HOW CAN I TELL IF MY BABY IS GETTING ENOUGH?

“Is my baby getting enough milk? ” New mums all over the world are constantly asking this question. Newborn feeding constantly leads to friction between new mothers and their mothers and mothers-in-law in Nigeria.

The anxiety this causes tempts us to introduce water or formula in the first few days of life when our actual goal was to breastfeed exclusively.  

These conflicts stem from:

• Ignorance of individual and general signs of hunger and feeding patterns in newborns
• Lack of knowledge of the normal progression of weight gain/ fluctuations
• Not knowing the signs that a baby is being adequately nourished.
• Poor infant feeding practices or alternatives when challenges arise

What are the general signs of hunger in newborns?

Babies are usually good communicators.

The trouble is we don’t often pay attention or know what to look out for. The following are common signs that your baby is hungry: 

• Baby keeps opening the mouth
• Sticking out the tongue
• Making sucking movements 
• Your little one is constantly bringing their hands up to their mouth
• Moving their limbs as though crawling or cycling in the air
• Turning their head towards the chest or breast of whoever is carrying them
• Crying and being irritable. When they cry, it is a late sign of hunger. Some may get so worked up that they won’t want to latch onto your breast or teat of the bottle! Alternatively, they could latch onto your nipple in their haste and annoyance.

This, I assure you, will bring you exquisite pain while breastfeeding

Are Preemies Different?

When preemies are hungry they could lick their lips, become restless, stick out their tongue or flutter their eyes.

Conversely, when they have had enough they relax, and their color changes if they are light-skinned). Some of them may change the rhythm of their nursing and they may touch the breast.

A satisfied baby is relaxed with inactive limbs. The baby may turn away from your chest, lets go from breast or bottle feeding and fall asleep.

Baby’s tend to cluster feed at times when they are experiencing rapid growth. Cluster feeding is characterized by showing signs of hunger more frequently than usual.

This is often observed by mothers who schedule their baby feeding times at intervals (as opposed to feeding baby on demand). A baby who usually feeds every 3 hours may demand food every 2 hours for a span of 3 days. For breastfeeding mothers, it’s nature’s way of increasing your milk supply. Demanding more milk from you in response to your baby’s next stage of growth is characterized by the need for larger quantities of milk. Growth spurts can be observed at 2 days old, 3 months old, and  6- 9 months old

How much milk does my baby need?

Your newborn’s stomach size is really small at first.

At the first to the third day of life, your baby’s tummy is the size of a cherry or 1 grape and can only hold a teaspoon of milk ie. 5-7 mls per meal. By day three to five, it is the size of a table tennis ball or walnut.

From six days old up to 3 weeks old baby’s stomach is the size of an egg and so on.  Knowing this should restrain you from overfeeding your baby which could cause undue discomfort and distract you from the real cause of why our child may be fussy.

All babies lose no more than 10% of their body weight within the first 5-7 days of life before returning to their birth weight by week 2. Baby’s weight should increase by 50% at 6-8 weeks old and double his/her birth weight at 4-5 months old.

This topic, weight gain, is another source of anxiety and potential conflict with loved ones as far as a first-time mum is concerned. Look out for these variations and verify during your first well-baby visit after childbirth. Make sure you use an appropriate infant weighing scale.

Any deviation from this may then prompt investigation of your baby’s nutrition or breastfeeding practices. The weight and length measurements for your baby should be entered in a chart which usually comes with your immunization card. Each entry is benchmarked against the normal range for baby’s age within our environment which is also indicated on the chart. This forms a more objective view of if your baby is being adequately nourished.

Signs That Your Baby Is Being Adequately Fed

A well-fed baby will :

• Have 4 -6 wet diapers (urine) and 3-4 poopy diapers daily. Note that exclusively breastfed babies can go up to 3 days without passing stool at 3 months old. Also, formula-fed babies can get easily constipated if you fail to follow the instructions for proportions of water to formula while preparing their meal.
• Gain weight in accordance with the normal range for his/her age and race as entered in the growth monitoring chart mentioned above

Is there a need for vitamin supplements in infants? Formula-fed babies do not need multivitamins. However, babies being exclusively breastfed are required to get vitamin D drops. There apparently isn’t enough vitamin D in breast milk and babies and mums don’t get as much sunlight as needed.

What Can I do When Challenges Arise

The bedrock of a breastfed newborn getting enough milk from its mother is ensuring your little one is draining the breast adequately. Next mother has to have an adequate supply.

Your infant will drain your breast if he/she latches on properly ie. your nipple and most of the areola complex are in baby’s mouth with the areola in contact with baby’s hard palate and tongue.

If your breast is constantly being drained by the end of each feeding session, the initial increase in milk production and supply which is governed by demand and supply feedback will be activated.

Some structural challenges such as tongue-tie in the baby or a mismatch between the size of their mouth and your nipple-areola complex can hinder adequate feeding. It is important that these are found early and addressed by a trained health professional or lactation specialist.

As mentioned above, it is important that the exact instructions for preparing a baby’s formula are followed. This prevents them from developing hard stools that are difficult to pass out (constipation). Constipation will come up from a concentrated mix of formula. On the other hand, a formula mix that’s too dilute will result in their not getting enough calories.

What if my baby doesn’t like feeding on a bottle?

This is a question that worries mothers who may need to return to work or leave their baby in the care of others for a few hours. If they refuse to breastfeed or accept a feeding bottle, the following alternatives are viable feeding options:

• Cup and baby spoon 
• A small syringe (without the needle)
• Feeding cup 

Feeding a newborn as a first-time mum can seem daunting. It is important to arm yourself with the right information to avoid common mistakes. Furthermore, information gives you the confidence to push back and advocate for yourself and your little one when the need arises. These are tips you should learn during an antenatal visit or birthing and breastfeeding class.