Recently I had a virtual consultation with a woman who lives in New York. She is currently in one of the worst “hot spots” of COVID-19 in the USA and has just given birth to a baby a couple of week ago. She has been self-isolating for the past 3 weeks with her husband, two year old and now newborn daughter. When she had her weighed at 3 days old, the doctor told her that she was not able to bring her baby back in until one month’s time, unless it was a serious emergency. These are very scary times for new mothers, especially if you are concerned with your baby’s breastmilk intake, weight gain or latching challenges. However I have some good news for you! Even if you never had access to a scale or never saw another person while raising your baby, there are many ways to assess their wellbeing. This includes trusting your own instincts and following the lead of your baby. They will let you know if things are working for them…or not. Here is a checklist for you go through on how to know your baby (and breastfeeding in general) is going OK…
Baby’s level of contentedness
Is your baby content and happy MOST of the time? When someone tells me their baby is upset or that they are “colicky”, I always ask them, “What percentage of the day are they unsettled?” The answer to this questions tells me a lot. If your baby is unsettled and unhappy most of the time, then that is not normal and is a red flag that there’s something going on. However, if your baby is generally pretty happy and only has occasional periods of time where they are unsettled or unhappy, then that’s really normal.
Wondering if the cluster feeding (very frequent feeding) is an indication that your baby is unsettled in a NOT normal way? Read my article, “Cluster Feeding. When is it normal? When is it not?”
Does your baby have at least 5-6 pretty heavy, wet nappies every 24 hour period? If your baby has at least 5 heavy, wet nappies then that’s great! That is an indication they are getting enough and staying hydrated. HOWEVER if your baby is peeing enough but not pooping (and is under the age of 6 weeks) then this can be an indication that they are getting enough to stay hydrated, but not necessarily getting enough to grow and gain as expected.
Does your baby have at least 2-3 poops every 24 hour period? Once your milk comes in (usually around day 2-3 following the birth), your baby should be pooping regularly. If they are pooping less than 2 times per day or skipping days, it’s important to contact an IBCLC so they can look at the whole picture and all factors, to assess whether or not there is reason for concern. Once your baby reaches around 6 weeks old, you might find that they start to poop less frequently and this can be totally normal.
If you have questions about your baby’s poop; the frequency OR how it looks, click here to read my article on this topic: “A Guide To Breastfed Baby’s poop!”
Do your breasts feels softer and “well drained” following a breastfeed? If you feed your baby and your breasts still feel really full and engorged, it can be a sign that your baby is not efficiently and effectively draining your breasts. This can be because of how they are latching on. Sometimes a baby with a shallow latch (where they keep your nipple more towards the front of their mouth rather than the back of their palate), will really struggle to remove the milk. This can lead to engorgement and mastitis, low milk supply and slow weight gain (or weight loss) in your baby.
Does your baby have periods of times where they sleep happily and seem content? There are a few things about baby’s sleep that’s 100% normal:
*Your baby only naps for about 30-40 minutes before they want another breastfeed and will then either fall back to sleep or be awake and happy.
*Your baby will only nap if they are being held by you.
*Your baby will only fall asleep by either breastfeeding or being held/rocked to sleep.
However, if your baby does not have periods of time where they are asleep or settled, then this can be an indication that something is not quite right. The underlying issue could be caused by a variety of different things including; food allergy or intolerance, not getting enough milk, reflux or “colic”, or a problem with how they are feeding such as a tongue tie.
Do you have any pain or discomfort on your nipples during or between breastfeeds? Pain or discomfort is NOT NORMAL. There can be many different causes of pain which includes; tongue tie, thrush, mastitis, vasospasms…the list goes on! It’s extremely important to seek help from an International Board Certified Lactation Consultant (IBCLC) to help you get to the underlying issue of why your baby is causing you pain. In most cases it’s just a matter of working on attachment and positioning. However if that is not helping then there is a reason! You do not just have to “push through” the pain and wait for the “early days” to pass. Get help sooner rather than later.