Night Time Feedings

New mothers usually want to know if they should wake their baby for night time feedings. The answer is dependent upon several things. First of all, if your baby is under two weeks of age, you will want to remove milk from your breasts every two to three hours. This will assist in establishing a good milk supply and keep you comfortable. Most full-term babies wake to feed at this frequency anyway, so it works out well for both. Babies who were born a little earlier than expected, may need to be aroused for their feedings in order to gain weight. A two- to three-hour interval works well. Once your baby is nursing effectively, stooling and voiding within normal limits, and gaining weight, it’s acceptable to allow for longer intervals between feedings, especially at night. So, if your breasts can tolerate a wee bit of fullness, I say go for it, and let baby sleep. Enjoy your ZZZ’s.

Fussing and Crying

Recently, I attended a professional conference addressing gastro-esophageal reflux in infants. I must say that the discussion brought back the passion (and empathy) I feel for the issue of excessive fussing and crying in infants. During the late 1990’s and early 2000’s, I was privileged to work with Dr Anthony Kulczycki of The Washington University School of Medicine, Division of Allergy and Immunology. Together, we explored the role of a certain cow milk protein in the incidence of infantile colic. We studied breast-fed and formula-fed infants alike. I became fairly skilled at assessing and managing excessive fussing and crying in the breast-fed infant.

I bring this topic to the table, because when a breastfeeding baby is ‘colicky,’ the practice of continued breastfeeding is placed at great risk. Most mothers jump to the conclusion that their baby is either hungry or ‘allergic’ to something they are eating. Some mothers discontinue their efforts to breastfeed in favor of formula feeding, which usually doesn’t help. In fact, formula feeding may worsen the symptoms. Other mothers starve themselves in an effort to avoid every food that has ever been implicated in producing gas or fussiness in babies. This usually doesn’t work either.

A baby’s excessive and sustained fussing and crying cannot be taken lightly. This can cause serious upheaval in any household. Breastfeeding may not seem to work. Parents are exhausted. Babies are at risk of being shaken (yes, even the best of parents can snap under these conditions). And, a mother’s gift for nurturing and protecting her baby is crushed by feelings of worthlessness and frustration.

If you have a baby that is fussing and crying to the point of concern, please don’t try to treat this yourself. Get help. Pick up the phone and call us. Here at MoBap, our team of lactation specialists is fully equipped to assist you in a systematic evaluation of the situation. We are genuinely happy to help, and you can always call me on the phone for another opinion! Whatever you do…don’t stop breastfeeding without first seeking help!!!

One-Breast vs Two-Breast Feedings

I am often asked whether one breast or two breasts should be offered per feeding. This is a tricky question, and every mother/infant couplet should be considered individually. However, in the first couple of weeks after birth, a mother’s breasts may be somewhat engorged (normal fullness) as they begin to regulate milk production. Offering both breasts per feeding allows each breast some relief of pressure, and therefore comfort for mother. Later, after the initial couple of weeks, one-breast feedings may serve to balance the intake of fore-milk and hind-milk (a discussion all in its own).

Indicators of Adequate Infant Intake

New mothers often wonder how they can tell if their baby is getting enough milk. Fortunately there are several indicators that can be used to determine the adequacy of baby’s milk intake.

First and foremost is weight gain. Most babies lose some weight in the days following birth. However, once a mother’s transitional milk comes in, her baby should begin to gain. By two weeks of age, she should expect to see a return to birth weight. Breastfed infants typically gain between four and eight ounces per week thereafter.

Stool output and urination is another important means of gauging adequate intake. An infant who is receiving adequate amounts of milk (and therefore enough calories for growth) will stool at least three times in every 24-hour period by the time he is five or so days of age. Often the stool is yellow in color and has a pasty or watery consistency. Tiny white seeds or curds may often be seen. Wet diapers are important as well, but are only an indicator of hydration, not caloric intake. So, while at least five wet diapers in every 24-hour period is expected (and certainly encouraging), stool output is the most reassuring indicator of adequate intake by an infant under six weeks of age.

Your Breasts (and you) Need to Arrive Alive!

Please don’t pump and drive!!! Yes, we’ve all been warned about texting, talking on the phone, applying make-up, etc. while driving. Well, here’s another one for you!

Now that we have hands-free pumping options, it doesn’t mean we shouldn’t use good sense. Sure, those of us who are in a hurry to get to work would have loved to nurse before we left the house. But, unfortunately no one may have told the baby. Or perhaps you slept through the alarm. At any rate, imagine the look on the police officer’s face when you try to explain that the milk was overflowing the bottle and you let go of the wheel to turn off your breast pump. Or worse yet, that you aren’t drunk. Instead, the release of the hormone relaxin made you feel so relaxed and sleepy that you began swerving from lane to lane! Your breasts (and you) need to arrive alive.For your safety and the safety of others on the road, please don’t pump and drive! Pumping really can wait a few minutes until you reach your destination! :-)