By Dr. R.K
Anand (MD, FIAP, FRCP, DCH)
New mothers have so many doubts lingering in their
minds regarding the feeding of the baby. They are concerned whether they are
producing enough milk to satisfy the babyâ€™s hunger. They also have many other
worries. Here we have answered some common queries associated with
Am I getting enough milk for my
Check your babyâ€™s urine output. A
baby getting motherâ€™s milk and nothing else (not even water) and who urinates
more than 6 times in 24 hours is getting enough breastmilk. If you fail to
count that, look at the colour of his urine. Light coloured urine is an
indication that he is getting enough breastmilk. An occasional passage of dark
urine can be ignored. For instance, if the baby is kept wrapped all the time,
he may sweat and thus may pass dark urine.
However, in the first few days at the hospital after
delivery, the frequency of urine may be less as the colostrum has less amount
of water in it. So in the first week, count the number of motions. If the baby
passes 3 or more motions each day, it indicates that all is well. It is true
that a two-month-old exclusively breastfed baby may pass a soft motion once
every few days. This could be normal around that age but not in the first week
to ten days after birth.
weight of the child also indicates if he was getting enough breastmilk or not.
For the first six months of life, a baby should gain at least 500 grams each
month, or 125 grams each week (one kilogram per month is not necessary). But remember
that most babies lose weight in the first few days after birth. They regain
their birth weight when they are about 10 days old. Make sure the
weighing machine is accurate and the baby is weighed on the same weighing
scale, either naked or with the same type of clothes on each
Here it may also be mentioned that when your baby is
about 6 weeks old, your breasts may feel soft. This only shows that the supply
and demand have balanced. Again, look at the diapers and the weight of the child to ensure that you are
producing enough milk for your baby.
My breasts are small. Will my baby
get enough milk?
This is just an old wives' tale with no basis in
truth. The size or shape of your breasts has nothing to
do with the quality or quantity of milk dispensed. Milk-producing
glands in all women are in the back part of the breasts, behind the
areola. Their location is the same, regardless of the size of the
mother's breasts. The size depends upon the supporting tissue or fat
in the breast.
Can a woman with flat nipples or
inverted nipples breastfeed?
Successful breastfeeding does not depend on the size
of the breast or the size of the nipple. Just touch or gently rub your nipple
with your fingers. If it becomes slightly more prominent, it is protractile. A
flat or a small nipple that becomes prominent (even a little) on being touched
is normal. So the size of the â€˜restingâ€™ nipple is not important.
In rare cases, a nipple does not protract. If you try
and pull it out, it goes deeper into the breast. This is an inverted or
retracted nipple. The baby has even more difficulty suckling from an engorged
breast with an inverted nipple. In such a case, the mother should express the
milk until the breast feels soft. This helps the baby to take enough of the
breast in her mouth.
Treatment for Inverted
Nipples: Some mothers with inverted nipples may need the help
of a disposable syringe (See the Figure Above). The nozzle end of a 10 ml
plastic disposable syringe is cut off (step one). This piston is introduced from
the ragged cut end side (step two). The mother then applies the smooth end to
her breast and pulls on the piston gently and holds it in that position for
about a minute (step three). The nipple protrudes out into to the syringe. The
mother reduces the traction while releasing the syringe. The nipple stays
protruded for some time; and the baby is immediately put to the breast. As the
nipple is easily taken into the mouth, the baby is able to suckle in a proper
The nipple retracts again after a while, but not to
the same extent. The procedure can be repeated several times a day for a couple
of days. This corrects the retraction permanently in almost all cases.
Can twins or premature
babies also be fed adequately on breastmilk?
Frequent suckling can provide enough milk for
twins. In short, one breast, when frequently emptied, can
provide enough milk for one baby
babies who can swallow but cannot suckle are given
expressed breastmilk in a cup or a bondla
or with a spoon. Our experience shows us that it is more practical to
feed with an ordinary cup, small glass or a bondla (also called
paladai) than with
a spoon. There is no risk of aspiration into the breathing passage in feeding
with a small glass. The mother holds the baby in her lap, lifts the head higher
than the rest of the body and gradually lets her sip from the glass. The milk
should not be poured into the mouth.
Sometimes, if a baby is too weak to swallow, she is
given expressed breastmilk through a stomach
It is important for the baby to start suckling at the
breast as soon as she is able to do
Premature babies need more proteins. It is Natureâ€™s
wonder that the breastmilk of the mother who delivers prematurely has higher
protein content than a mother who delivers at full term.
Is there any drug that can
increase milk supply?
Frequent suckling in combination with the avoidance
of bottlefeeding, increases the production of milk. While there are some drugs
like Metoclopramide (available as Perinorm, Maxeron or Reglan) that may help
increase the milk supply, the natural method of frequent breastfeeding is preferable.
However, the purpose will be defeated if the baby is being bottle-fed at the
Which breastfeeding concerns do new mothers have? How
to know if the baby is getting enough milk? How can women with inverted nipples
breastfeed? Discuss here.
Dr. R. K. Anand
has vetted this article for medical accuracy. Please note that ads
displayed on this page do not reflect his views.