery County East – has information about breastfeeding support groups www.lllofeasternpa.org/web/MontgomeryEastPA.html
KellyMom Parenting/Breastfeeding – evidence-based information on breastfeeding and parenting written by a lactation consultant who is also a mother of three. https://kellymom.com