Common Concerns During the Early Weeks of Breastfeeding

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Many nondemanding, sleepy babies do better with a few simple breastfeeding modifications. If the infant does not sustain suckling very long, it is preferable to restrict her nursing to only five minutes per breast. Babies generally take more milk nursing for a shorter duration at both breasts than nursing a little longer on one side only. An exception to this recommendation is the sleepy infant who cannot be enticed to take the second breast after being removed from the first side. In this case, letting the baby nurse longer on the first breast is preferable to interrupting nursing on the first side and then having the baby refuse the second side altogether.

If your baby sucks vigorously for only a few minutes and then stops, try arousing her and switching her to the other breast. You can keep her on the first breast as long as she swallows after every couple of sucks. When her swallowing slows down or she starts to doze off, remove her from the breast, try to bring her to a more wakeful state, and switch her to the other side. This "switch nursing" method will provide her with more milk than allowing her to drift off at the first breast.

Is My Baby Getting Enough Milk?
Even though you can't see exactly how much milk your baby takes while nursing, observant parents usually can tell whether breastfeeding is off to a good start. If your baby can latch on to both breasts well, nurses often with frequent audible swallowing, seems contented after feedings, wets six or more diapers, and has at least four yellow bowel movements each day, she is probably thriving. The following questionnaire developed at the Lactation Program in Denver has proved useful in distinguishing whether breastfeeding is off to a successful start or whether additional help is necessary. If you have any concerns, call your baby's doctor and arrange to have your infant weighed. Remember, if a problem is caught early, it is easier to solve.

Early Breastfeeding Screening Form
Please complete this screening form when your baby is four to six days old. If you circle any answers in the right-hand column, call your baby's doctor to arrange for further evaluation. The earlier problems are identified, the easier they are to correct. Ask your doctor to refer you to a lactation consultant who can observe your nursing technique and provide one-on-one assistance.

Do you feel breastfeeding is going well for you so far?	Yes	No
Has your milk come in yet? (That is, did your breastsget firm and full between the second and fourth post-partum days?)	Yes	No
Is your baby able to latch on to your breast withoutdifficulty?	Yes	No
Is your baby able to sustain rhythmic sucking for atleast ten minutes total per feeding?	Yes	No
Does your baby usually demand to feed? (Answer "No"if you have a sleepy baby who needs to be awakenedfor most feedings.)	Yes	No
Does your baby usually nurse at both breasts at eachfeeding?	Yes	No
Does your baby nurse approximately every two tothree hours, with no more than one longer interval ofup to five hours at night? (at least eight nursings eachtwenty-four hours?)	Yes	No
Do your breasts feel full before feedings?	Yes	No
Do your breasts feel softer after feedings?	Yes	No
Are your nipples extremely sore? (for example, causingyou to dread feedings?)	No	Yes
Is your baby having yellow, seedy bowel movementsthat look like cottage cheese and mustard?	Yes	No
Is your baby having at least four good-size bowelmovements each day? (that is, more than a "stain" onthe diaper?)	Yes	No
Is your baby wetting his/her diaper at least six timeseach day?	Yes	No
Does your baby appear hungry after most feedings?(that is, crying, sucking hands, rooting, often needinga pacifier?)	No	Yes
Do you hear rhythmic suckling and swallowing whileyour baby nurses?	Yes	No

Copyright © Lactation Program, Denver, CO. Used with permission.