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by Heisje de Jong,
Certified Lactation Consultant

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06.- IS BABY GETTING ENOUGH?                    <previous topic         next topic>


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Many breastfeeding mothers worry if their baby gets enough to drink. When you are breastfeeding you can not actually see how much milk baby is getting at each feeding, in contrast with bottle feeding, when you know exactly how much he is getting. But there are several ways of knowing if your baby is getting enough milk. Keeping track of what's coming out is one way of knowing if your baby is getting enough.

URINE OUTPUT

During the first few days one or two wet diapers a day is normal.
Once your milk becomes more plentiful (usually your milk "comes in" the third or fourth day) the baby's wet diapers should increase until he has at least 5 or 6 really wet diapers a day.
The urine should always be pale in color, never orange or brown.

STOOL OUTPUT

The stool pattern of the breastfed baby can be used as an indicator of milk intake.
In the first few days after birth the baby will pass the black, tarry stool called meconium that was in his intestines before birth.
After your milk has "come in" your baby's stool gradually lightens in color and and becomes less sticky and more liquid.
The stool of the totally breastfed baby is loose and unformed, at times it may contain small curds and the color is a greenish yellow to mustard yellow. The odor is mild, "yeasty".
Most babies stool at least 2-5 times a day.
After the first month to six weeks of life the frequency of stooling gradually declines while the volume increases. Your baby may go several days, 7-10 days is not abnormal, without stooling, the long periods between stools in the second and later months after birth are not a concern, provided that the baby's abdomen is soft, the stool is loose and baby is content and alert.

WEIGHT GAIN

Many babies lose some weight during the first few days, a weight loss of 5-7% is considered normal. Baby should regain his birth weight by 2-3 weeks of age.
One reason for this weight loss is that babies are born with excess fluids, which they lose in the early days.
Once your milk becomes more plentiful after the third or fourth day your baby should begin gaining weight.
Normal weight gain during the first 3-4 months is 4-8 ounces (113-227 grams) per week. From 4-6 months of age, normal gain is 3-5 ounces (85-142 grams) a week and from 6-12 months of age normal weight gain is 1.5-3 ounces (42-85 grams) per week.
Generally speaking, babies double their birth weight by about 5 months, triple it by one year of age, and quadruple it by two years of age.

OTHER INDICATORS OF GROWTH

Increases in length and head circumference are also important measures of growth.
Growth in length should be about 1 inch (2.5 cm) per month and growth in head circumference ½ inch (1.27 cm) per month during the first 6 months, and about half that during the second 6 months.


OTHER SIGNS OF SUFFICIENT HYDRATION

Your baby's skin should be soft and moist; if pressed the skin should return to normal and not remain dented. The tissue around the eyes and in baby's mouth should be moist and pink.
Baby should appear healthy, have a good color, be alert and have a good muscle tone.


CONTACT YOUR DOCTOR WHEN:

* Baby has fewer than 5-6 wet diapers per day (after third or fourth day).
* Baby has less than 2 bowel movements per day (up to 5-6 weeks of age).
* Baby is still losing weight after day 5.
* Baby has not regained his birth weight at 3 weeks of age.

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