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What is normal breastfeeding? We ask our expert and in-house Lactation Consultant, Sioned
"Many mothers are uncertain if they are feeding too much, too frequently or not enough and question their body’s capabilities to meet the ever-changing needs of their babies. The truth is every mother and baby is different, every feeding experience is unique and what might be the norm for one, is not the same for another.
What can help mums is having some idea of what the parameters of normal are and knowing that this is responsive feeding, to their own and their baby’s needs.
For many years the infant feeding industry has evolved around scheduled feeding, volume led with routines and time restrictions. However, nature has a very different agenda. Research from leading lactation researcher Dr Jacqueline Kent from the University of Western Australia outlines the boundaries for normal breastfeeding. Dr Kent’s findings actually confirm that there is no breastfeeding norm.
So what should you expect in the first 6 weeks and then beyond?
First six weeks after the birth of your baby is when you both learn how to breastfeed, your baby has been practicing swallowing and sucking for many months during pregnancy but hasn’t experienced hunger, breathing whilst sucking and swallowing or not being nearby to mum.
From mums’ point of view, the breasts get switched on after birth and it’s a supply and demand hormone regulation that initiates mums’ milk production – moving to milk coming to volume and maintenance of milk volume.
Having too much or too little breast milk is a frequent concern for new mums. In the first few weeks, it is common for mums to produce more milk than their baby needs. On the other hand, if your breasts do not feel ‘full’, this is not usually a sign of low breast milk supply.
Often mothers find that they feel fuller in these early weeks – again this is because many mums have oversupply initially and this settles as the feedback inhibitor of lactation – a fine tuning hormone kicks in and establishes a production recipe that is tailor made for your baby’s needs, depending on their growth spurts, immunological and developmental needs.
Babies are efficient feeders. Sometimes it seems that your baby is not consuming much milk, but their little mouths are more efficient than you might realise. They will take as much as they need as long as it is available. It is important to remember that a mum’s milk supply adjusts to the baby’s needs, not the other way around. Also, for the first few weeks, a baby does not need a lot of milk to fill their stomach, which is rather small.
But is it normal for a new baby to spend so much time nursing? Many of the books refer to efficient feeds of about 10-20 mins per breast and this is worrying for many mums whose babies feed for an hour, or feel that each feed falls into the next. In the early weeks you and your baby are learning how to feed. It is normal to spend a lot of time to get it right and it does need fine tuning, lots of support.
There are some key things that your midwife will monitor to make sure both you and baby are on the right track. Such as:
Nappies – day 2 onwards nappies will be wet and the urine (if nappy not soiled should look like a pale straw colour–yellowish), if it looks dark yellow it may be that your baby is jaundiced, or if it smells strong again it can signal that your baby’s not getting much milk. Your baby’s poo – day 1-3 meconium, followed by a changing stool – greeny –brown, and then when your milk comes in, your baby’s stool will look like yellow mustard, a bit loose. Nappies that show green frothy stools for a period of time need to be mentioned as this can be an indicator that baby is having lots of short feeds and not having much of the fat rich hind milk.
Feeding pattern – if your baby is a little sleepy – feeding every 2 -3 hours is ok, waking your baby up is often advised if they are looking a little jaundiced, the more they feed the quicker they overcome the jaundice as the ‘bilirubin’ is removed with milk moving through the gut and excreted. It is normal to have 12-14 feeds in a day in the first few weeks – cluster feeds in the early evening and every 1-2 hours in the day.
Weight – as your baby adapts to life outside the womb, he now needs to keep himself warm and is responsible for all his body functions so he uses up his stores during delivery and whilst mum’s milk comes to volume. It is normal for babies to lose about 10% of their birthweight and regain by 2 weeks (some babies lose a little more and take longer to regain their birth weight- again this is closely monitored with your midwife).
- Latch – if baby is not latching on well – then you may need to experiment with different feeding positions, a semi reclined, lying down, using a small roll under the breast to lift a full breast, position ‘gymnastics’ – you may need to think outside the box and find what suits you both. The key thing here is if it hurts or doesn’t feel right, try latching on again – seek advice early it may be a tongue tie, inverted nipples, a sore that won’t heal, a missed cleft, all of these need additional interventions to keep your milk production going and to help you and your baby overcome the blip and keep you both nursing.
After the first 3-4 weeks you have established your milk supply, found your feet and you are both well on your way. The below patterns are based upon the established breastfed baby and ranges of normal are varied. You may fit into these – thinking things were not right but then finding it’s ok to be feeding only 4 times a day or 14 times a day – every mum and baby are unique.
The normal range for the amount of milk consumed during a breastfeeding session is 54-234mls. Your breast is never emptied completely in one session, so do not worry that your baby has not had enough to drink.
A baby’s needs define milk production and it takes time to adjust and increase the supply so that you can produce more than what the baby needs to drink. If your baby is nursing constantly and voraciously and you feel like you never get a chance to get up from the rocking chair or do anything else, take heart: as infants get older their feeds tend to become shorter and less frequent, even though they are still getting the same amount of milk. They become more efficient.
What is normal – is a range. Every baby and mum is different and comparing against other mums and babies is not a true reflection. Yes, we can loosely classify when we should be observant and what parameters of growth and development we should expect and in the early months you should expect to have contact with your health visitor, baby clinic and practice nurse for immunisations, weight and general health checks. These are opportunities for a chat and catch up and to find where the breastfeeding support groups are, talk and share your success and concerns. Your questions will be ones that many mums want to ask but are unsure of."
At Medela we are here to help, support and signpost. We have a live drop-in-clinic weekly on Facebook and a monthly Breastfeeding Café on Facebook. You can also contact Lactation Consultant, Sioned, here on the Medela website: www.medela.co.uk