Breastfeeding: How to Tell if Things are Going Well, and Things to Watch For

If we don’t know what to expect from breastfeeding the first time, it can be a really stressful experience. We might think it’s supposed to be easy, we might have learned about what most often happens and so we have certain expectations. We hear about averages and norms and assume we and our babies will fall into those ranges, but what if we don’t?

My first baby and I definitely didn’t fall into the category of “average” when we were getting started with breastfeeding. I had a very sleepy newborn, and she didn’t often wake up for anything. That sounds dreamy, doesn’t it? Should I have relaxed and enjoyed a baby that could sleep for 5-7 hour long stretches? Yes! Did I? Unfortunately, no. I was not at all relaxed. Instead, I was so worried about the fact that she wasn’t eating often enough. I stayed awake or mostly awake expectantly waiting for any little sign that she might be waking up and ready to eat.

I was told to let my baby eat for at least 10 minutes on each breast every 2-3 hours at first. But my baby was finished in 5 minutes total, and she only wanted to eat every 4-5 hours! Nothing I could do would make her get or stay on the breast more. Did that mean that she wasn’t getting enough milk? In our case, NO! It turns out that she was just really good at getting her fill quickly, but I worried about this so much at first. I didn’t know that some babies are more efficient than others when draining milk.

How did I finally know that things were going well when she didn’t meet the breastfeeding “standard”?

At first, I was SO worried that I didn’t have enough milk, or that there was something wrong with my baby. I saw a lactation consultant who recommended that I watch for these five markers:

1. She was happy at the breast, and she was pretty content between feedings
2. She was fairly alert and active when she was awake
3. She made lots of wet diapers
4. She made a good amount of dirty diapers
5. After a little bit of time, I could see that she was gaining weight at a normal rate

When she visited with me, she saw that my baby was content most of the time, that she was alert when she was awake, and that she made wet and dirty diapers. Then she recommended that I get her weighed regularly to ease my mind. I took her to a place with a baby scale almost daily for a while. At first, the weight gain was a little slow, but soon she was gaining weight at a rate that was normal to high. That’s when I finally relaxed and trusted that things were working.

How would I have known if things were NOT working?

1. If my baby had seemed frustrated at the breast or between feedings.*
2. If my baby seemed tired and weak when she was awake
3. If my baby wasn’t making enough wet diapers
4. If my baby wasn’t making enough dirty diapers
5. If my baby didn’t start gaining weight after a few days or had started to lose weight
6. If I was having pain or nipple damage

These are some basic guidelines to watch for when you’re getting started and wondering if things are “normal” or going well. If you have doubts, it’s a great idea to see a lactation consultant. They can definitely help troubleshoot problems when there are some, or they can at least give you some peace of mind that things ARE going well and will start to get easier soon. Please remember that lactation support services are most often covered by insurance, so be sure to look into your benefits.

*Sometimes this also happens when babies are cluster feeding and it can be normal. It’s part of the normal milk-making process when babies go through periods of big growth and they need more eating time. They might act frustrated as if they can’t seem to get enough to eat! It might seem like they are constantly at the breast, and STILL HUNGRY! They are extra hungry, but this will pass quickly once your body catches up to making enough milk, which it does if we let the baby spend a lot of time stimulating the milk production. It might not be advisable to give supplemental feedings from a bottle during these times. Supplemental feedings could negatively affect milk production because the baby is spending less time stimulating milk let down. See a lactation consultant if you’re unsure.