There are two schools of thought when it comes to feeding your new baby... on demand or on a schedule. I am a proponent of combining the two methods. I fed my babies when they wanted it and woke ‘em up if they slept through a feeding time (evident by the leak tracks on my shirt.)
On-demand feeding is offering your baby the breast whenever he shows signs that he is hungry. Consider that anytime your baby is indicating that he would like to eat, he is communicating with you and it is important to validate that communication with a response.
If you spend any time in the NICU, you’ll learn all about scheduled feedings... you might even think you’ve signed up for baby bootcamp. The nurses will feed your baby (or have you feed him) according to a strict schedule that they will determine for you. Because it takes a little longer to feed a baby with low tone, you may find the NICU schedule hard to keep. At home, it might be easier to let your baby determine when he should be fed, unless of course, he would be content to sleep through feedings. If you find that your baby is sleeping for more than two hours during the day or three hours at night since his last feeding, you should rouse him and feed him.
Baby Math 101
How much milk is enough? A newborn baby should eat approximately 90-100 calories per kilogram of body weight per day. There are 20 calories in one ounce of breast milk, which means your baby should drink 4 1/2 to 5 ounces of milk per kilogram per day. For a 7 pound baby this equals about 14 1/2 to 16 ounces of breast milk per day. Take heart, that’s only 2 oz. (or 60 ml.) per feed (every three hours)!
Huh? How do you figure that out? Take your baby’s weight in pounds, convert it to kilos, multiply it by 100 (or 90, your choice) and then divide it by 20. That number is the total ounces of milk your baby needs per day at his current weight.
You will know that your baby is getting enough to eat by:
the number of wet diapers he produces. Your baby should have between 5-6 wet diapers per day (after your milk comes in). You can also weigh your baby’s diapers on a small scale. By subtracting the diaper’s dry weight (say 22 grams for a Pamper’s Swaddler #2) from the weight of the wet diaper, you will get an indication of how much your baby is taking in. For liquid volume, one gram is equal to one milliliter (ml) and 30 ml is equal to one ounce of milk.
the number of poopy diapers he produces. In the first few days there are usually only a couple tar-like (meconium) poops per day, however, by the end of the first week he should be pooping 3 or 4 times per day. Some babies poop after every feed!
the weight he gains. For the first three months of life, a new baby will gain just about an ounce a day, adding up to about 6-7 oz. per week. This can be difficult to measure at home so if you are really concerned with weight gain, you may want to rent a baby scale. Some insurance companies will cover part of the rental fee if your pediatrician writes a script for this. Another option is to get a script for a visiting nurse who can come weekly to weigh your baby (and do vitals and other routine checks). Remember, as your baby gains weight, his caloric needs go up accordingly.
For some of us (and we all know who we are) keeping track of exactly how long the baby nursed, on which breast, and at what time can become a bit of an obsession. Print off a couple copies of this handy chart to facilitate your record keeping. You may find that your baby has a preference for one breast over the other, or has certain nursing patterns.
Dang, This Just Isn’t Working
Not all babies take to nursing right away. Check out my post, Nursing Tips, in which I share some ideas that might make a difference for your baby.