What Should I Do? (Baby Edition)

Learn About Wonders Of Breastmilk

Nursing your baby on breastmilk is not just good for the baby, it's also great for the mother. How is breastmilk produced? What components in breastmilk are good for the baby, and why?...

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Hints For Continuing To Breastfeed

For better breastfeeding, here are some helpful hints....

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What Should I Do? (Mother Edition)

“I don’t think I have enough breastmilk…” “I’d like to go back to work.” We’ll answer these and others questions about the mother’s body and lifestyle....

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What Should I Do? (Baby Edition)

“My baby doesn’t seem to be gaining enough weight…” “My baby bites my nipples…” We’ll answer these and other questions about the baby’s body and condition....

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To First-Time Father

When your first child is born, your wife will be filled with anxiety about herself and about your baby....

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To Medical Personnel

This information is about the various conditions that prevent babies from nursing directly from the breast. We introduce various products for low-birth-weight babies, babies with cleft palates, and baby...

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Babies grow at different rates

You may sometimes worry that your baby isn't gaining weight, and wonder if your baby is drinking breastmilk appropriately, or if if breastmilk alone is not enough

Each baby grows at his own pace. One baby may seem to be growing at a fast pace, while another seems to be growing at a slow pace. Babies sometimes don't gain much weight even if they drink enough breastmilk, so there's really no need to be concerned.

Also, it is said that newborn babies lose 10% of their body weight during the first few days after birth.

This is a physiological phenomenon that is caused by the elimination of excess body fluid, which babies retain inside the uterus.

Babies usually return to their birth weight 2-3 weeks after birth when breastfeeding is going normally.

How to determine if your baby is gaining weight adequately

Determine if your baby is gaining weight appropriately not only by whether he is drinking enough breastmilk, but also by whether your baby is energetic, how much urine is released, how your baby drinks breastmilk, the characteristics of the breastfeeding rhythm. Develop an eye for determining if your baby is getting enough breastmilk.

If you observe signs such as the baby being unenergetic and not responding well, the diapers not being wet often, infrequent bowel movements, an inconsistent breastfeeding rhythm (breastfeeding sessions are too long, intervals are too short, your baby can't drink appropriately), consult doctors, midwives or consultants.

If your baby doesn't gain weight steadily, the possible causes include lack of breastmilk intake, which means that breastmilk is insufficient in quantity, and hyposecretion of breastmilk. Don't try to judge the production quantity by yourself; seek advice from a specialist.

Signs that a newborn is receiving sufficient breastmilk

  • He breastfeeds at least eight times in 24 hours.
  • During a feed, his suckling rhythm will slow down as milk is released, and swallowing or gulping may be heard.
  • He is alert, and has good muscle tone and healthy skin.
  • He is contented between feeds (though well-fed babies may be fussy for other reasons, leading mothers to believe they don't have enough milk).
  • He has six or more wet diapers in 24 hours; with pale, diluted urine.
  • He will have three to eight bowel movements in 24 hours. As babies grow older, stooling may be less frequent.
  • He shows a consistent weight gain, with an average of 18-30 grammes/day.
  • The mother's breasts may feel full before a breastfeed and softer afterward, though not all women experience a dramatic change.

(Source: UNICEF WHO, "UNICEF/WHO Breastfeeding Management and Promotion in a Baby-Friendly Hospital, an 18-hour course for maternity staff", 1993, p. 68)

Signs that a baby is not gaining weight adequately

  • He grows less than 18 grammes/day.
  • He has not recovered his birth weight by three weeks.
  • His growth line is not rising appropriately on the growth curve.
  • He sleeps for long periods of time to conserve energy.
  • He seems lethargic and has a weak or high pitched cry.
  • His urine output may be low with concentrated urine; or urinary output may be normal.
  • Urinary output alone is not a reliable measure of weight gain.
  • He has very few stools, or none at all.
  • He may stay at the breast consistently.
  • He may have a worried look on his face, with hanging folds of skin on his body.

(Source: UNICEF WHO, "UNICEF/WHO Breastfeeding Management and Promotion in a Baby-Friendly Hospital, an 18-hour course for maternity staff", 1993, p. 69)

Relax, and establish a breastfeeding style that suits you and your baby.

Signs and reasons that your baby can't latch on well

It takes some time to learn to breastfeed a newborn baby appropriately because both you and your baby are not used to it.

Sometimes the baby can't latch on to the breast well, or can't keep sucking.

If the following signs are present, then there is a possibility that your baby is not latching on well.

  • Nipple is flat or has streaks
  • Nipple hurts
  • Breasts engorge
  • Suckling callus on baby's lips

If your baby can't latch on well, your nipples may hurt after breastfeeding or your breasts may feel engorged because enough breastmilk wasn't taken. It may be hard until you get used to it, but be patient and continue breastfeeding until you find the breastfeeding style that suits you and your baby.

We would also explain how to let baby latch on to mother's breast well.

The most important thing to make it easier for your baby to latch on is for both of you to relax. Breastfeeding is a time for the two of you to have physical contact with each other and nurture bonding in a relaxed state. Take it easy and create an environment in which both of you can have physical contact while breastfeeding and in which your baby can latch on at her own initiative.

Reasons for not being able to latch on, and methods of coping

  • Your baby twists her neck when breastfeeding.
  • Method of coping: Hold your baby close to your breast and keep her face at the same level as the breast, facing it.
  • Your baby's mouth isn't open wide.
  • Method of coping: Tickle your baby's lips with tip of your nipple and wait until your baby opens her mouth wide.
  • The breast is so engorged that the nipple is flat.
  • Method of coping: If your breast is too engorged, express your milk to help the nipple stick out.
  • The nipple is inverted.
  • Method of coping: Use a nipple puller or breast shell to pull the inverted nipple out before breastfeeding.

Reasons for not being able to continue latching on and methods of coping

  • The baby has to stretch, twist or move her neck to continue sucking on the breast.
  • Method of coping: Hold your baby close to your breast and keep her face at the same level as your breast, facing it.
  • Your baby can't breathe while latching on.
  • Method of coping: Don't bend your baby's head forward.
  • Your baby's mouth releases the breast because her head isn't held tightly enough.
  • Method of coping: Hold your baby with a side hold and hold her head with your hand.
  • The breastmilk is released too strongly
  • Method of coping: If the breast is too engorged, express your milk to help the nipple stick out.

One form of communications between you and your baby

The baby's appearance, how the baby drinks breastmilk, the amount and frequency of urine and feces output and the baby's body weight are indicators of whether enough breast milk is being produced.

Baby's frequent crying and slight engorgement of the breast do not indicate that insufficient breastmilk is being produced.

Breastmilk production increases and the amount of breastmilk stabilizes as you continue to breastfeed.

Reason why babies bite nipples

Your baby may sometimes bite your nipple when he gets used to breastfeeding.

This is nothing to worry about; it's not a sign that you're not producing enough breastmilk or that your breastmilk doesn't taste good.'Exploring sucking or exploratory sucking' can be seen 3 months after the birth. Even though he should be hungry and ready to nurse, your baby will roll your nipple with his tongue, smile with the nipple in his mouth, and may seem to play without concentrating on breastfeeding. At that time, your baby may bite your nipple, but it doesn't mean that he hasn't had enough breastmilk or doesn't like breastmilk any more. It's a phase in which the tongue and lips start moving in various ways, and your baby explores and enjoys moving his tongue and lips.

Although this varies among individuals, your baby will cut his first tooth about 7-8 months after birth, and will sometimes bites your nipple during breastfeeding at this time as his gums feel itchy.

This is tough on you, as it certainly hurts, but your baby isn't refusing to drink breastmilk. Don't scold your baby, but treat him well.

Breastfeeding becomes painful when the nipple is bitten and injured, either when your baby is exploring and cutting his first tooth. When that happens, take care of the nipple appropriately, following guides for care.

Reasons on the baby's side and methods of coping

Inappropriate timing

Feeling sleepy (Your baby won't drink breastmilk appropriately when she is sleepy or shortly after she wakes up.)

Not hungry (Your baby may still be satisfied with the breastmilk that she had the last time, and may just not be ready for the next breastfeeding session.)

Method of coping: Breastfeed your baby after she is fully awake and is ready for breastfeeding. Your baby may not be able to latch on well shortly after she wakes up, or when she is sleepy. Adapt to the baby's breastfeeding rhythm.

Methods of how your baby drinks

  • Inability to latch on (There is a possibility that your baby isn't positioned properly or she isn't latching on appropriately.)
  • Not used to drinking breastmilk (Your baby won't always be able to drink well shortly after birth.)
  • More used to bottle-feeding

Method of coping: Check the appropriate positioning and latch on.

If your baby can't latch on even when she is positioned correctly, check if she is taking hold of the breast tightly with her mouth wide open. 

Poor physical condition

  • Constipation, insufficient burping, stuffy nose, fever, temporary bad health, inability to relax
  • Diseases (cleft lip and palate, cerebral palsy, internal disease, allergies, etc.)

Method of coping:Let your baby burp sufficiently before the next breastfeeding. Don't forget to check if your baby has a stuffy nose or constipation.

Consult a doctor if the case of poor health if the cause is unknown.

If your baby has disabilities, don't act on your own judgment; consult doctors, midwives or consultants.

Reasons on the mother's side and methods of coping

1. Excessive breastmilk production: Your baby chokes on the excess breastmilk.

Method of coping:This is common shortly after the baby's birth.

Once breastmilk production has stabilized, milk doesn't spurt out as often when your baby latches on.

This problem also decreases as your baby becomes used to breastfeeding.

When your baby releases the nipple because of spurting breastmilk, stop the flow using a towel, and once things are calm, try again.

2. Inappropriate positioning: The breastfeeding position is making your baby uncomfortable

Method of coping: It's possible that your baby isn't positioned appropriately, and doesn't have good latch on. Check the appropriate breastfeeding positioning and latch on.

If your baby can't latch on even when she is in the right position, check whether she is catching the nipple tightly with the mouth wide open.

3. Problems with breasts and nipples

(a) The nipple is inverted or flattened

If the mother's nipple is inverted or flattened

Method of coping: There are several methods that can be used. Moms can use a method called "reverse pressure softening"--a technique in which a mom can use her fingers to gently soften the circle around her nipple and areola. This technique briefly moves some of the swelling back and up into her breast to soften her areola. Pushing back the swelling also makes it easy to remove milk with her fingertips or with short periods of slow gentle pumping, combined with gentle forward massage of the upper breast, if you need to remove milk for your baby (Source: K. Jean Cotterman RNC, IBCLC.) Alternatively, a mom can use a nipple puller to evert the nipple using gentle suction.

If the nipple is flattened because of breast engorgement, a little milk expressionmakes the breast softer and makes it easier for your baby to latch on. Be sure that production of breastmilk from both breasts is stable.

(b) Engorgement(engorgement of one breast makes it difficult for your baby to latch on)

When one breast is so engorged that it's hard for your baby to latch on

Method of coping:If the nipple is flattened because of breast engorgement, a littlemilk expression makes the breast softer and makes it easier for your baby to latch on. Be sure that production of breastmilk from both breasts is stable.

If you're still having problems even after trying these coping strategies, don't act on your own, but consult doctors, midwives or consultants.

4. Inability to relax

Caused by impatience due to insufficiency (pressure to product breastmilk), mental fatigue caused by stress, etc.

Method of coping: Both you and your baby need to be relaxed.

The mother's ability to relax is the most important factor in the baby being able to latch on comfortably. If your baby is agitated, relax her by taking a walk in a park or by holding her tightly in your arms.

Let your baby drink bottled milk the same way he drinks breastmilk

Reasons and methods of coping

Feeling sleepy

Your baby may not be used to using a bottle especially when he is sleepy or shortly after he wakes up.

Method of coping: Give your baby milk after he is fully awake.

Give your baby milk after he has woken up and is ready to drink. Your baby may not latch on well shortly after he wakes up or when he is sleepy.

Not hungry

Your baby may still be satisfied with the amount of breastmilk he had at the last feeding, and may just not be ready for the next feeding session.

Method of coping: Don't rush and don't force your baby to take the milk.

Breastmilk is more easily digested than infant formula, so your baby may feel hungry after a short time. Also, breastfed babies regulate the amount of breastmilk they need when feeding at the breast though when she is offered milk in a bottle, she may drink all contents from a bottle. If you are not exclusively breastfeeding and are supplementing with formula, your baby may prefer the breastmilk. Moms are often concerned that their baby isn't drinking enough milk or that he isn't gaining weight smoothly, but try to relax and keep an eye out for the indications and signs that show that your baby is getting enough breastmilk, then trust in the signs.

If you feel that either breastmilk or infant formula is insufficient, consult doctors, midwives or consultants.

Discomfort in the feeding position

It is natural to use a breastfeeding position even when you are bottle-feeding.

Method of coping: Give your baby milk in a position that relaxes him.

Your can help your baby feel relaxed during a feeding.

Your baby is not able to relax

Method of coping:Try to relax your baby.

Your baby is sensitive to slight changes in the environment. If your baby feels anxious because the environment is different from usual or the weather is bad, try to make him feel relaxed by taking a walk or carrying him.

Health problems/Birth defects such as cleft lip and palate

Using inappropriate size of the nipple for nursing bottle

Your baby finds drinking milk stressful when too much or too little milk comes out.

Method of coping:Select the appropriate nipple size.

When your baby refuses the baby bottle, there is a possibility that the nipple for the nursing bottle is not the right size. Your baby finds drinking milk stressful when too much or too little milk comes out. Check the nipple size again and select the appropriate nipple size.

Make enough time to enjoy the breastfeeding period.

You may give your baby milk 8-10 times a day when you breastfeed her. Newborn babies may drink breastmilk as often as 12 times a day. Each breastfeeding period ranges from 10 to 30 minutes. Sometimes there are 10-minute breastfeeding sessions 3-4 times close together and sometimes your baby drinks milk for 20-30 minutes and then sleeps for 5-6 hours.

It may be hard for the mother when the breastfeeding periods and the intervals between are not stable shortly after the baby's birth, but the most important thing is to give the baby sufficient breastmilk and to allow both you and your baby to enjoy the precious breastfeeding period.

When the breastfeeding period is too short

When the breastfeeding period is excessively short (it lasts only for a few minutes), or the interval is too short (your baby begins to cry after 30 minutes), the following reasons may be responsible

  • Your baby can't latch on well
  • How to hold your baby and help your baby latch on. Your baby can't latch on to the breast well
  • Poor health of baby, vomiting
  • Deconditioning / Vomiting / Medical section
  • There are problems with the mother's breast

When the breastfeeding period is too long

When the breastfeeding period is excessively long, lasting for as long as 40-60 minutes (including when the baby drinks intermittently), the following reasons may be responsible.

  • Your baby can't latch on well
  • How to hold your baby and help your baby latch on. Your baby can't latch on well (Exploratory suckling, etc.)
  • Your baby refuses to drink breastmilk
  • Your baby is drinking breastmilk not for the nutritional intake, but for the feeling of security
  • (formation of bond between you and your baby).

It may be a sign of weaning

If your baby is around 1 year old, has started to eat baby food (supplemental food), and has a very short breastfeeding period or only drinks intermittently and doesn't seem to want to drink milk, it may be a sign of weaning.

Although WHO recommends that you continue to breastfeed until the baby is 2 years old or older, even after he starts eating baby food (supplemental food), some babies stop drinking milk naturally. Consider weaning in consultation with a professional, and be sure not to force weaning.

When a mother takes drugs, most of them are transferred to the breastmilk and then more or less to the baby.However, only a few drugs harm breastmilk, and most drugs are safe for mothers during the breastfeeding period.Considering the baby's healthy growth, the advantages of breastfeeding are said to outweigh the risks of drugs, but you need to obtain the advice of a medical specialist and evaluate appropriately the detriments and danger of stopping breastfeeding with the amount of drugs that are transferred to the breastmilk, as the risks depend on the kind and amount of the drug.