Written by Danielle Blair, MS, IBCLC http://www.gaithersburgbreastfeeding.com
This is Part Two in our supplementation series. Don’t miss Part One: I'm Told my Baby Needs Supplementation...Now What?
If you were instructed to offer supplemental feedings shortly after birth, it can be challenging to know when your baby no longer needs extra food. You will be working closely with your baby's pediatrician, and hopefully an IBCLC as well, to determine how baby is progressing.
The Why May Determine the When...
The reason for supplementation will most likely determine when supplements will stop. Some conditions, such as low blood sugar and jaundice, are resolved relatively quickly with good management. In these cases the doctor may instruct you to stop supplements once the problem is solved. Longer-term supplementation, such as for a premature baby, baby with feeding challenges, or a mom working to increase her milk supply, will likely require a longer weaning process. In both cases, though, watching the baby for signs of effective breastfeeding will be an important part of baby's care.
How can I tell if my baby is breastfeeding well?
As your milk volume increases and your baby gets better at breastfeeding, you may start to notice swallowing, either audible swallowing or deep sucking with a pause as the jaw drops. (Your IBCLC can show you what this looks like.) Feedings should be comfortable, without nipple pain during or between feeds. Your breasts may feel full before a feeding and softer after, although this may be less noticeable after the first few weeks of life. Your baby may fall into a deep sleep after feeding, and will be satisfied for about 1-3 hours before asking to eat again. If you have been offering supplements after breastfeeding, baby may refuse to take the extra food, or may go longer periods without rousing to nurse. A well-fed baby will also have lots of dirty diapers...at least 5 wet and 4 poops after day 5.
If your baby is refusing supplements and is otherwise well, it may be a good time to check in with the pediatrician. He/she may tell you to discontinue supplements on your own, or he/she may recommend a visit with an IBCLC to assess feeding before stopping supplements. In addition to watching your baby nurse, an IBCLC can weigh your baby before and after breastfeeding to measure the milk intake. This can be very helpful in determining whether supplements are still necessary.
I'm afraid to trust breastfeeding!
As mentioned earlier, there are many visible signs that a baby is breastfeeding well. But if you have been offering extra feeds, it can sometimes be difficult to trust that your baby can get everything he needs directly from the breast. It can also be hard to let go of a regimented feeding schedule (feeds exactly every x hours, always y amount), if that's what has been prescribed for your baby. Healthy, fully-breastfed babies feed often, about 8-12 times each day. Feeding times can vary...some very efficient babies only need 5 minutes to take several ounces of milk, while others prefer more leisurely nursing sessions. (And most babies will do some short, focused feeds and some longer sessions.) You should see lots of diaper output, and your baby should gain about 4-7oz per week in the early months. Your doctor will weigh your baby at each visit...no need for a scale at home.
Need more reassurance?
Stop by a breastfeeding support group that has a scale to weigh your baby before and after a feeding. Also, checking in at these groups every few weeks can be very comforting, as you can see how much weight your baby is gaining over the weeks. An IBCLC can help you be sure your baby is getting plenty to eat, as well. If you struggle with milk supply or need to continue supplements, an IBCLC can help you with a plan that works for you and your baby.
For more information about supplementation reasons, methods, and choices, check out these The Boob Group podcast episodes:
Exclusive Breastfeeding and Early Supplementation http://www.theboobgroup.com/exclusive-breastfeeding-early-supplementation/
Breastfeeding the Jaundiced Baby http://www.theboobgroup.com/breastfeeding-the-jaundiced-baby/
When Breastfeeding Doesn’t Go As Planned http://www.theboobgroup.com/when-breastfeeding-doesnt-go-as-planned/
Low Milk Supply: Donor Milk, Milk Banks, and Formula http://www.theboobgroup.com/low-milk-supply-donor-milk-milk-banks-formula/
I first became interested in supporting breastfeeding mothers after receiving wonderful support when I was a new mother. What began as a way to "pay it forward" grew into a passion and a calling. I have been helping new mothers breastfeed their babies since 2004 and became an International Board Certified Lactation Consultant (IBCLC) in 2010. I am the owner of Gaithersburg Breastfeeding, LLC, offering home visits in Montgomery County, Maryland, and also work at a local hospital providing in-patient lactation services. I have worked with mothers at all stages of breastfeeding, from the delivery room through toddlerhood and beyond. I truly love supporting mothers as they learn the art of breastfeeding, and particularly enjoy watching moms develop the confidence that they can breastfeed their babies!
In addition to my work in lactation, I hold bachelor's and master's degrees in engineering from West Virginia University. Much of my professional work in engineering involved sharing scientific information in layman's terms, as well as teaching and training; these skills have served me well as I teach parents about their new babies. I live in the Maryland suburbs of Washington, DC, with my husband and two children.