Q1 How do I know if my newborn is hungry, and if she’s getting enough milk?
Of course you know that crying is one way a hungry baby communicates. The good news, however, is that your baby gives a number of “hey mom, I’m hungry” signals before crying. One important signal is called the “rooting reflex” and it even kicks in as early as an hour after birth . Here’s how it works: your baby moves her head toward a stimulus, such as your finger stroking her cheek, or her own fist brushing against her mouth. She opens her mouth, either in quick, small open-and-shut movements, or widely for a second or two. That’s your cue to start nursing.
Once your baby latches on to your breast, check to see if she’s sucking or swallowing. Sucking means that she’s enjoying the comfort of your breast, but isn’t actually swallowing any milk. The movement is her chin is short and quick.
Swallowing, on the other hand, is marked by the underside of the chin dropping down in a long, slow, deep movement. Some babies make a little noise when they swallow, like a light sigh or a small click. It gets easier to see the difference between sucking and swallowing after your milk comes in several days after birth and your milk flows faster.
One of the best and simplest ways to see if your newborn is getting enough milk is to keep track of the number of wet and dirty diapers she has. At four or five days old, your baby should have about five very wet diapers and several dirty diapers in a 24-hour time period.
Q2 What is cluster feeding, and what’s the best way to handle it?
Cluster feeding means that your baby is constantly at your breast at certain times of day, often in the late afternoon or early evening, and much less at other times of the day. Obviously, this non-stop nursing can be tough on both you and baby, but there are some ways to deal with it.
Cluster feeding tends to happen at two separate times. The first is in the first few days after birth, when your milk may not have fully come in yet and your baby is looking for more. Your lactation consultant may recommend pumping to bring in your milk more quickly.
After breastfeeding has been established (that is, feedings have a beginning, middle and end) around two weeks after birth, cluster feeding can still occur from time to time. It could signal a normal growth spurt, or it could mean that while your milk supply is fine, your baby isn’t able to access a full feeding from the breast. If the cluster feeding persists, a lactation consultant or your pediatrician can help you determine what the issue is. And remember to enlist your partner to help soothe your baby with walking and cuddling between feedings.
Q3 How can I increase my milk flow?
If your baby starts to slow down while nursing, switch him to the other breast. Why? While your baby has been drinking from the first breast, milk has been pooling in the other breast, meaning that the flow will be faster (and easier for him/her to drink) when you switch.
After your baby slows down on the second breast, gently pull him in closer and use your hand to firmly squeeze your breast. This expresses more milk into his mouth. If these two techniques aren’t enough, you can pump and supplement. This means that after nursing your baby for 20-to-25 minutes, use a breast pump to drain your breasts, which gives them the signal to switch into higher production mode. You can then use this pumped milk at your next feeding—first nursing, then offering a bottle of breastmilk.
Your milk supply is at its peak in the morning so that’s a great time to pump. Other factors that affect milk supply include combination birth control pills, high stress levels and an incorrect latch.
Heather Kelly is an International Board Certified Lactation Consultant (IBCLC) who has been practicing in New York City since 2001. Bravado also draws on resources from our parent company Medela, a leader in breastmilk and breastfeeding research and information.