‘IS YOUR BABY FEEDING AGAIN?’

If you a breastfeeding mother you have probably had this said to you at least once. Whether it was your partner, a family member, a friend or a complete stranger the words can cast doubt upon your breastfeeding relationship and have you reaching for a bottle worrying that you are starving your baby or that breastfeeding is failing. So is it normal for a breastfeeding baby to feed a lot and how can you tell if your baby is getting enough breastmilk?*

After birth and in the early days you will be producing colostrum, which is like liquid gold and perfect for everything your baby needs. This magical liquid is low in fat, and high in carbohydrates, protein, and antibodies to help keep your baby healthy, it also has large amounts of living cells which will protect your baby. One of these is an antibody called secretory immunoglobulin A. IgA protects your baby’s mucous membranes such as the throat, lungs, and especially the intestines. Colostrum also contains leukocytes, these protective white cells can destroy and protect your newborn from bacteria and viruses.

Colostrum is also easy to digest for your newborn and has a laxative effect on your baby, helping pass early stools, which aids in the excretion of excess bilirubin and so helps prevent jaundice. Colostrum has an especially important role to play in the baby’s gastrointestinal tract. A newborn’s intestines are very porous. Colostrum seals these tiny holes by coating the gastrointestinal tract which helps prevent foreign infection causing substances from entering these holes and also helps sets up the right bacteria for good flora to grow. Precious liquid indeed!

Colostrum is low in volume but richly packed with nutrients which suits your newborn perfectly. When your baby is born tummy size is around 5-7 ml think a teaspoon. By day by three when milk starts to transition its now around 22-27 ml the size of a walnut, and at day five your newborns tummy is still only around 45-60 ml or the size of an apricot. Small indeed!

So doesn’t it make sense that your newborn with its tiny tummy will want to feed regularly? Of course, feeding often in the early days is normal and a good sign. As we have already said your milk is easily digested and so passes through your baby with easy having very little wastage, stools progressing from black to green to yellow in the first few days. 

Feeding often also has a beneficial effect on your milk supply. Lets meet ‘FIL’. Breastmilk contains a small protein called ‘Feedback Inhibitor of Lactation’ (FIL). FIL appears to slow milk production when the breast is full. Thus milk production slows when a breast is full of milk (and more FIL is present), and speeds up when the breast is emptier (and less FIL is present). So the more your baby feeds the more your breasts will produce milk!  So your baby feeding often is ensuring a good milk supply, isn’t nature clever.

Also think about how we eat as adults. Sometimes we have a sandwich, sometimes a cup of tea, sometimes we want a three course meal and yes sometimes we want chocolate cake too. Why would it be any different for our babies? If you look at your day do you go exactly 3 hours before you have a drink or a snack or lunch? Of course not so why do we expect our babies to? Im sure if you counted up all your meals, drinks and snacks for a day you maybe surprised how much you actually consume.

Babies often clusterfeed too. What is clusterfeeding? This when you find that feeding all cluster together especially at certain times of the day usually the evening. This a classic time where moms feel that they do not have enough milk and well meaning comments such as above are often said. However nature is clever, clusterfeeding means supply is kept high, (remember FIL) it also means that baby is learning and perfecting the skills needed for breastfeeding. Clusterfeeding also means baby is topping up her level of cholecystokinin (CCK). What is (CCK)? It’s a hormone that makes your baby sleepy. As the levels of CCK rise your baby will feel sleepy and full, as the levels fall it will wake your baby and she will want to feed again. Nature is amazing, CCK allows your baby to not work too hard at the breast, allows a chance to ‘top up’ as needed, allows a new baby to learn nursing skills and to increase and maintain your milk supply. Your baby will also clusterfeed during growth spurts thus increasing your supply to meet your babies needs. Again this can be a time many mom’s may doubt their milk supply because baby is suddenly feeding more often and feel that supplementation is needed.

What happens if we restrict feeds, use dummies or try to have a feeding routine? Restricting feeds will only make your baby kranky, (how do you feel when a meeting goes over lunch time?). By the time your baby is crying they are truly distressed and feeding will be more difficult. Also remember milk production slows down when your breasts are full so leaving a long time between feeds will mean a lower supply. Breastmilk as we said earlier digests really quickly, how do you feel when your over hungry? Again this applies to having a routine for feeding, do you eat on routine? Of course not you eat to appetite, just as it should be. A breastfeed baby will have at least eight feeds in 24 hours but most will feed for more.

What about dummies? Well firstly your baby is learning how to perfect the actions of latching and sucking at the breast. The sucking of a dummy is different to how they will suck when breastfeeding and this can be confusing to some babies making latching difficult. Also sucking on a dummy will release the hormone CCK and so yes make baby feel full and so fall asleep, however this may mean baby misses a very much needed meal and again your FIL will slow down your milk production.

Responsive means responding to your babies feeding cues

So, how can you tell if your baby is feeding well?*

Firstly, does breastfeeding hurt? If your nipples are sore, cracked and damaged then chances are your baby isn’t latched well and most likely nipple feeding thus struggling to access a feed well. Your baby may then be feeding all the time, or fall asleep at the breast worn out because she’s struggling to access milk. It’s important that your baby is latching well so if you have sore nipples then seek help from your midwife, health visitor, breastfeeding peer support worker or lactation consultant.

What are your babies nappies like?

• The first 24 hours you can expect one wet and one dirty.
• By day 3 you should see three wet and two dirty,and the stools should be changing in colour.
• By day 6 your baby should be having at least six wet and two dirty nappies in 24 hours, this will continue for the next few weeks till around a month when dirty nappies may slow down.

If your baby is having less than six wet nappies or two dirty nappies you should again seek advice from a health care professional.

Another sign is weight gain. It is common for babies to lose weight after birth but your baby shouldn’t lose more than 10% and be back to birth weight around the two week mark. Your baby then should show steady weight gain. It’s important to look at the whole baby and other signs that feeding is going well such as plenty of wet and dirty nappies. Of course all babies will be their own shape and size and some babies are lean others not so.

Other signs of feeding going well are, when latched to the breast, full round cheeks, open wide mouth with a good mouthful of breast, lips turned out, nose free of breast and chin making contact with the breast. Look for fast sucking, then rhythmic sucks with pauses, then even slower sucks until your baby comes off the breast. Your baby may want to have a little break before going back for a bit more, just like you may have a little break before your big piece of chocolate cake.

Is your baby feeding again? Yes? It’s ok, let your baby lead the way. Responsive feeding is the best way to feed your baby. Responsive means responding to your babies feeding cues and needs, but also means listening to your body and if your breasts are feeling full then it’s telling you to feed your baby. Don’t clock watch, but listen to your baby, trust your body and follow your instincts. Plus what better excuse is there for sitting on the sofa with a cup of tea, a few chocolate biscuits and your favourite film than to feed your beautiful baby.

http://www.nhs.uk/start4life/Documents/PDFs/Start4Life_Off_To_The_Best_Start_leaflet.pdf

*Please note this applies to full term, healthy babies. Premature babies or babies compromised by illness would need advice from your healthcare professional.