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Thread: Growth spurts vs milk supply

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    #1

    Growth spurts vs milk supply

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    What was your newborn's typical behavior during a growth spurt? I know one week is a normal time to have one, but I can't help but be concerned. He's kind of a sleepy baby, but normally wakes up on his own every 2-3 hours to nurse before falling back to sleep. This morning when he woke up at 5ish, he cluster fed every hour or less straight up until 11:30... I was completely exhausted and I was really worried about my milk supply because I felt so empty. He's still having wet and dirty diapers, and I notice milk at his lips but I feel significantly less full than I did yesterday. After he fell asleep around noon, he slept for almost 5 hours and I finally had to wake him up for the first time ever to feed. Since then, he's just really sleepy. He falls asleep at the breast and doesn't seem to be gulping as much or taking nearly as much as he has been since my milk came in. And I definitely don't feel as full.

    I had to start using a nipple shield a couple days ago because he has a small chin that he pulls back and compresses my nipple with every latch no matter what I do and my nipples were so cracked and bleeding and I was in horrible horrible pain. It's the Medela brand that's silicone and claims not to affect your supply. I don't have a pump yet because I ordered one through my insurance and it hasn't shipped yet. Should I go buy one and pump between feedings to increase my supply? Or should I just keep watching it until his check-up Thursday to see if he's gaining weight? Breastfeeding is so stressful.
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    Here is some good information:


    Breastfeeding your newborn — what to expect in the early weeks

    September 2, 2011. Posted in: Breastfeeding Basics,What is Normal?




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    By Kelly Bonyata, BS, IBCLC


    Image credit: jcgoforth on flickr

    The First Week

    How often should baby be nursing?

    Frequent nursing encourages good milk supply and reduces engorgement. Aim for nursing at least 10 – 12 times per day (24 hours). You CAN’T nurse too often–you CAN nurse too little.

    Nurse at the first signs of hunger (stirring, rooting, hands in mouth)–don’t wait until baby is crying. Allow baby unlimited time at the breast when sucking actively, then offer the second breast. Some newborns are excessively sleepy at first–wake baby to nurse if 2 hours (during the day) or 4 hours (at night) have passed without nursing.

    Is baby getting enough milk?

    Weight gain: Normal newborns may lose up to 7% of birth weight in the first few days. After mom’s milk comes in, the average breastfed baby gains 6 oz/week (170 g/week). Take baby for a weight check at the end of the first week or beginning of the second week. Consult with baby’s doctor and your lactation consultant if baby is not gaining as expected.

    Dirty diapers: In the early days, baby typically has one dirty diaper for each day of life (1 on day one, 2 on day two…). After day 4, stools should be yellow and baby should have at least 3-4 stools daily that are the size of a US quarter (2.5 cm) or larger. Some babies stool every time they nurse, or even more often–this is normal, too. The normal stool of a breastfed baby is loose (soft to runny) and may be seedy or curdy.

    Wet diapers: In the early days, baby typically has one wet diaper for each day of life (1 on day one, 2 on day two…). Once mom’s milk comes in, expect 5-6+ wet diapers every 24 hours. To feel what a sufficiently wet diaper is like, pour 3 tablespoons (45 mL) of water into a clean diaper. A piece of tissue in a disposable diaper will help you determine if the diaper is wet.

    Breast changes

    Your milk should start to “come in” (increase in quantity and change from colostrum to mature milk) between days 2 and 5. To minimize engorgement: nurse often, don’t skip feedings (even at night), ensure good latch/positioning, and let baby finish the first breast before offering the other side. To decrease discomfort from engorgement, use cold and/or cabbage leaf compresses between feedings. If baby is having trouble latching due to engorgement, use reverse pressure softening or express milk until the nipple is soft, then try latching again.


    Call your doctor, midwife and/or lactation consultant if:
    ◾Baby is having no wet or dirty diapers
    ◾Baby has dark colored urine after day 3(should be pale yellow to clear)
    ◾Baby has dark colored stools after day 4(should be mustard yellow, with no meconium)
    ◾Baby has fewer wet/soiled diapers or nurses less frequently than the goals listed here
    ◾Mom has symptoms of mastitis(sore breast with fever, chills, flu-like aching)




    Weeks two through six

    How often should baby be nursing?

    Frequent nursing in the early weeks is important for establishing a good milk supply. Most newborns need to nurse 8 – 12+ times per day (24 hours). You CAN’T nurse too often—you CAN nurse too little.

    Nurse at the first signs of hunger (stirring, rooting, hands in mouth)—don’t wait until baby is crying. Allow baby unlimited time at the breast when sucking actively, then offer the second breast. Some newborns are excessively sleepy—wake baby to nurse if 2 hours (during the day) or 4 hours (at night) have passed without nursing. Once baby has established a good weight gain pattern, you can stop waking baby and nurse on baby’s cues alone.

    The following things are normal:
    ◾Frequent and/or long feedings.
    ◾Varying nursing pattern from day to day.
    ◾Cluster nursing (very frequent to constant nursing) for several hours—usually evenings—each day. This may coincide with the normal “fussy time” that most babies have in the early months.
    ◾Growth spurts, where baby nurses more often than usual for several days and may act very fussy. Common growth spurt times in the early weeks are the first few days at home, 7 – 10 days, 2 – 3 weeks and 4 – 6 weeks.

    Is baby getting enough milk?

    Weight gain: The average breastfed newborn gains 6 ounces/week (170 grams/week). Consult with baby’s doctor and your lactation consultant if baby is not gaining as expected.

    Dirty diapers: Expect 3-4+ stools daily that are the size of a US quarter (2.5 cm) or larger. Some babies stool every time they nurse, or even more often–this is normal, too. The normal stool of a breastfed baby is yellow and loose (soft to runny) and may be seedy or curdy. After 4 – 6 weeks, some babies stool less frequently, with stools as infrequent as one every 7-10 days. As long as baby is gaining well, this is normal.

    Wet diapers: Expect 5-6+ wet diapers every 24 hours. To feel what a sufficiently wet diaper is like, pour 3 tablespoons (45 mL) of water into a clean diaper. A piece of tissue in a disposable diaper will help you determine if the diaper is wet. After 6 weeks, wet diapers may drop to 4-5/day but amount of urine will increase to 4-6+ tablespoons (60-90+ mL) as baby’s bladder capacity grows.

    Milk supply?

    Some moms worry about milk supply. As long as baby is gaining well on mom’s milk alone, then milk supply is good. Between weight checks, a sufficient number of wet and dirty diapers will indicate that baby is getting enough milk.



    This information is also found as part of the professional Breastfeeding Logs.
    http://kellymom.com/bf/normal/newborn-nursing/
    http://militarysos.com/forum/image.php?type=sigpic&userid=8121&dateline=1213248817 TAKEN AT NISQUALLY WILDLIFE PRESERVE
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    If he is not waking up, I was told when I was breastfeeding, to take blankets and clothing off to cool them off. Lightly tap on their feet or move their arms to get them to wake up. Strip down to the diaper if you need to. This will help with waking your little one up and get him to nurse every 2 to 3 hours and will help to establish your milk supply.

    Newborns can tend to be sleepy at first and you need to help them establish a routine so they get enough and help your supply to get built up enough.
    http://militarysos.com/forum/image.php?type=sigpic&userid=8121&dateline=1213248817 TAKEN AT NISQUALLY WILDLIFE PRESERVE
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    I never had to wake him up before today, though, he's been waking up on his own just fine. Then the sudden cluster feeding, followed by being really sleepy and not wanting to wake up. I would write it off as a growth spurt if I didn't feel so empty... that's really what concerns me.
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    Since this is the first time I would just monitor him. Make sure he wakes for his feedings even if you have to set the alarm. Feeling empty will happen when they cluster feed like that. But your body will produce more. Make sure you drink plenty of liquid, preferably water, to make it easier for your body to produce more milk. He could be one of those babies who cluster feeds and sleeps a lot just before a growth spurt but as young as he is I would still try to get him to feed every couple of hours because it is better for both of you to keep your supply from drying up.

    And if he continues to have trouble waking and nursing I would check with your doctor to make sure everything is going well. You might want to keep a journal for now with times of feeding, how long, number of wet diapers, how often you have to wake him etc so you can really get an idea and can report to your doctor or the lactation nurse.

    This being the first time I wouldn't stress to much but I would wake him and offer the breast from this point on.
    http://militarysos.com/forum/image.php?type=sigpic&userid=8121&dateline=1213248817 TAKEN AT NISQUALLY WILDLIFE PRESERVE
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    Cluster feeding is great and normal. It's his natural way to boost your supply for an up co ing growth spurt. Babies eat like they are ordering their next day meal just keep an eye on his diapers, and slowly start to work off the shield. Shields are meant for a short fix, but over time can cause more damage then help.
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    I keep trying an occasional feed without it, but no matter how wide I get him to open his mouth or how deep I can manage the latch, he tucks his chin and bottom lip under and it hurts like hell. Any advice on that? All the lactation consultant at the hospital could give me was to have my husband try pulling his jaw down during the feedings which makes zero sense since he's not present for all feedings, and when we've tried it, doesn't work anyway.
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    I'm 90% sure this is the problem... it sounds exactly like what I'm experiencing. And now I'm terrified there's something neurologically wrong with him.

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    Could it be a tongue tie?

    LLLI | Tongue-Tie and Breastfeeding

    eta: if it is a possibility, EBFing is definitely still possible! Your local LLL could likely help guide you to a doctor, dentist, or ENT who can revise the tie to help make BFing more comfortable for you both. It does sound like you guys are doing well otherwise though!
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    Quote Originally Posted by happy_mama View Post
    Could it be a tongue tie?

    LLLI | Tongue-Tie and Breastfeeding

    eta: if it is a possibility, EBFing is definitely still possible! Your local LLL could likely help guide you to a doctor, dentist, or ENT who can revise the tie to help make BFing more comfortable for you both. It does sound like you guys are doing well otherwise though!
    It's definitely a possibility. I feel his bottom gums chomping and him pulling his tongue back while nursing, and it's with every suck. I started pumping today and giving him bottles and I'm definitely not pumping enough. We've been having to supplement with a few bottles of formula. I think maybe his poor latch, especially on the nipple shield, wasnt stimulating enough but after one day of pumping I already feel like it's starting to increase again. So I'm going to focus on boosting my supply and ask the doctor to check his tongue at his appointment. I'm hoping that's what it is so we can fix it and hopefully be able to nurse again.

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