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Breastfeeding Quiz:  How Much Do You Know About Your 1-Month-Old Breastfed Baby (4 of 4)

Hard to believe that a month has gone by!  You and your baby are a team... you have your routines, mostly. You know when he likes to eat, likes to sleep, if he’s the kind of kid who hates being in a wet diaper or if he’ll sleep through the noise of the vacuum cleaner.

Here are a few questions that will make you think.

1. My month old exclusively breastfed baby should be:

       a. given a bottle of expressed breastmilk by my partner so I can sleep through the night.

       b. eating every 4 hours and sleeping for 4 hours in between.

       c. offered my breast whenever he displays feeding cues, like hand sucking or breathy vocalizations. If I keep him close, I won’t miss these communications.

2. I have noticed that my baby sleeps for several hours when:

       a. he feeds rhythmically and continuously from one breast per feed and detaches spontaneously. He doesn’t want to re-latch when stimulated.

       b. I stop him from sucking and swallowing on one breast after 5 minutes and switch him to the other breast for 5 minutes. He would re-latch if I let him.

       c. I give him 2 ounces of EBM or formula by bottle after every feeding. He needs some coaxing but will take the nipple. He spits up a lot.

3. My breastfed baby was having 6 bowel movements a day, now he only has 1 or 2. My sister’s formula fed baby has 4 nearly every day. What should I do?

       a. nothing. A soft yellow stool, once a day is normal for a 1 month old, exclusively breastfed baby. By 6 weeks, he’ll likely skip days.

       b. give him 2 oz of sugar water (1 teaspoon in 8 oz of water) in between feedings.

       c. stimulate his rectum with a pediatric glycerin suppository or well-lubricated thermometer if he doesn’t have a bowel movement every day.

ANSWERS:

1 – c.  Most breastfed babies don’t sleep through the night at the age of 1 month.  Night time feedings are critical for signaling your body to make enough milk in the following 24 hours to satisfy your baby’s growing appetite. Your prolactin level (one hormone involved in milk production) rises with sleep. You need to move your milk out when your baby awakens to feed in the night or you’ll be telling your body... I don’t need this much milk.  You’ll be plenty full in the morning but production will decrease and you’ll have a fussy feeder come 4 or 5 o’clock the next afternoon... not enough milk!

2 a. Feeding on one breast per feed is the best way to get your fatty hindmilk into your baby. The fat content of your milk rises with each let down. Your breasts are able to have a renewed volume of milk every 5-7 minutes, therefore your baby will get a more complete feeding if you stay on one breast.  Your thinner, free-flowing foremilk – designed to keep baby swallowing and content when most hungry – comes first, followed by fattier and fattier milk with each subsequent letdown. 15 minutes of sucking and swallowing gets him to the heavy cream... fat + full stomach = sleepy baby.

3 – a.  Breast milk contains 90% liquid and 10% solids. This translates into lots of urine and less solid matter.  Formula is a 50-50 blend. More undigestable solids = more poop. There’s never a good reason to offer sugar water and rectal stimulation always needs to be discussed with your healthcare provider first.

Paula Zindler

RN IBCLC

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