Hong Kong Sanatorium & Hospital
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Breastfeeding

 



Q1. How to tell if your baby is getting enough milk?
Many mothers, especially those who exclusively breastfeed, may worry if their babies are getting enough milk. And the signs to look out for are first the nursing frequency and second the number of diapers, as a newborn should have one diaper with stool and one wet diaper on the first day, followed by two of each on the second day, and so on. After the milk comes, or after 5 days, there should be at least 6 to 8 wet diapers and 3 to 6 diapers with stool each day. The third sign is your baby’s weight gain, for it is normal for a baby to lose some weight after birth and return to their birth weight within 10 to 14 days. The fourth one is its jaundice level. Asian babies are more likely to have jaundice, some of which may have to do with breastfeeding. Finally, you baby feels full if it looks content and relaxed after feeding. All these signs help you determine if your baby is getting enough milk.
 
Q2. How often should babies be breastfed?
Many mothers often ask, “Am I feeding my baby too often or too little? It is recommended to feed them “on demand”, or follow the baby’s cues and needs. Typically, babies should be breastfed at least 8 to 12 times a day, or at least every 3 hours. Mothers who exclusively pump should pump at least 6 to 8 times per day.  As prolactin stimulates milk secretion and is at its highest level from 12:00 am to 6:00 am, don’t forget to feed or pump at night. It is also recommended to offer both breasts at feedings: if you start with the left breast, then offer right one, and alternate at the next feeding.
 
Most babies experience growth spurts from week 2 to week 3 as well as during week 4 and week 6. Milk production is stimulated during these periods as babies tend to nurse more often to keep up with their needs. Whether one breastfeed or bottle-feed, the amount of breastmilk, nursing frequency, etc. will mostly become stable after week 6.
 
Q3. Is it OK to skip a night feeding? Should I wake up my baby for feeds?
Newborns have small stomachs and may wake up from sleep for various reasons. With prolactin at its highest level from 12:00 am to 6:00 am, for newborns make sure that it is no more than 3 hours between feeds. A baby should be fed as frequently as it wants once it has returned to its birth weight. Babies may wake up in the middle of the night for different reasons such as hunger, colic, pooping and wetting diapers, fright, etc. And breastmilk can provide babies with nutrients and soothe their minds. Mothers can breastfeed their babies whenever babies wake up in midnight. 
 
Q4. Should mothers continue to breastfeed when falling ill?
Mothers should continue to breastfeed if they or their babies fall ill. It is normal for babies, especially those who are exclusively breastfed, to nurse more frequently when unwell. Mothers are advised to consult their doctors when feeling sick and take medications as prescribed. Many may wonder if it is ok to breastfeed while taking medicine. And the truth is there is no cause for worry as most medicines are safe to use while breastfeeding.
 
Milk supply may drop temporarily during an illness. It will increase upon recovery. Although antibodies can be passed to the baby through breastmilk, mothers should observe personal hygiene when falling ill, such as washing hands before touching the baby. In case of upper respiratory infection, try to minimise the risk of infecting the baby by wearing a mask. 
 
Q5. How can mothers prepare to return to work?
As most breastfeeding mothers are concerned about getting back to work, better start storing milk 4 to 6 weeks in advance. Mothers who exclusively breastfeed need 1 to 2 more pumping sessions a day, often with the help of a double pump. Bottle feeding can be introduced so that other caregivers or family members can help with the feeding. In office, you may need a private and comfortable place for milk pumping as well as a fridge for milk storage. Consult a lactation consultant to address all related issues even you cannot pump breastmilk at work. 

Check out YouTube videos [1] from HKSH Medical Group for more health information.
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Source URL: https://www.hksh-hospital.com/en/Ask%20Dr.HKSH/54

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[1] https://www.youtube.com/channel/UCeCVnmGUmLAL37PB7S3Kk6A