Breastfed babies have variable feeding routines.
Babies may have 8 or more feeds in 24 hours - this does not mean that the mother doesn’t have enough milk. Mothers vary with the volume of milk they can store at any given time in their breasts which influences how many feeds a baby needs in 24 hours. This is considered normal breastfeeding, and you should always remember, mothers differ enormously.
Babies will have some short feeds and some long feeds which are normal. Sometimes the baby will take milk from one breast and as baby grows they will use both breasts. Mothers have more available milk in their breasts in the morning and less in the afternoon. This may cause babies to cluster feed at the end of the day, however, this doesn’t mean that the mother doesn’t have enough milk.
Babies get all of their water from the first part of the breastfeed which means they sometimes have a short feed to get a drink of water. Therefore the amount of water in a feed changes depending on how hot the day and the breast will add more water during warmer months.
Normal Breastfeeding should not be painful
It may be normal for nipples to be tender in the first few days but not painful. So use expressed milk on the nipple and areola after a feed first. Furthermore, pure anhydrous lanolin may help.
Discourage, any other creams as this will mask the natural scent of the mother which the baby finds pleasant.
If breastfeeds are painful during a feed or afterwards then the baby is not latching properly or something else is wrong.
Therefore, being referred to a specialist health professional (Lactation Consultant/ Midwife/Child Health Nurse) may help. Also, the Australian Breastfeeding Association (ABA) may be of assistance with latching/assessment.
NOTE: If a mother finds blood in her milk or sees it in baby’s mouth, it is still ok to continue feeding. The only time it may be advised to stop is if the mother is positive for HIV or Hepatitis C. This information is available from antenatal records.
Output from breastfed babies can vary considerably
Most mothers use disposable nappies and typically change about 6 -7 wet nappies in every 24 hours after the first 3-5 days. The nappies become heavier as the baby takes more milk.
Description:
In the first few weeks breastfed babies pass frequent soft bowel motions often with a yellow mustard curd. This will continue until the baby is about 4 weeks old when the frequency of bowel movements usually decreases to every couple of days. It may also extend to 10-14 days between motions. If the baby is fully breastfed and thriving, then this is normal and when the baby passes a motion it will be soft.
Posseting and refluxing are normal for babies
- A baby will posset because it has taken more milk than the stomach can comfortably hold at one time (babies don’t always have control over how fast the mother's milk lets down).
- Reflux is common in all babies but may become a problem if baby is upset by the regurgitation of stomach contents.
- Sometimes mothers’ diet may make this worse. Therefore, the problem is alleviated by a change of diet – Refer to a Lactation Consultant/Dietician for assessment.
- If baby remains distressed by reflux or it is causing baby not to thrive then a specialist referral (e.g. Paediatrician) for an assessment may be required. Medication will not stop the regurgitation, but it will help with the associated pain.
Complementary feeding may not be necessary for breastfed babies
NOTE: Most mothers can make enough milk to feed their babies
Problems can arise by giving babies additional feeds that they don’t need. Commencing additional feeds frequently leads to a decrease in breast milk supply and cessation of breastfeeding. Assessment and evaluation of breastfeeding and associated factors will enable the health professional to identify possible problems and solutions without the introduction of complementary feeds.
Possible problems:
- Breastfeeding management issues
- Supply issues (mother)
- Functional issues (baby/mother)
- Physiological causes (baby)
Complementary feeding may be necessary, and this would be advised following a full breastfeeding assessment by an appropriate health professional (Lactation Consultant/ Child Health Nurse).
Frequent waking is normal and protective for breastfed babies
It is normal for babies to wake during the night and need to be breastfed and to need the security and attention from parents. Babies initially spend a lot of time in restless sleep; this is when they grow. Also, it has been noted that frequent arousal is a SIDS protection.
Commonly breastfed babies fall asleep at the end of feed, this is normal as cholecystokinin is released at the end of feed which makes both mother and baby sleepy.
It can be normal for babies to feed well and then need a top up 30 minutes or so after a feed and this puts them to sleep.
Finally, babies grow at different rates - You are doing OK with your normal breastfeeding!