Feeding your baby
Paediatrician Dr Sarah Donoghue discusses some important issues:
FEEDING YOUR BABY
Parenthood is such an exciting and exhausting time. Adapting to the challenges that a new baby brings to the family with the lack of sleep, the physical and emotional changes are all factors that new parents have to find ways to cope.
WHAT IS NORMAL FOR BABIES IN TERM OF WEIGHT GAIN AND LOSS?
From birth it is normal for a baby to lose up to 10% of their birthweight in the first three days of life. Any amount greater than that and it suggests that baby isn’t getting enough breast milk. It is normal for babies to regain their birthweight within the first two weeks of life. The average weight gain for babies is 15-30 grams a day and it is normal for babies to gain a couple of hundred grams each week.
WHAT IS NORMAL FOR BREAST FEEDING?
On the first day of baby being born you will start producing milk. This is usually a very small amount of yellowy-creamy liquid called colostrum. Over time and as baby becomes more adept at feeding your milk supply will improve. The more often that baby feeds and the longer that baby feeds the more milk you will produce. It is not uncommon that baby may want to feed 2 hourly initially for about 10-30 minutes.
HOW DO I KNOW IF MY BABY IS GETTING ENOUGH MILK?
You will be able to tell that baby is getting enough milk if you need to regularly change the nappies because they are wet and if they are regularly dirty. It is normal to need to change either 8 cloth nappies or 5 disposable nappies in a 24 hour period. What you should also be seeing is the stool colour change from the initial dark green meconium colour to a paler yellowy brown colour. Babies will give you feeding cues such as opening their mouths and putting their tongue forward and they usually become unsettled if they aren’t getting enough to drink.
If babies are not getting enough milk they will cry or they might become drowsy and suck poorly. You may notice that their skin may be a more yellowed colour called jaundice. If this is happening to you then you need to get assistance with feeding and may need to have supplemental feeding, particularly if your baby is losing weight. If your baby is drowsy and you feel they are not well then you should be seen by a medical practitioner.
WHAT CAN I DO TO INCREASE MY MILK SUPPLY?
- Feed or pump regularly
- Drink a lot of water
- Eat regular nutritious meals
- Try to relax
- Seek help from a lactation consultant if you are experiencing difficulty attaching baby to the breast or having difficulties with breast feeding.
- Medication/supplements can help in some circumstances when you have low breast milk supply. It is also important to make sure that you keep addressing any other feeding issues and look after yourself to help maintain breast milk production.
WHEN MAY MY BABY NEED SUPPLEMENTAL FEEDS?
In most cases of babies needing supplemental feeds this is a temporary situation and mothers are able to breast feed as soon as their breast milk supply increases.
- If you had diabetes in pregnancy and your baby has low blood sugar, usually this problem will resolve within the first few days of life. They may temporarily need more milk because their body has responded by producing more insulin in response to your blood sugar levels.
- If you baby has low blood sugar. Sometimes babies may have experienced situations where their stored sugar reserves have not had time to develop fully such as in prematu rity or low birth weight infants, or they have been depleted more rapidly because baby has been stressed or sick. Other problems in generating enough sugar are rare.
- If you had a caesarean section then it may take slightly longer for your milk to come in. If you have had a large amount of blood loss during delivery then often it also takes longer for your milk to come in.
- Some medical conditions, such as polycystic ovarian syndrome, may interfere with the production of milk.
- Some medications are not recommended when breastfeeding, if you are on medica tion you should check with your GP to see if it is safe.
- Sometimes breast feeding is more technically difficult with inverted nipples or breast implants.
LOOK AFTER YOURSELF
It’s important to try and take care of yourself as much as possible in these early days and seek help when you need it. It is very normal to need help or assistance. Many maternal child health centres have a lactation consultant available who can help you if your baby has difficulties attaching. Sometimes mothers may feel like they have failed if they aren’t able to exclusively breast feed their child. What I would say to that is that everyone has a very different journey and the invention of infant formula has given mothers a safe option to help nourish their infants. Breast milk is a wonderful source of nourishment for your baby if breastfeeding is working for your family. Some people can be evangelical about breast feeding, I’m more pragmatic because I’ve had one of those journeys where I needed some extra assistance and I embraced supplemental feeding because it was necessary.
1. The Australian Breast Feeding Association
This is a non-for-profit organisation that you can join. They have a breast feeding helpline 1800 686 268. They can also direct you to breast feeding classes, tell you where to hire a good hospital grade pump and they have lots of useful information on breastfeeding.
2. Raising children network
This is a good resource for new parents. It has great videos on breast feeding. It also has very good videos on formula feeding as well. There is also reliable information on common problems, such sore nipples, supplemental feeding and feeding positions.
3. Beyond Blue
With so many new changes it is easy to feel overwhelmed. Beyond blue provide resources for both mums and dads to assist with coping with parenthood.
4. Other resources
There are other very important resources for information and support, such as your maternal child health nurse and your GP.