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Baby bringing up milk 2 hours after feed


Reflux | Breastfeeding Challenges | Start for Life

Breastfeeding challenges

There may be times when breastfeeding is challenging. Never ignore any issues you may have – talk to your health visitor, midwife, GP or breastfeeding specialist as soon as possible, they will be able to help you sort it out quickly.

Here are some common breastfeeding issues, and tips on what to do.

  • Colic
  • Constipation
  • Mastitis
  • Milk supply
  • Reflux
  • Sore nipples
  • Thrush
  • Tongue-tie

Baby reflux

If your baby brings up milk, or is sick during or after feeding, this is known as reflux. Reflux, also called posseting or spitting up, is quite common and your baby should grow out of it, usually by the time they are 12 months old.

What causes baby reflux?

The muscle at the bottom of the food pipe acts as a kind of door into the stomach – so when food or milk travels down, the muscle opens allowing the food into the stomach.

However, while this muscle is still developing in the first year, it can open when it shouldn't (usually when your baby's tummy is full) allowing some food and stomach acid to travel back up again. Acid in the stomach is normal and a necessary part of the digestion process – it helps break down food.

In most babies, reflux is nothing to worry about as long as they are healthy and gaining weight as expected.

Baby reflux symptoms

  • Constant or sudden crying when feeding.
  • Bringing up milk during or after feeds (regularly).
  • Frequent ear infections.
  • Lots of hiccups or coughing.
  • Refusing, gagging, or choking during feeds.
  • Poor weight gain.
  • Waking up at night a lot.

GORD

When reflux becomes painful and it happens frequently, this is known as 'gastro-oesophageal reflux disease' (GORD). GORD is more serious than mild, everyday reflux. The strong stomach acid can irritate and make the food pipe sore and inflamed, which is painful for your baby and may result in them needing medication.

The main signs and symptoms of GORD in your baby are:

  • spitting up frequently
  • abdominal pain
  • feeding difficulties
  • seeming unsettled and grizzly after a feed

These symptoms can lead to your baby not gaining weight, or even losing weight.

Silent reflux

Silent reflux can be confusing as there are no obvious signs or clues (such as spitting up). It's when the food travels back up the food pipe – but it's swallowed rather than spat out so is harder to identify. But your baby may display similar symptoms to those of regular reflux.

Breastfeeding Friend from Start for Life

The Breastfeeding Friend, a digital tool from Start for Life, has lots of useful information and expert advice to share with you – and because it's a digital tool, you can access it 24 / 7.

Breastfeeding tips for babies with reflux

  • Feeding little and often (smaller feeds stop their tummy getting too full).
  • Burping them requently during feeds – have a look at our guide to burping your baby for techniques.
  • Try a different feeding position – check out our our guide to breastfeeding positions.
  • Keep your baby upright, for at least an hour after feeding, this should help keep the milk down.

If you are mixed feeding (combining breastmilk and formula feeds), have a look at our advice on bottle feeding and reflux.

When to see the GP

If your baby has difficulty feeding or refuses to feed, regularly brings milk back up and seems uncomfortable after a feed, talk to your pharmacist, GP, or health visitor. They'll be able to give you practical advice on how to ease the symptoms and manage it – they may also need to rule out other causes (such as cow's milk allergy).

It might be helpful to keep a record of when your baby feeds, with details of how often and how much your baby brings the food back up, and how often your baby cries or seems distressed. This will help your health visitor or GP decide if your baby needs treatment.

Signs, symptoms and how to help

Reflux and regurgitation

Reflux and regurgitation are when your baby brings up small amounts of milk after a feed. It’s perfectly normal. In fact, around 30% of healthy babies experience regurgitation during their first year, while their digestive system is still maturing1.

Read on to learn about the signs and symptoms to look out, what causes reflux and regurgitation, and how to relieve it.  

What is reflux or acid reflux in babies?

Reflux (or acid reflux) in babies is when milk goes into your baby’s stomach, but then comes back up into their oesophagus – or food pipe2. This is referred to as gastro-oesophageal reflux. If it becomes painful and happens frequently it’s known as gastro-oesophageal reflux disease (GORD)2.

Regurgitation (also known as ‘posseting’ or ‘spitting up’) is when milk goes into your baby’s stomach, but then comes back up into, or out of, their mouth. Unlike vomiting there’s no straining involved; it’s effortless, more like a hiccup2.

Reflux and regurgitation are both very common and completely normal. You may worry that your little one isn’t getting enough nutrients, but as long as they aren’t showing signs of discomfort or losing weight, there shouldn’t be a problem.

Gastro-oesophageal reflux disease in babies (GORD/GERD)

Gastro-oesophageal reflux disease, (GORD, or GERD in the US), is when your baby experiences prolonged symptoms of acid reflux, which can become troublesome or begin to cause complications.

Silent reflux in babies

Confusingly, some babies suffer from silent reflux3. This is much harder to diagnose because they only bring up a small amount of milk, or don’t spit out what comes back up but swallow it instead. While babies with silent reflux might not appear to bring up their milk, and may even continue to gain weight normally, they may show some of the other symptoms of reflux.

Signs and symptoms of reflux in babies

Symptoms of reflux include3:

  • Bringing up small or large amounts of milk during and after feeding on a regular basis, with no other obvious signs of illness.
  • Coughing or spluttering during feeding and having trouble swallowing milk.
  • Crying during and after feeds.
  • An arched back during and after feeds.
  • Crying suddenly and/or constantly.
  • Recurrent hiccups.
  • Irritability and unsettled sleep.

What causes reflux in babies?

It makes no difference if your baby is breast- or bottle-fed. Reflux can affect any baby from shortly after birth until their first birthday.

When your baby is born, the oesophagus (the pipe leading from your baby’s mouth to their stomach) isn’t always fully developed. The oesophagus has a valve which closes over the stomach, helping food to stay down and be digested. In newborn babies, this valve may not be quite ready to fully function, meaning that milk and stomach acid occasionally come back up. The good news is that this valve gets stronger during your baby’s first year of life. As this happens, the chances of your baby developing reflux get much, much lower4.

There are other things that can contribute too:

Your baby’s developing digestive system

Feeding is new to your baby and their tiny tummy is still getting used to the sensation and process of eating and feeling full.

Lying down after feeds

If your baby spends a lot of time lying down, with a lot of milk in their tummy it may be harder for them to digest.

Your baby drinking too much at once

This can cause discomfort in their tummy.

How long does reflux last in babies?

Reflux usually starts before a baby is 8 weeks old and usually resolves itself before their first birthday4. If baby gets reflux for the first time after they’re 6 months old, or is older than 12 months and still has reflux, make an appointment with your GP4.

Baby reflux management: how to help

While reflux is usually nothing to worry about and generally resolves itself,
there are plenty of things you can do to help:

  • Feed your baby little and often – smaller amounts of milk are more manageable for tiny tummies.
  • Take your time – babies with reflux don’t cope well if feeding happens too quickly.
  • Try to keep your baby upright during and after feeding.
  • Try winding your baby before and after feeds.
  • Avoid bouncing your baby up and down after a feed.
  • Avoid dressing your baby in outfits that are tight around the waist.
  • If you’re bottle-feeding, try a slow-flowing teat to stop your baby guzzling their milk and taking in too much in one go.
  • You might also want to speak with your GP or pharmacist about the special infant formulas available for babies with reflux.

Taking care of you: Happy mum, happy baby

Coping with reflux is hard. You may feel as though you don’t want to feed your baby anywhere other than at home, where there’s an abundance of muslin cloths and a change of clothes at hand. You may also feel that all you do is feed your baby, because the moment you’re finished they bring it all back up and you have to start all over again. Or you may find yourself worrying that your baby isn’t getting enough nutrients - but rest assured that this is highly unlikely.

It’s completely normal to feel a bit helpless or anxious about your baby’s next feed if your baby is suffering from with reflux. We also know that trusting your instincts is the right thing to do; after all, you know your baby better than anyone else. If you’re concerned about your baby’s weight, or your baby is often bringing up large amounts of milk and appears to be distressed or in pain, talk with your Health Visitor and GP. Together you can look at ways to make feeding time more manageable for you and your little one.

References

  1. Vandenplas Y et al. J Pediartr Gastroenterol Nutr 2015;61(5) 531-7
  2. NHS Start 4 Life. Breastfeeding challenges. [Online]. Available at: https://www.nhs.uk/start4life/baby/breastfeeding/breastfeeding-challenges/reflux/ [Accessed October 2020].
  3. Vandenplas Y et al. J Pediartr Gastroenterol Nutr 2009;49:498-547.
  4. NICE. NG1. Gastro-oesophageal reflux disease: recognition, diagnosis and management in children and young people. 2015. Available at: https://www.nice.org.uk/guidance/ng1/resources/gastrooesophageal-reflux-disease-recognition-diagnosis-and-management-in-children-and- young-people-51035086789  [Accessed October 2020].
  5. NHS. Reflux in babies. [Online]. 2019. Available at: https://www.nhs.uk/conditions/reflux-in-babies/ [Accessed October 2020]

Last reviewed: 18th October 2020
Reviewed by Nutricia’s Medical and Scientific Affairs Team

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Breastfeeding in the first month: what to expect

Not sure how to establish lactation and increase milk production? If you need help, support, or just want to know what to expect, read our first month breastfeeding advice

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The first weeks of breastfeeding are a very stressful period. If at times you feel like you can't handle it, know that you are not alone. Feeding your baby all day long is completely natural and helps produce breast milk, but can be quite tiring at times. Be patient, think about yourself and remember: after the first month, when milk production stabilizes, it will become easier.

How often should a baby be breastfed?

Babies are born with a small stomach that grows rapidly with increasing milk production: in the first week it is no larger than an apricot, and after two weeks it is already the size of a large chicken egg. 1.2 Let the child eat as much as he wants and when he wants. This will help him quickly regain the weight lost after birth and grow and develop further.

“Be prepared to feed every two to three hours throughout the day. At night, the intervals between feedings can be longer: three to four or even five hours, says Cathy Garbin, a recognized international expert on breastfeeding. Some eat quickly and are satiated in 15 minutes, while others take an entire hour to feed. Do not compare your breastfeeding regimen with that of other mothers - it is very likely that there will be nothing in common between them.

At each feed, give your baby a full meal from one breast and then offer a second one, but don't worry if the baby doesn't take it. When the baby is full, he lets go of his chest and at the same time looks relaxed and satisfied - so much so that he can immediately fall asleep. The next time you feed, start on the other breast. You can monitor the order of the mammary glands during feeding using a special application.

Why does the child always ask for a breast?

The first month is usually the hardest time to breastfeed. But do not think that because the baby is constantly hungry and asks for a breast almost every 45 minutes, then you do not have enough milk.

In the first month, the baby needs to eat frequently to start and stimulate the mother's milk production. It lays the foundation for a stable milk supply in the future. 3

In addition, we must not forget that the child needs almost constant contact with the mother. The bright light and noise of the surrounding world at first frighten the baby, and only by clinging to his mother, he can calm down.

Sarah, mother of three from the UK, confirms: “Crying is not always a sign of hunger. Sometimes my kids just wanted me to be around and begged for breasts to calm them down. Use a sling. Place the cradle next to the bed. Don't look at the clock. Take advantage of every opportunity to relax. Forget about cleaning. Let those around you take care of you. And not three days, but six weeks at least! Hug your baby, enjoy the comfort - and trust your body."

Do I need to feed my baby on a schedule?

Your baby is still too young for a strict daily routine, so
forget about breastfeeding schedules and focus on his needs.

“Volumes have been written about how to feed a baby on a schedule, but babies don't read or understand books,” Cathy says. - All children are different. Some people can eat on a schedule, but most can't. Most often, over time, the child develops his own schedule.

Some mothers report that their babies are fine with scheduled feedings, but they are probably just the few babies who would eat every four hours anyway. Adults rarely eat and drink the same foods at the same time of day - so why do we expect this from toddlers?

Offer your baby the breast at the first sign of hunger. Crying is already the last stage, so be attentive to early signs: the baby licks his lips, opens his mouth, sucks his fist, turns his head with his mouth open - looking for the breast. 4

What is a "milk flush"?

At the beginning of each feed, a hungry baby actively sucks on the nipple,
thereby stimulating the milk flow reflex - the movement of milk through the milk ducts. 5

“Nipple stimulation triggers the release of the hormone oxytocin,” explains Cathy. “Oxytocin is distributed throughout the body and causes the muscles around the milk-producing glands to contract and the milk ducts to dilate. This stimulates the flow of milk.

If the flushing reflex fails, milk will not come out. This is a hormonal response, and under stress it may not work at all or work poorly. Therefore, it is so important that you feel comfortable and calm when feeding.

“Studies show that each mother has a different rhythm of hot flashes during one feed,” Kathy continues, “Oxytocin is a short-acting hormone, it breaks down in just 30-40 seconds after formation. Milk begins to flow, the baby eats, the effect of oxytocin ends, but then a new rush of milk occurs, the baby continues to suckle the breast, and this process is repeated cyclically. That is why, during feeding, the child periodically stops and rests - this is how nature intended.

The flow of milk may be accompanied by a strong sensation of movement or tingling in the chest, although 21% of mothers, according to surveys, do not feel anything at all. 5 Cathy explains: “Many women only feel the first rush of milk. If you do not feel hot flashes, do not worry: since the child eats normally, most likely, you simply do not understand that they are.

How do you know if a baby is getting enough milk?

Since it is impossible to track how much milk a baby eats while breastfeeding, mothers sometimes worry that the baby is malnourished. Trust your child and your body.

After a rush of milk, the baby usually begins to suckle more slowly. Some mothers clearly hear how the baby swallows, others do not notice it. But one way or another, the child himself will show when he is full - just watch carefully. Many babies make two or three approaches to the breast at one feeding. 6

“When a child has had enough, it is noticeable almost immediately: a kind of “milk intoxication” sets in. The baby is relaxed and makes it clear with his whole body that he is completely full, says Katie, “Diapers are another great way to assess whether the baby is getting enough milk. During this period, a breastfed baby should have at least five wet diapers a day and at least two portions of soft yellow stool, and often more.”

From one month until weaning at six months of age, a baby's stool (if exclusively breastfed) should look the same every day: yellow, grainy, loose, and watery.

When is the child's birth weight restored?

Most newborns lose weight in the first few days of life. This is normal and should not be cause for concern. As a rule, weight is reduced by 5-7%, although some may lose up to 10%. One way or another, by 10–14 days, almost all newborns regain their birth weight. In the first three to four months, the minimum expected weight gain is an average of 150 grams per week. But one week the child may gain weight faster, and the next slower, so it is necessary that the attending physician monitor the health and growth of the baby constantly. 7.8

At the slightest doubt or signs of dehydration, such as
dark urine, no stool for more than 24 hours, retraction of the fontanel (soft spot on the head), yellowing of the skin, drowsiness, lethargy, lack of appetite (ability to four to six hours without feeding), you should immediately consult a doctor. 7

What is "cluster feeding"?

When a baby asks to breastfeed very often for several hours, this is called cluster feeding. 6 The peak often occurs in the evening between 18:00 and 22:00, just when many babies are especially restless and need close contact with their mother. Most often, mothers complain about this in the period from two to nine weeks after childbirth. This is perfectly normal and common behavior as long as the baby is otherwise healthy, eating well, gaining weight normally, and appears content throughout the day. 9

Cluster feeding can be caused by a sharp jump in the development of the body - during this period the baby especially needs love, comfort and a sense of security. The growing brain of a child is so excited that it can be difficult for him to turn off, or it just scares the baby. 9 If a child is overworked, it is often difficult for him or her to calm down on his own, and adult help is needed. And breastfeeding is the best way to calm the baby, because breast milk is not only food, but also pain reliever and a source of happiness hormones. 10

“Nobody told me about cluster feeding, so for the first 10 days I just went crazy with worry - I was sure that my milk was not enough for the baby,” recalls Camille, a mother from Australia, “It was a very difficult period . I was advised to pump and supplement until I finally contacted the Australian Breastfeeding Association. There they explained to me what was happening: it turned out that it was not about milk at all.

Remember, this is temporary. Try to prepare dinner for yourself in the afternoon, when the baby is fast asleep, so that in the evening, when he begins to often breastfeed, you have the opportunity to quickly warm up the food and have a snack. If you are not alone, arrange to carry and rock the baby in turns so that you have the opportunity to rest. If you have no one to turn to for help and you feel that your strength is leaving you, put the baby in the crib and rest for a few minutes, and then pick it up again.

Ask your partner, family and friends to help you with household chores, cooking and caring for older children if you have any. If possible, hire an au pair. Get as much rest as possible, eat well and drink plenty of water.

“My daughter slept a lot during the day, but from 23:00 to 5:00 the cluster feeding period began, which was very tiring,” recalls Jenal, a mother from the USA, “My husband tried his best to make life easier for me - washed, cleaned, cooked, changed diapers, let me sleep at every opportunity and never tired of assuring me that we were doing well.

If you are concerned about the frequency of breastfeeding, it is worth contacting a specialist. “Check with a lactation consultant or doctor to see if this is indicative of any problems,” recommends Cathy. “Resist the temptation to supplement your baby with formula (unless recommended by your doctor) until you find the cause. It may not be a matter of limited milk production at all - it may be that the child is inefficiently sucking it.

When will breastfeeding become easier?

This early stage is very special and does not last long. Although sometimes it seems that there will be no end to it, rest assured: it will get easier soon! By the end of the first month, breast milk production will stabilize, and the baby will become stronger and learn to suckle better. 2.3 Any problems with latch on by this time will most likely be resolved and the body will be able to produce milk more efficiently so inflammation and leakage of milk will begin to subside.

“The first four to six weeks are the hardest, but then things start to get better,” Cathy assures. It just needs to be experienced!”

The longer breastfeeding continues, the more benefits it brings, from saving on formula and improving sleep quality 11–13 to boosting your baby's immune system 14 and reducing your risk of certain cancers. 15

“When you feel like you're pushing yourself, try to go from feed to feed and day to day,” says Hannah, a UK mom. “I was sure I wouldn’t make it to eight weeks. And now I have been breastfeeding for almost 17 weeks, and I dare say it is very easy.”

Read the resource Breastfeeding Beyond the First Month: What to Expect

Literature

1 Naveed M et al. An autopsy study of relationship between perinatal stomach capacity and birth weight. Indian J Gastroenterol .1992;11(4):156-158. - Navid M. et al. , Association between prenatal gastric volume and birth weight. Autopsy. Indian J Gastroenterol. 1992;11(4):156-158.

2 Neville MC et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation .Am J Clinl Nutr . 1988;48(6):1375-1386. at the beginning and at the peak of lactation." Am F Clean Nutr. 1988;48(6):1375-1386.

3 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet , Gynecol , & Neonatal Nurs . 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". J Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121.

4 Australian Breastfeeding Feeding cues ; 2017 Sep [ cited 2018 Feb ]. - Australian Breastfeeding Association [Internet], Feed Ready Signals; September 2017 [cited February 2018]

5 Kent JC et al. Response of breasts to different stimulation patterns of an electric breast pump. J Human Lact . 2003;19(2):179-186. - Kent J.S. et al., Breast Response to Different Types of Electric Breast Pump Stimulation. J Human Lact (Journal of the International Association of Lactation Consultants). 2003;19(2):179-186.

6) Kent JC et al . Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3):e387-95.

7 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p . - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." Seventh edition. Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2010. P. 1128.

8 World Health Organization. [Internet]. Child growth standards; 2018 [cited 2018 Feb] - World Health Organization. [Internet]. Child Growth Standards 2018 [cited February 2018].

9 Australian Breastfeeding Association . [ Internet ]. Cluster feeding and fussing babies ; Dec 2017 [ cited 2018 Feb ] - Australian Breastfeeding Association [Internet], Cluster Feeding and Screaming Babies; December 2017 [cited February 2018].

10 Moberg KU, Prime DK. Oxytocin effects in mothers and infants during breastfeeding. Infant . 2013;9(6):201-206.- Moberg K, Prime DK, "Oxytocin effects on mother and child during breastfeeding". Infant. 2013;9(6):201-206.

11 U.S. Department of Health & Human Services [Internet]. Surgeon General Breastfeeding factsheet; 2011 Jan 20 [cited 2017 Feb] - Department of Health and Human Services [Internet], "Breastfeeding Facts from the Chief Medical Officer", Jan 20, 2011 [cited Feb 2017]

12 Kendall-Tackett K et al. The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. clinical lactation. 2011;1;2(2):22-26. - Kendall-Tuckett, K. et al., "Influence of feeding pattern on sleep duration, maternal well-being and the development of postpartum depression." Clinical Lactation. 2011;2(2):22-26.

13 Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: Association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breast Med . 2015;10(5):246-252. - Brown A., Harris W., "Night feedings and infant sleep in the first year of life and their association with feeding frequency, daytime supplementation, and infant weight." Brest Med (Breastfeeding Medicine). 2015;10(5):246-252.

14 Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl immunology. 2013;2(4). - Hassiot F. et al., "Infectious diseases of the mother and child stimulate a rapid leukocyte reaction in breast milk." Clean Transl Immunology. 2013;2(4):e3.

15 Li DP et al. Breastfeeding and ovarian cancer risk: a systematic review and meta-analysis of 40 epidemiological studies. Asian Pac J Cancer Prev . 2014;15(12):4829-4837. - Lee D.P. et al., "Breastfeeding and the risk of ovarian cancer: a systematic review and meta-analysis of 40 epidemiological studies." Asia Pas J Cancer Prev. 2014;15(12):4829-4837.

What is normal breastfeeding? | Interview with Dr. Jacqueline Kent

It can be difficult for new mothers to understand if breastfeeding is going well, so we decided to ask the expert if it is possible to talk about the norms when it comes to breastfeeding.

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Dr Jacqueline Kent, Research Fellow, Hartmann Human Lactation Research Group:
Jacqueline joined the University of Western Australia research group in 1986 and received her PhD in 1999. She is currently researching the biochemical and physiological aspects of breast milk synthesis and release in search of scientific information to help mothers breastfeed longer.

Dr. Jacqueline Kent and her colleagues have been studying breastfeeding for many years. As it turned out, for all mothers and babies, this process occurs in its own way.

What were the most surprising results of your research?

Variety. It turns out that the limits of the norm are extremely wide.
We are used to textbooks that say that an infant should eat 8-12 times a day and gain 150 grams per week. But babies don't read textbooks and do things their own way! Some gain weight more slowly, others very quickly.

We followed exclusively breastfed infants aged one to six months. As our studies have shown, on average, a child is breastfed 4 to 13 times a day, and the duration of one feeding varies from 12 minutes to 1 hour. 1

How much milk do breastfed babies usually consume?

According to our research, the amount of milk consumed by baby
ranges from 54 to 234 ml per feeding. 1

Sometimes it seems to the mother that the baby ate well, but when weighed, it turns out that he ate very little milk. And it happens the other way around: the child is distracted, breastfeeds for only a few minutes and still eats 100 ml of milk. Even if the baby is restless, this does not mean at all that he is malnourished.

All babies are different, but they all get as much milk as they need in one way or another. One needs 500 ml of milk per day, while others eat up to 1356 ml!

By the way, boys on average eat 76 ml more milk per day than girls. The main thing is that you have enough milk, and the baby will decide when and how much he will eat.

Should I offer my baby a second breast?

I advise offering the second breast to the baby after the first has been completely emptied. If he accepts it, then he hasn't finished eating. If not, don't worry. Let the baby decide for himself - only he knows when he is full. According to our research, 30% of babies get enough milk from one breast, 13% eat from two breasts at each feed, and 57% from time to time. 1

How do you know if a baby is getting enough milk?

In my experience, mothers often blame themselves for not producing enough milk. Ask yourself: Is my child growing? Is he putting on weight? Is he cheerful? Is his skin healthy? How often does he get diapers dirty? If the answer is “yes”, then the baby is getting enough milk, no matter if he eats a lot or a little.

What is the most common misconception about breastfeeding?

Mothers usually think that the older the child gets, the more often
he needs to be fed and the more milk he will eat. They are often surprised to learn that between the 4th and 26th weeks, total milk production normally does not change. 2

In the first few months, the baby grows very fast and his metabolism is accelerated. The milk that the child consumes during this period is almost completely used for growth and maintenance of metabolism.

Between the ages of three and six months, metabolism slows down and growth slows, so the same amount of milk is sufficient for the baby. In other words, the baby does not have to consume more and more milk as they grow older. On the contrary, feedings become shorter and less frequent, but at the same time the child receives the same amount of milk, because he suckles better.

Do studies say anything about the age at which breastfed babies start sleeping through the night?

Most babies need to be fed at night.
The baby's stomach is not large enough to go all night without feeding, and breast milk is digested very quickly. Therefore, it is natural for the baby to wake up at night - and this usually continues for at least the first six months. Feeding at night is normal. When you feed your baby at night, do not even hesitate - all over the world at this moment other mothers of babies of the same age are doing the same. Be patient - it usually only lasts a few months. 1

What worries new mothers the most during the first few weeks of breastfeeding?

The most common concern is whether the baby latch on correctly, sucks well, and is full during feeding. Often mothers also worry about sore nipples. The main thing is to find the right position for feeding from the very beginning and ensure that the baby is latching on correctly. Practice shows that this significantly affects the flow of milk and the convenience of feeding.

What breastfeeding symptoms should be of concern?

Milk production usually returns to normal levels two weeks after birth. If the child does not begin to gain weight on the fifth or sixth day of life, it's time to sound the alarm. You should contact your doctor to make sure that milk is being produced and that its composition is changing from colostrum to mature breast milk.

What advice would you give to a new breastfeeding mother?

Try to ensure skin-to-skin contact with the baby as soon as possible after delivery. If possible, feed your baby within the first hour of life, or at least breastfeed. As soon as possible, contact a specialist to correct the position and grip of the breast during feeding and thus avoid damage to the nipples.

Feed frequently. Young mothers do not immediately succeed in correctly recognizing the signals that the child gives. Be sure to feed your baby on demand, and not at set intervals. Offer the breast as soon as you notice any signs of hunger - as a rule, the baby suckles better when he is calm. If he cries, it is more difficult for him to take the breast. If you are not sure what the child wants, offer him the breast. He decides whether he wants to eat or not.

To learn more about Dr. Kent's research, download infographic "How to determine the limits of normal when it comes to breastfeeding" or see it below.

Literature

1 Kent JC et al. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics . 2006;117(3): e 387-395. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics).

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