In the last 20 years there has been a major change in breastfeeding practice. Most women in the United States initiate breastfeeding. This was not the case 20 years ago when infants were primarily formula fed. Parents understand breastfeeding is best for their infant for both health and nutrition. Breast milk protects infants from gastroenteritis, otitis media, respiratory illness, asthma, allergic problems and eczema or atopic dermatitis. Breastfed infants have a lower incidence of SIDS, obesity, diabetes, celiac disease, inflammatory bowel disease and even some types of leukemia.
Parents worry if their infant is receiving enough milk and if colostrum is enough for their infant. Usually there is no need to worry. Infants have a limited stomach capacity in the first few days of life. On day 1 the stomach can hold 1-2 tsp. (10cc) and this increases to 2 tbl (30cc) by day 3. By 1-2 weeks of life the stomach can hold 2-3 ozs. This is why milk does not need to be available in large quantities from the beginning. Your infant is born with enough nutrients to allow this transition to feeding by mouth to go slowly and successfully. By watching urine and stool output hydration can be monitored. We like to see 2 wet diapers every 12 hours and 1-2 stools on days one and two and 3-12 stools per day after day 3. Some infants skip up to 5 days between stools and this should be monitored by you and your pediatrician but is often normal.
Another way to follow your infant’s hydration is by tracking the weight. Infants often lose up to 7% of their birth weight. This should be expected. Greater weight loss will need to be evaluated. Most infants gain between 3/4 and 1 oz. per day for the first several months and 1/2 oz. after 6 months of age.
If bottle supplementation is needed then use of expressed or pumped breast milk is best. Formula is also reasonable. Most supplementation is in the 1/2 oz. (15ml) range and is given after your infant has breastfed. Advice and support from a breastfeeding consultant here in the office can help you with supplemental options. A few infants tend to have difficulty returning to breastfeeding after a bottle is given. Breastfeeding infants use mostly their posterior tongues to nurse while bottle fed infants suck with their anterior tongues and use less of their cheek muscles. We think this is a reason why some infants have difficulty transitioning back and forth and although this is uncommon it needs to be watched for.
Breastfeeding is recommended for a minimum of 12 months. And women in some industrialized countries nurse their children until 3-4 years of age. Breastfeeding for longer than 12 months does have cumulative benefits for both the child and the mother.
Please refer to other blog entries for more tips on successful breastfeeding.