Breastfeeding: Management

Why is managing your breast feeding important?

The most common cause of slow weight gain in babies is related to mismanaged breastfeeding.

What can you do to manage your baby’s breastfeeding and weight gain?

• Watch for signs from your baby that he or she wants to feed. Your baby should wake and cue to breastfeed about eight to 12 times in 24 hours by rooting, making licking or sucking motions, bobbing his head against the mattress, your neck or a shoulder or bringing his hand to his face or mouth. Put your baby to your breast right then. Crying is a late feeding cue.
• Many mothers find milk production increases and babies' weight gains improve if they and their babies let chores and activities go for two or three days, so they can breastfeed, more or less, around the clock.
• When your baby is not breastfeeding, hold him skin-to-skin on your chest. This may help you become more sensitive to your baby's feeding cues.
• If your baby is a sleepy baby who doesn’t cue to feed at least eight times in 24 hours, you will have to wake your baby to feed frequently about every two hours during the daytime and evening hours and at least every three to four hours at night until weight gain improves.
  • Be sure your baby is mainly uncovered during breastfeeding. A baby that is bundled papoose-style can get much too warm and comfy, and is more likely to doze off too quickly during feedings. If there is a chill in the air, drape a sheet or light blanket over you and your baby, as needed.
  • If your baby falls asleep within minutes of latching on, massage your breast as you breastfeed to re-trigger sucking by stroking downward and inward on the breast.
• Make sure your baby is latching on correctly and sucking effectively.
• In general, avoid switch nursing, which is breastfeeding at one breast for a few minutes, then the other and then back again. This may interfere with your baby getting enough of the calorie-rich hindmilk, which your baby gets more of as a feeding continues on one breast. However, the switch strategy sometimes stimulates a sleepy baby so he or she wakes up and begins sucking again.
• Offer a supplement during, or after, breastfeeding (when prescribed) to provide additional calories. Use your own expressed milk first for any alternative feedings if any supplementary feedings are recommended.
• Use an alternative feeding method recommended by a certified lactation consultant (IBCLC). There are many alternative feeding options, so let her know if a recommendation does not feel right for you. Alternative feeding methods include:
  • cup feeding
  • a tube system with a special feeding tube taped to the breast or a finger
  • syringe feeding
  • an eyedropper
  • spoon feeding
  • bottle feeding
• Pump your breasts after as many daily breastfeedings as possible, especially if you are uncertain whether your baby is effectively removing milk during breastfeeding. Pumping will remove milk effectively, so your breasts will know to produce more milk. Ideally, you should use a hospital-grade, electric pump with an appropriate collection kit to obtain milk.
• Your baby should be weighed on a frequent and regular basis until he is gaining weight at a satisfactory rate.

What is weight gain does not increase?

If breastfeeding is properly managed, yet your baby still is not gaining adequate weight, it's likely that some other factor is affecting milk production or your baby's ability to breastfeed effectively. Always consult your physician in this case.