Is baby drinking enough?

Graham

Graham

Registered User
My wife has been breastfeeding our 2-week old son since birth. However, he has a tendency to fall asleep on the breast. We are lucky if we can get him to do two 15-20 minute long feeds per day. All his other 8-9 feeds are in the region of 5-10 minutes only before he falls asleep. Stroking his cheek or winding him doesn't seem to help much with waking him up. Is this something to be worried about?

Weight gain does not seem to be a problem so far. When he was born on 11th June he was 7.62lbs, After about 5 days when he was next weighed he had dropped slightly, down to 7.39lbs, but after 10 days (the last time he was weighed), he was up to 8.22lbs.

He's urinating 5-6 times per day and making poo 3-4 times daily, orange color, which from what I understand is the correct color.

He's quite active during the daytime and especially the last few days has had long wakeful periods of serveral hours at a time. It's just when he gets on the breast he likes to sleep rather than suck (I guess it's so comfortable there).

Initially, my wife's milk supply was a little low, but it seems to be much better now and she's actually leeking a lot. And the nurses at the baby clinic say little Jeffrey latches on very well, so we are not worried about that. We did supplement with 2 bottles of formula a day when my wife first came back from hospital, but we stopped that about a week ago.

I guess what I'm asking is are these short feeds something to be concerned about? I'm worried baby is not getting enough hindmilk.

Graham
 
Obviously keep consulting with your doctor when he gets weighed, but I don't think it sounds like anything to worry about. It's perfectly normal that newborns fall asleep when breastfeeding, because of the hormones in breastmilk, which are quite intoxicating! This gets less strong as the baby gets older. In the meantime, you could try feeding your baby a few minutes after he wakes up, instead of when he's tired.

From what I've read, foremilk/hindmilk concerns were all the rage a few years ago, but latest studies suggest it is not a big deal - the breasts will produce more hindmilk later in the day regardless of your baby's feeding style. If it is something to be concerned about, it is later on, if your baby is not gaining weight or is lactose intolerant. At your baby's age, the most important thing is to get breastfeeding well established, and believe mother's milk is the perfect food for your baby.
 
Dear Graham,

It sounds as though your wife and baby are both doing well and so there is no need to change your son?s diet by adding water.

There are five points that are important to know in order to know whether or not a baby is getting enough milk.

? Your baby may have only one or two wet diapers during the first day or two after birth. Beginning about the third day or fourth day, your baby will have at least six to eight really wet cloth diapers (five to six disposables).

? Your baby will pass meconium, the greenish-black, tarry first stool, over the first day or two. Baby will begin having at least two to five movements a day beginning about the third day after birth.

? Your baby may lose up to seven percent of his/her birth weight during the first three or four days. Once the milk supply becomes more plentiful on the third or fourth day, except your baby to begin gaining at least four to eight ounces (113 to 227 grams) per week or at least a pound (454 grams) a month. Be sure to count weight gain from the lowest weight (his weight on the third or fourth day), not from birth weight.

? Your baby will nurse frequently, often every one and one-half to three hours, averaging about eight to fourteen times a day.

? Your baby will appear healthy, his colour will be good, his skin will be firm, he will be filling out and growing in length and head circumference, and he will be alert and active.

From the baby?s health point of view a lot of small feeds are actually better than a few larger feeds. The most important thing is that the milk is being transferred from the mother to the baby. This is clearly the case with your baby son because he is having lots of wet and dirt diapers and is graining weight well.

As your son is gaining weight so well I can assure you that he is receiving lots of milk with a high fat content (hind milk). It is really a very rare problem for there to be an imbalance in the fore/hind milk. And as JennyB pointed out it is the intake over the whole day that is important not the individual feeds.

Best wishes,
SARAH HUNG
International Board Certified Lactation Consultant
 
Graham,

If your wife is leeking you can start pumping and building a stash of milk in the freezer. Very useful for later.

Rani
 
Thanks everybody for all your comments, they have made both my wife and I feel more reassured.

Anyway, Jeffrey was weighed again today, his 15th day since being born and he continues to put on weight at what I have been told is a normal rate. He's now 8.57lbs, up nearly half a pound since the last time he was weighed 5 days ago.

I guess I've just got first time parent's nerves and as he's eating, peeing and pooing regularly and gaining weight, I should quit worrying so much.

The only thing that has shaken my wife's confidence a bit is that she tried expressing her breast milk today, using an NUK electric pump (just to get some practice at expressing), but was only able to express less than 1 ounce in 15 minutes, and then gave up as it made her nipples sore. We had the same thing happen when we tested the pump for the first time about a week ago. Is it normal to get so little milk?

It seems expressing is really difficult and we have no idea how we are going to be able to stock up enough breast milk for when my wife goes back to work. Are we doing something wrong?

Graham
 
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Graham,

Some days pumping isn't easy. Have you tried pumping while nursing? Used to work for me.

Also don't forget to drink lots of water during the day.

Rani
 
Dear Graham,

The first and most important thing to remember about expressing milk is that the amount you get out is NOT an indication of the amount you have.

When you breastfeed there are many elements working together to help the milk flow. The first is the hormone levels. For example the levels of Oxytocin are much higher when you directly breastfeed than when you are expressing milk either manually or with a pump.

Also the baby uses both the negative suction that the pump uses and the milking action with its mouth that hand expressing uses. But because the baby uses both these at the same time it is much more efficient at extracting milk than either pumping or hand expressing.

The baby is also able to change the way it sucks to either stimulate the breast or to draw the breast from the breast. Pumps usually only have one mode of working, the drawing the milk from the breast. Often when mothers aren?t getting much milk it is not because the milk isn?t there but because the let-down has not been stimulated and so the milk is difficult to get out.

It is important to find ways to encourage the milk to let-down. Many mothers find it helpful to hand express until the let-down happens and then use the pump to collect the milk. Others find it helps to have pictures of the baby to look at while expressing. A number of mothers have told me that nipple stimulation before trying to express really helped.

It is very usually to only get a small amount when you first start to express milk ? one ounce is already quite a lot. As your wife becomes more familiar with pumping she will get more.

Also remember that it is much easier to express milk instead of feeding the baby than to express milk as well as feeding the baby. So often mothers find that building up a stock to have for the return to work is harder than expressing at work.

Having said that expressing milk and pumping is very effected by your stress and confidence levels. It is much more affected than breastfeeding is. (I think this is because of the hormones but don?t actually have any proof of this.). For example if something happens to upset you at work the result can often be seen in a drop in the amount of milk you can collect. This doesn?t mean that your supply has dropped just that you are finding it harder to get the milk out. Likewise one mother told me that she?d never collected so much milk as the day she was promoted.

Please make sure that you are using the pump correctly. It shouldn?t cause sore nipples. Sometimes the flange is either too big or too small and often the suction is turned up too high.

I would also recommend that your wife contact La Leche League. This is a mother-to-mother support group which holds monthly meetings in Central. It can be a great source of support to talk to other mothers going through the same stages as you are. LLL Leaders are experienced breastfeeding mothers who volunteer their time and are trained to provide support and up-to-date information.

Their next meeting is 13th July 2004 in Central,
http://forum.geobaby.com/calendar.php?action=getinfo&eventid=557
and their web-site is
http://www.lalecheleague.org/HongKong.html

Best wishes,
Sarah Hung IBCLC
 
Graham

All I can say to you and your wife is don't panic - when I started to pump in preparation to go back to work I didn't even manage to get 1oz and was horrified. By the time I went back I had a freezer full of milk and managed for another 6 months to get about 18ozs a day so practice does make perfect!

Amongst the very good advice Sarah has given is the comment about finding what gets your wife to 'let down' - some people swear that looking a picture of their baby works with me it was completely switching off and reading a book as I pumped (especially at work as I couldn't pump when stressed!).

Your wife might want to go along to a La Leche meeting to get the support from qualified leaders and other mum's in the same boat - it really is reassuring to know that you are not alone in this.
 
Hi Graham,

I had the same experience as your wife, that I got very little from the pump at first. I found this improved as my baby (now 7 months old) got older because although with time the breasts get less full, they gradually produce more milk in accordance with your baby's needs.

Also, like somebody else has commented, I find I can get MUCH more milk if I pump when feeding from the other side. It can be tricky to get the positioning right if you have a fidgety baby (mine tries to kick the pump) or if he/she keeps bobbing off the breast, but I can get up to 150ml in 10 minutes when I'm very full first thing in the morning, whereas the best I have done at any other time is 90ml in 30 minutes. If you want to build up a stock in advance, your wife could try this whenever her breasts are full. But don't panic too much about filling the freezer now. I have a friend whose freezer defrosted and she lost gallons! It will get easier as the baby gets older.
 
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