Learn the Basics

Is Breastfeeding Effective?

By March 30, 2014 One Comment

One of the #1 biggest concerns breastfeeding parents have is, “Is my baby getting enough?!” 

So, here is how you know if your baby is getting enough, a.k.a. if breastfeeding is “effective”:

1.Your baby is meeting daily diaper minimums.

2. Your baby is getting enough feedings in 24 hours.

3. Your baby is doing the right thing on the boob.

4. You baby doesn’t lose too much weight in the first four days.

5. You baby returns to birthweight by two weeks of age.

6. Your baby continues to gain about five to seven ounces per week.

Once you get these suckers checked off, you can officially say that breastfeeding is effective.

1. Your baby is meeting daily diaper minimums.

Have you gotten access to the Balanced Breastfeeding Diaper Logs?  These charts give you the minimum diaper expectations on each day of baby’s life.

Want an easy way to remember?

Day one: one of each

Day two: two of each

Day three: three of each

Day four: four wets and three poops

By day five, your baby should be having five wets and three yellow seedy poops (see picture above).

2. Your baby is getting enough feedings in 24 hours.

Your baby needs to eat eight to twelve times per 24 hours.  Technically this is every two to three hours, but I don’t like to say that because then you will ask me questions such as

“Is that every two hours from the beginning of the feeding or the end of the feeding?”

and

“If the baby nurses on one breast and doesn’t want the other breast, but then 20 minutes later wants the other breast, does that count as one feeding or two?”

And I will reply, “You are missing the point.” There is no right answer to these questions.  All that matters is whether you are getting at least eight feedings in per 24 hours?

FYI: Ideally, you are stacking feedings in your favor by encouraging frequent daytime feedings. If you go to bed knowing that you have already had six feedings, then you can increase the odds that your baby won’t need to eat as much at night. Caveat: A newborn baby who is below birth weight may not go longer than four hours without eating. So, in this case, yes, you do wake a sleeping baby!

3. Your baby is doing the right thing on the boob.

When you latch your baby on, it needs to be comfortable.

Once your baby starts to suck, he needs to be doing the right thing to get milk out.

Day one to day three or four: Baby should be actively nibbling at the breast.  Think: “Drinking a triple thick milkshake out of a coffee stirrer.”  Baby needs to give you six or more strong, rapid sucks in a row, pause, and go again.

Day three or four and onward (once your milk is in): You need to see baby actively drinking at the breast.  Think: “Drinking milk out of a wide bore straw.”  With each suck or two, baby pulls enough milk out of the breast to necessitate a swallow.  Listen and feel for swallows. Use breast compressions to find “sweet spots” that keep baby drinking.

A baby is not going to get milk via osmosis by just setting his mouth on the nipple without working for it.

4. Your baby has not lost too much weight in the first four days.

It is normal for a newborn baby to lose 7-9% of his body weight.  We expect this, so don’t freak out.  How do you figure this out?

In this example, a baby was born at 8 pounds, 6 ounces and on day three weighs 7 pounds, 14 ounces.

Convert baby’s birth weight to all ounces by multiplying the pounds by 16 and adding the ounces:

8 pounds, 6 ounces = (8×16)+6= 128+6= 134

Convert baby’s current weight to all ounces by multiplying the pounds by 16 and adding the ounces:

7 pounds, 14 ounces = (7×16)+14= 112+14= 126

Subtract current weight by birth weight to get the difference in weight:  134-126= 8

Divide difference in weight by birth weight in ounces: .059

Multiply by 100 to get the percentage of weight loss:  5.97% or 6%

A great way to avoid letting your baby lose too much weight is by hand expressing into a teaspoon after every breastfeeding session and topping baby off with that milk.

But what should you do if your baby loses 10% or more of his birth weight?

5. You baby returns to birth weight by two weeks of age.

Once baby hits “bottom,” or the lowest weight he will reach, he then needs to turn the corner and regain. This tends to occur right around when your milk comes in (around 72 hours).

If your milk doesn’t come in at 72 hours, there is a higher chance that baby will lose too much weight.

Ideally, he is back to birth weight by two weeks, or is at least trending in the right direction.

Expect your newborn to four-month-old to gain about five to seven ounces per week.

Here are some factors that don’t determine if baby is getting enough:

Number of minutes on the boob

Whether he is nursing on one boob or two

Whether or not you “feel let down”

Whether or not you can pump a lot after breastfeeding

Whether or not you can pump very little after breastfeeding

Whether or not your baby spits up

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