Breast feeding is best _ _ _

But some babies may need a bit more milk, in the first few days.

Most babies born at term with a good weight (average 3.5kg = 7.7 lb), have enough stores to last for initial 24-48 hours when mothers don’t produce much milk (only colostrum). Some babies are born small or premature and don’t have these stores. They definitely need some top up milk to stop them going ‘Hypoglycaemic’ (low blood sugar level).

Normally, babies loose some weight from Day 1 to day 5, and then stabilise from D5-7 and regain their birth weight by Day 10-14. By day 5, when they are usually weighed, weight loss of up to 10% is acceptable. If it’s more than that, usually they will need to be seen by a doctor, to check if their is some problem with the baby or mother’s milk supply.

We see lot of babies referred to us in A&E by midwives who have lost >10% of their birth weight. Most of these cases are due to insufficient milk supply or poor technique of breastfeeding like difficulty on latching on the breast. Grandmothers and  midwives are very good in supporting mothers in breastfeeding, if available.

Sometimes, mothers keep trying to feed the baby, and the baby keeps on sucking vigorously, without getting much milk in return, thereby using lot of calories and loosing weight. If milk supply is an issue, I usually advise formula top ups (only till breast milk starts to come) in babies who are at risk of going hypoglycaemic or dehydrated (with high sodium) This plan is just ‘one of many’ strategies, but can always be modified!

  1. Breastfeed (always) first, on one breast, for 10-15 min (MAX) and then top up with any formula as much as they take. (All term milk formulae are same)
  2. Next time, feed with 2nd breast and then top up with formula. The gap should be atleast 2-3 hours, otherwise mother will get really tired, adversely affecting milk supply. It’s important to empty one breast first to get both ‘FORE’ & ‘HIND’ milk.
  3. Mothers should drink plenty of fluids, including water, milk, juice etc (Not alcohol please 😉 and eat healthy diet.
  4. Relax, as this is temporary and will improve. Relaxation will help your milk supply. Take rest in between feeds. Usually, babies are being constantly fed as they are never satisfied, which does not help your milk production.
  5. Baby should be always put to breast first as the sucking reflex stimulates Oxytocin production in the brain, which helps breast milk production.
  6. slowly over the next few days, you’ll notice, that as the breast milk supply gets better, the baby will not need that much top up, and will be wholly satisfied with the breast milk. At that point, top up with formula can be stopped.

You will find multiple strategies from different professionals, as there is no single solution. This one works for many and is worth trying. Enjoy your baby!!



Categories: Neonates & infants

3 replies

  1. https://fedisbest.org/
    A very worthwhile read. This website was drawn to our attention by our neonatal SpRs. Helpful advice for the postnatal ward.

    Like

    • Yes. Sometimes, there is too much pressure on mothers to breastfeed exclusively. That pressure, per se, creates anxiety and leads to reduction in milk production. There are lot of situations these days like Caesarean section, which can make breast feeding difficlut and there is no harm in supplementing these babies with formula, till mother starts producing enough milk. That also takes the pressure off mothers who may be in lot of pain etc.

      Like

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