AAP PARENTING CORNER Q & A: BREASTFEEDING: GETTING ENOUGH MILK

Your baby should have several wet or dirty diapers each day for the first few days after delivery. Beginning around the time that your milk comes in, the wet diapers should increase to 6 or more per day. At the same time, stools should start turning green, then yellow. There should be 3 or more stools per 24 hours. Typically, once breastfeeding is going well, breastfed babies have a yellow stool during or after each feeding. As your baby gets older, stools may occur less often, and after a month, may even skip a number of days. If stools are soft, and your baby is feeding and acting well, this is quite normal.

Your baby's feeding patterns are an important sign that he is feeding enough. A newborn may nurse every 1½ to 3 hours around the clock. If you add up all the feedings over the course of the day, your baby should feed at least 8 to 12 times a day.

When feeding well with good latch-on, the infant will suckle deeply, you will hear some swallowing, and the feeding won't be painful. The baby should appear satisfied and/or sleep until time for the next feeding. If your baby sleeps for stretches of longer than 4 hours in the first 2 weeks, wake him for a feeding. If your baby will not waken enough to eat at least 8 times per day, call your pediatrician.

Your child will be weighed at each doctor's visit. This is one of the best ways to tell how much milk your baby is getting. The AAP recommends that babies be seen for an office visit (or home visit) between 3 to 5 days of age to check on breastfeeding and baby's weight. During the first week, most infants lose several ounces of weight, but they should be back up to their birth weight by the end of the second week. Once your milk supply is established, your baby should gain between ½ and 1 ounce per day during the first 3 months.

Signs of hunger

You will soon get to know your baby's feeding patterns. In addition, babies may want to breastfeed for reasons other than hunger. It's OK for you to offer these "comfort feedings" as another way of meeting your baby's needs.

Nearly all newborns are alert for about 2 hours after delivery and show interest in feeding right away. Let the hospital staff know that you plan to take advantage of this opportunity—it's very important to the breastfeeding process. After 2 hours, many newborns are sleepy and hard to wake for the next day or so.

Watch for the early signs of hunger. This is the time to pick your baby up, gently awaken her, check her diaper, and try to feed her. Your baby starts to let you know when she's hungry by the following early signs or cues:

Small movements as she starts to awaken
Whimpering or lip-smacking
Pulling up arms or legs toward her middle
Stretching or yawning
Waking and looking alert
Putting hands toward her mouth
Making sucking motions
Moving fists to her mouth
Becoming more active
Nuzzling against your breast

Healthcare professionals may order this publication in multi-copy packs.
Parents can find more information on this topic in Caring for Your Baby and Young Child: Birth to Age 5. To order a copy of this book visit the AAP Bookstore.

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The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.