The only way to be absolutely sure that your baby is getting enough milk is to check his weight regularly. Remember that it is normal for him to lose 5-7 % of his weight in the first couple of days (doctors often become concerned when weight loss approaches or exceeds 10%). For the average baby, this is close to a half a pound weight loss (often more for larger babies). You need to ask what your baby's discharge weight is when leaving the hospital, because that is the figure you will be calculating his weight gain from, not from his birth weight. For example: your baby weighs 7 lbs 8 oz at birth. 48 hours later when you leave the hospital, he weighs 7 lbs 1 oz. Once your milk comes in, your baby should gain about an ounce each day for the first several months of life. Most babies will regain their birth weight within 2-3 weeks. Many doctors are pleased if the baby has regained his birth weight by 2 weeks, and will do a weight check at that time. I like to see babies regain their birth weight by 10 days, and most babies will do that if breastfeeding is progressing smoothly. Some doctors check the babies weight around the third day of life, and then make a follow-up appointment for 2 weeks to see if he has regained his birth weight. I strongly encourage mothers to check the weight at about 1 week - at that point, her milk should be in, the baby should have good urine and stool output, he should be gaining weight, and any breastfeeding difficulties can be addressed. Breastfeeding problems are much easier to remedy if recognized and treated early. Most doctor's offices will offer free weight checks, since the doctor does not actually have to see the baby at that time (just ask the nurse to put the baby on the scale). The information you get will be invaluable -- either you will know that breastfeeding is going well, and you can relax, or your will know that there is a problem that needs to be addressed and you can take care of it before a little problem develops into a big one.
One last note on this topic:
Every mother's nightmare is that she won't have enough milk and her baby will become dehydrated. Horror stories abound, and unfortunately, this has (rarely) occurred. There is absolutely no reason for this to happen if you follow the above guidelines. True dehydration is an extremely uncommon medical occurrence, and there are warning signs which indicate that your baby needs more fluids immediately. If you notice any of the following symptoms (especially if they occur concurrently with other "red flags" such as low urine and stool output), contact your doctor ASAP.
• weak cry
• dry mouth or eyes
• the fontanel (soft spot) on the baby's head is sunken in or depressed
• the skin loses its resilience (when you pinch it, it stays pinched looking)
Anne Smith, IBCLC has breastfed a total of six children (three boys, three girls). She feel that her first hand experience plus her more than twenty years experience of counseling nursing mothers are among her most important credentials. Anne has been a La Leche Leader since 1978 and IBCLC since 1990. As a nursing mother, LLL Leader, and IBCLC, Anne has worked in many areas over the years. She has led support group meetings, taught breastfeeding classes, trained breastfeeding peer counselors to work with low income mothers, worked one-on-one with mothers to solve breastfeeding problems, helped thousands of mothers with breastfeeding questions over the phone, held workshops for health professionals on various breastfeeding topics, taught OB, Pediatric, and Family Practice Residents breastfeeding at Bowman Gray School of Medicine, and run a breast pump rental station with over 100 pumps, scales, and nursing bras for the past eleven years. We invite you to visit Anne's website.
Copyright © Anne Smith. Permission to republish granted to Pregnancy.org, LLC.