When Baby Isn’t Feeding Well: Early Initiation of Milk Removal

Many new mothers look forward to breastfeeding with great anticipation. You’ve devoted time and energy to preparing for your baby’s arrival, imagining those first magical days together. While some babies seem to be born knowing exactly what to do, it’s important to know that breastfeeding doesn’t always start out smoothly. When feedings don’t go as planned, it can lead to worries about weight loss, elevated jaundice levels, and low milk supply, which can feel stressful and overwhelming.1,2,3,4

Newborns, especially those born a little early, can be quite sleepy, making feedings more challenging. Long labors or surgical interventions can leave you both feeling exhausted. Some babies may struggle with latching due to factors like tongue tie or flat nipples. Understanding that there are many reasons why mothers and babies might face challenges in the beginning can help ease your concerns.1,2,3,4 By knowing what to look for and recognizing the signs that your baby is getting enough milk—or not—you can help prevent further complications and ensure your little one receives the nutrition they need.

How to Know Your Baby is Getting Enough Milk1,2,3,4

  • Feeding at least 8-12 times per day (some clustering is normal).
  • Breastfeeding on both breasts most or all of the time.
  • Latch is comfortable and your baby is content in between feedings.
  • Having more wet and dirty diapers every day the first week.
  • Significant breast changes (fuller, heavier, warmer, leaky) by Day 3.
  • Yellow, seedy stools by Day 4-5.

Signs Your Baby May Not Be Feeding Well1,2,3,4

  • Infrequent Feeding: Fewer than 8-12 feedings in 24 hours.
  • Lethargy: Baby appears unusually tired and is having difficulty waking for feeds.
  • Poor Latch: Difficulty latching, refusing to latch, or unable to stay latched.
  • Fussiness: Excessive crying or irritability during feeding times.
  • Weight Concerns: Excessive weight loss or insufficient weight gain.
  • Wet Diapers: Fewer than 6 wet diapers per day after the first few days.
  • Stooling: Stools should transition from dark and tarry to yellow and seedy by Day 4-5.

Steps to Take When Your Baby Isn’t Feeding Well1,2,3,4

  • Practice Skin-to-Skin
    • Hold your baby skin-to-skin, as often as possible.
    • This will help you respond quickly to your baby’s feeding cues and trigger vital newborn feeding reflexes that will help your baby latch.
  • Watch for Early Hunger Cues
    • Look for early feeding cues such as smacking lips, sucking on hands, or turning their head toward your breast.
    • Offer your breast quickly when you notice these cues, rather than waiting for later feeding cues, such as crying.
  • Offer Frequent Feedings
    • If your baby is very sleepy or only breastfeeding on one breast per feeding, expect very frequent feedings, perhaps every hour or two during the day.
    • You can try to stimulate your baby to take both breasts by burping them and changing their diaper after the first side.
  • Experiment With Feeding Positions
    • Ensure you and your baby are positioned comfortably.
    • Experiment with different breastfeeding positions (cradle hold, side-lying, football hold, laid-back, etc).
  • Strive for a Good Latch
    • A deep and comfortable latch enables your baby to remove milk effectively.
    • Your baby should latch well beyond your nipple and their mouth should cover a good portion of the areola.
    • If the latch is painful, break the suction with your finger and try again.
  • Hand Express Your Colostrum
    • To prevent your baby from losing too much weight and developing other complications, start gently hand expressing your milk after feeding attempts.
    • This milk can be fed to your baby using a spoon or syringe before, during, or after feedings until you are more confident that feedings are going well.
  • Get Started Pumping
    • By Day 2, if your baby is still struggling to latch, get started pumping after feeding attempts.
    • Continue doing hand expression after pumping sessions, as this may be more effective at removing colostrum than pumping alone.
  • Take Care of Yourself
    • Eat enough calories and stay well hydrated.
    • Rest whenever you can.
  • Seek Professional Help
    • Ask for as much help as possible while still in the hospital.
    • Discuss any concerns about your baby’s weight, feeding patterns, or overall health with your baby’s pediatrician.
    • A Lactation Consultant can provide invaluable support. Don’t hesitate to reach out if you have questions or need help.

Feeding challenges are common in the early days of breastfeeding, and it’s important to remember that you’re not alone. By staying informed and proactive, you can ensure your baby is receiving the nourishment they need. Celebrate the small victories, lean on your support network, and, most importantly, cherish those precious moments together. This journey may be filled with ups and downs, but your dedication and love will pave the way for a healthy and nurturing feeding experience.

What If I Have Questions?

If you are interested in learning more, these Aeroflow classes expand on some of the topics discussed above:

  • Ultimate Breastfeeding Prep
  • Pumping 101

To register for these classes, log into your portal or click here.

Want More Info?

For a directory of Aeroflow’s other Care Guides offering information on pregnancy, baby care, and more, browse our comprehensive list of titles:

References