it’s with a professional, your mum, your sister, your partner or a friend who is going through the same thing ... breastfeeding is not without its drama days, and it’s nice to know you’re not the only one.
I remember when ... I first worked in rural Kent getting a desperate call from a mum late one Christmas Eve. She was near to giving up breastfeeding her newborn baby, and there was no way I was going to make her wait for help until after Boxing Day. It was getting dark and I made my way through the snow down the country lanes in my trusty Mini to see her. When I got there I saw straight away that she had a very long baby who was also a very cross baby who needed more breast milk to satisfy his mighty appetite. When I looked in his nappy he had a light green poo that only stained his terry towelling nappy. We both knew he needed more milk. I sat down with his mum and together we calmly revisited latching on and how to calm him; we talked about and tried to find a good feeding position for her, and I told her about the ways you can tell if your baby is getting enough milk. This lovely mum also needed a little TLC herself; she was rushed off her feet and needed to take a little time to eat and drink while I had a cuddle with the baby. I was with them for a couple of hours, and when I got back to my Mini I realised I’d left the headlights on and the battery was flat. Now, the snow was falling heavily and I was miles from home. I walked to the telephone box to call out the local mechanic, trying to work out how I was going to pay the bill. He came out on Christmas Eve and got my little Mini going, and when I asked him how much, he said, ‘No charge, Nurse.’ I learned that day that patience and perseverance are just what mums and newly qualified health visitors need to get them through. I’ll never forget the kindness of that mechanic; he had the true spirit of Christmas.
Is my baby getting enough milk?
I don’t think I have ever met a breastfeeding mother who didn’t have some anxiety about whether her baby was getting enough milk, even when it feels like you are feeding non-stop. I have found there are three signs that tell you if a baby is getting enough milk, which I will talk you through in a moment.
I know it can be hard to believe that all your baby’s food and drink needs can be satisfied by breast milk – but for the first few months they really are. It is supply and demand; the more the baby suckles, the more milk is produced, and this is why your Little One needs to feed so frequently. You’ll notice your appetite increases, too, and you need to eat well and drink lots of extra fluids to make that milk.
The three signs your baby is getting enough breast milk
1st sign: the sound your baby makes when feeding
When a baby is getting mouthfuls of feed and swallowing it sounds like gulping, there will be a glug, glug, glug noise as the milk goes down into their stomach, often with a siss, siss, siss sound as well.
When the baby latches on they will feed for a few minutes and then have a little rest and a breather whilst more milk travels down. After a couple of minutes’ rest, if you gently move your baby they will start up again and have some more. They may do this several times before they have finished on that breast. It’s like they are saying to you, ‘Not finished yet, Mum. A little more, please.’ They will do this four or five times before they allow you to finish on that side, and they will look sleepy – milk drunk, in fact.
If you think about the way you eat, generally we don’t take everything on our plate in one go. Sometimes you feel like a light lunch and other times you fancy a really big dinner, but you like to have a little pause in between your starter and your main course. You’ll find your baby will have different requirements with each feed; just tune in to them and they’ll soon show you the way.
Trust Yourself
Test to See If the Breast Is Empty
Gently use your thumb and forefinger in a pressing-down motion on the nipple to see if there is any milk left.
Feeding from both sides
You’ll want your baby to empty the breast and get the lovely rich hind milk that comes down towards the end of the feed. Babies often know they have had the lot before you do, and start crying for more and getting very cross with the empty breast. You’ll soon learn when the breast is empty, although you may not feel any sensation as strong as you do when the breast feels full. It can be frustrating for your baby if they are sucking on an empty breast. Giving them the other side as well will keep your Little One topped up and give you a little more time in-between feeds, as the baby will be fuller for longer.
Some babies may have both sides at most of their feeds, others only when they are extra hungry like after a long sleep. Sometimes it seems like they can hardly wait five seconds while you switch them over from one breast to the other. If you’ve got a baby that usually just wants to feed, feed, feed with virtually no stopping, change their nappy at the start of the feed; if they are on the sleepy side, changing their nappy at ‘half time’ will wake them up a bit and stimulate their appetite for the other side, ensuring they get plenty of milk and a nice full tummy. Always start the next feed on the side they didn’t have or that you finished on.
2nd sign: understanding how your baby gains weight
A baby’s weight is individual to that baby, and comparing it to another child is not an indicator of how well they are doing – you wouldn’t expect all adults to be the same height and weight. Understanding the weight gain that is right for and unique to your baby can be really helpful and put your mind at rest.
The weight your baby puts on will help you to tell if your baby is getting enough milk. If you’re in the UK, the midwife and then your health visitor will weigh the baby to monitor their growth, and chart it on what is called a percentile chart (usually referred to as ‘centiles’). These graphs are next to the weight pages in your Parent Held Record (The Red Book) and show how your baby is progressing along their own line.
It can be difficult to get your head round what the centiles mean. If you think about 100 babies born on the same day as your baby, they will be charted somewhere on the graph. Let’s say your Little One is on the ninth centile, which means 91 babies would weigh more and eight babies less than your baby. If your baby was born on the 50th centile, half of the 100 will weigh more and half less. It doesn’t matter where on the chart your baby starts; it’s the progress they make along their own line that matters, not what anyone else’s baby weighs. What you want to see is your baby progressing along their line or moving above it. If your baby started to drop significantly below their own centile line, you would want to get them checked and discuss why that may be happening.
Babies seem to have an inner clock that regulates how much they need to feed. Sometimes they feed very frequently and other times they can go longer and seem to be less frantic. It is amazing, but more often than not a baby follows their centile line perfectly (though if they are poorly they might deviate from their usual rate of growth until they get better). It is always good to see their progress and to act on anything that is not expected.
Your health visitor should monitor their progress with you, so keep an eye on it but don’t worry about small fluctuations. If you do have any concerns about weight gain, seek help from your health visitor or doctor. Get your baby’s weight checked at clinic every two weeks until you are happy with their weight gain, and then go every three to four weeks just to get it checked if you want to.
The minimum weight you would expect a breastfed baby to gain in a week would be 3–4 oz/90–120 g. Your baby may gain a lot more than this, and some babies put on 8 oz/250 g in just over a week. This is just a very rough guide, and if your baby is feeding well and having lots of wet and dirty nappies, and is content as well as looking well and active, they will be putting on the weight they need in nearly all cases.
So many women have told me they feel under pressure when their baby is losing weight in the first week. This is often due to the passing of meconium stools (the blackish first stools the baby passes after birth) and because your baby has not started to gain weight yet. If your Little One is on the large side you may find it will take them longer to regain their birth weight.
Most babies will lose some weight because they suddenly have to work very hard to get their grub; when they were a foetus, life