How do I know my baby is getting enough milk?

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You will be learning together. Breastfeeding is a skill that can be learned, so take that time in the early days to relax and focus on getting to know your new baby. Your job is solely to cuddle and feed him, everyone around you needs to care for you! So snuggle up in bed, snooze, smell the top of his gorgeous head, cuddle, study his adorable face and tiny little finger nails. Savour every moment. Follow your instincts, you are his mam you will know if he is getting enough milk. Granted, you will be flooded with hormones and perhaps haven’t slept for a while so here are some basics to get you off to a great start! 

How does your baby appear? A baby who is getting enough milk will be alert and active during wakeful times. He will appear bright and healthy. He will have a good colour (not too jaundiced or pale) and have moist lips. He will be gradually growing in length and head circumference, your PHN & GP with keep track of this.

How often should my baby feed? A new born tummy is tiny, only the size of a marble. A full feed is 5-7mls (a tea spoon) this gradually increases to the size of a hens egg by one month old, about 80-150mls. Because they can only take in these tiny amounts, they need to feed often. Most new babies feed 10-12 times in 24 hours, some feed more! Follow your baby’s feeding cues. Don’t watch the clock thinking “It has only been an hour, he can’t be hungry again!” Those first few days and weeks are all about learning. Your baby has never breastfed before so he needs to find his rhythm (along with learning to breathe, smell, taste, see and process his new world) Offer encouragement and support as you both learn this new skill together!

How long should feeds last? A feed can last from 5-30 minutes on one side, once you can audibly hear your baby swallowing – he is still extracting milk from that breast. So leave him to work away! Once the rhythm slows to about one swallow every 7 sucks it is a good idea to switch sides. When he is finished that side you can change his nappy, wind him a little (most breastfed babies don’t suffer from much wind) and then offer the second breast. He may not be interested, take a small feed or sometimes feed on that side for 30 minutes again! Trust that your baby knows what he is doing. Relax and enjoy those new baby snuggles. 

What goes in must come out! If your baby is having lots of wet and dirty nappies then there must be milk going in to create it. You are looking for about 5 or 6 wet nappies per day and one dirty per day of life (ie one dirty on day one, two dirty nappies on day two and so on up to day 4) Your baby’s poo should change from the black sticky meconium to a greenish colour and then mustard colour by around day 5. Some breastfed babies have a poo after every feed!

Weight gain. Many new parents can become obsessed with their baby’s weight. Don’t worry too much about it, however it can be a good guide as to how your baby is doing. Weight loss of 5-10% is normal after birth. This can be higher if you had a lot of IV fluids during your labour and birth. You would be looking for your baby to regain his birth weight by about 2-3 weeks old. A rough guide is for your baby to gain about 5-7oz (or 150-220 grams) per week. Remember weight is just one part of the picture, it is not the sole focus. 

Remember breastfeeding can be tender for some in the early days but it should NEVER hurt. If nursing your baby is painful there is something wrong. Remember it is a skill that can be learned together so seek support. Ask your nurse to assist you, reach out to supports around you (listed below) or of course, have a Postpartum Doula by your side!

Doula Jen x

Jen Crawford

Co Owner & Founder of DoulaCare Ireland 

Further reading & helpful resources: 

http://kellymom.com/hot-topics/newborn-nursing/ Tips for the early days breastfeeding your baby. 

http://www.breastfeedinginc.ca/content.php?pagename=vid-reallygood Great video clip from Dr Jack Newman & IBCLC Edith Kernerman page ‘Breastfeeding Inc’. This clip shows what a good latch & drinking looking like. 

https://www.breastfeeding.ie/First-few-weeks/Guidelines-for-mothers/ Great chart with guidelines for first few weeks. 

Breastfeeding Supports:

Association of Lactation Consultants Ireland http://www.alcireland.ie/find-a-consultant/ 

Cuidiu, Irish Childbirth Trust http://www.cuidiu-ict.ie/supports_breastfeeding_counsellors

Le Leche League Ireland https://www.lalecheleagueireland.com/groups/

Friends of Breastfeeding http://www.friendsofbreastfeeding.ie/wp/support-2/

National HSE Breastfeeding support https://www.breastfeeding.ie/ 

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Power Pumping

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Increasing Breast Milk Supply-Power Pumping

If you are exclusively expressing for your baby, for any reason it is important to replicate normal infant growth spurts. Baby’s who feed at the breast will naturally increase their feeds when they are due a developmental leap or growth spurt. However, a pump cannot recognise these millstones, so you will need to mimic your baby. This triggers an increased release of prolactin from the pituitary gland – the ‘make more milk!’ message.

Because breasts work on the principle of supply and demand, using a breast pump is often recommended once your milk has come in (around day 2 or 3 after birth). Before this it is best to use hand expression, as colostrum is made is small quantities and is thicker – thus harder to bring out with the manual pump. Regular pumping delivers to the brain a ‘make more milk!’ message and can be very effective in increasing supply. However despite regular pumping sessions many women do not see results as quickly or as effectively as they had hoped. Enter power pumping!

How do I power pump?

Firstly it is important to set yourself up with the right equipment. Ensure you are using a hospital grade, double breast pump. Most Irish hospitals use the Medela Symphony. Ask a member of staff to check that the flange (bit that goes over your nipple) is the correct fit. The standard size is 24 but many Irish women will need the 27. Get into a comfortable position, with your bottle of water, a snack and items from your baby (like photos, or something that smells of them)

Power pumping is not a replacement for regular breast pumping to increase supply. Instead, power pumping is intended to boost your progress by replacing one regular pumping session with a strategically designed alternative. It works by repeatedly emptying the breast, signalling the body to make more milk, more quickly. This is mimicking a baby’s ‘cluster feeding’, many do this in the evening time.

To power pump, pick one hour each day or night (eg. 8pm every night) and use the following pumping pattern:

Always begin with a good breast massage. Some coconut oil can help to minimise friction.

1. Pump for 20 minutes; then rest 10 minutes, massaging again.

2. Pump for another 10 minutes; rest for 10 minutes, massaging again.

3. Pump again for 10 minutes; finish.

This means you will have 40 minutes of active pumping in a 60 minute period. During the rest phase, massage your breast, look at photographs of your baby, smell an item that has been with your baby and relax.

You can watch a movie or read a book if it helps you to relax, do not focus on the pump and how much milk is coming out. This is not the aim. You are trying to trigger your body to make more milk tomorrow. You are not aiming for increased milk volume today. Try to view it as an hour each evening for you to put your feet up, have a nice treat and cup of tea and maybe watch a TV show. 

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