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Sunday, December 8, 2013
5 nursing sessions/day
Hi, I have a breastfeeding question that I cannot seem to find an answer to. First off, my baby girl is 9 weeks 3 days old. She weighed 8lbs 7 oz. at birth. On her 2 month check up, one week ago she wieghed 12lbs 2 oz. She has been breastfed exclusively from birth. Twice she was given a bottle while I was away but I pumped. I have never been very successful at pumping (with my first baby I nursed until she was 11 months, never able to pump more than 2-3 oz. even at feeding time) Anyway, she has been a very content baby, never asking to nurse sooner than 2.5-3 hours during the day and sleeping through the night (6+ hours) from three weeks old. I began waking her when she did that, not allowing her to go longer than 5 hours between feeds. When I took her in at one month I told my doctor that she had been sleeping that long at night and he said not to wake her as long as she was content and gaining fine. She is. So I stopped. She began extending her daytime sleep as well about at about 6 weeks old. I found I was continually having to wake her up to not let her exceed the three hour mark. Again my doctor said to allow her to sleep. So I did. Then her routine began to look like she nursed every four hours for the first part of the day and every 3 hours the second half of the day. A typical day looked like this: typically she would awaken around 6-7, having slept all night- receiving her last feeding around 10 the night before. If she awoke at 7, she might not wake to nurse until 10:30 or 11. Then she would stay awake awhile and go back to sleep, going another four hour stretch. Then she would wake around 2:30 or 3 (depending on what time the earlier feeding took place). From then on she would nurse at 5:30 or 6. Then anywhere between 8:30-9. If on the earlier side I would nurse her again before I put her down for the night even if the previous feeding was only an hour and a half ago. Now, this usually totals to 5 feedings a day. I worried about this at first, not for her sake as much as the sake of my milk supply. She seems to be very content, gaining well and also having at least one bowel movement a day. Usually more, especially since she began eating fewer times(?). So I tried to look at this and feel ok about her eating only 5 times a day. A friend of mine loaned me a baby scale the other day. I began weighing her after every feeding and the uneasiness returned. She usually only weighs about 4-6 oz after nursing. At five times a day she would only be taking around 20 oz. a day. She weighed more in the morning after nursing (almost 7 oz.) As the day progressed she would take in less, finishing at night only weighing about 3.5 oz. after nursing. In your opinion, how accurate are these scales generally in telling you how much your baby ate? And do you think my milk supply will be okay with only the five nursing sessions? I do not want to begin waking her (I have another child and I also work from home- I need the time she sleeps in the day as well as my rest I recieve at night). But breastfeeding is very important to me. I enjoy it tremendously and I know it is best for both me and my daughter. Will my milk supply decrease if I continue to allow this much time to pass between feedings? I understand the milk production is based a lot upon removing it from the breast. As long as the milk is being removed, does it matter if 2-3 oz are being removed every 2-3 hours versus 4-6 oz being removed every 3-4 hours? And what can I do to increase the milk supply that I have. If I am not willing to wake her, should I add pumping sessions? should I set an alarm and pump in the night? If you would please respond with your suggestions it would be greatly appreciated. Thank you. Kind Regards.
First, if you baby is gaining weight, happy and content, quit worrying! She is obviously getting enough food for growth. As long as she gains an average of ½ ounce per day, she is getting enough to eat. (this means on an average that they double there birth weight by six months, and triple by one year)
The accuracy of the scale depends on the scale model and a variety of other things. I generally don't recommend that you look at them after each feeding, because the often frustrate parents(like you!) Weekly weights can be helpful, to reassure you that your baby is gaining weight. But remember the scale will be different than the physician's and accuracy is often a problem with "home" baby scales.
Your milk supply is based on her needs, and her ability to empty the milk. If you are really worried about your milk supply you could pump between feedings, but remember you won't get the same amount of milk that your baby would get. A mechanical pump is simply not as effective as a baby in emptying you breast. The advantage of this is that it would also give you some milk for those occasions when you want to be away from your baby.
Keep up the good work!
Tina Weitkamp, RNC, MSN
Associate Professor of Clinical Nursing
College of Nursing
University of Cincinnati