What is 'normal' in breastfeeding?

What a great question! What is ‘normal’ when it comes to breast feeding?

Many women are often confused by all the information they are given when they become pregnant, and that only seems to increase once baby is born and then everyone has a tip on how best to feed/change or settle your baby! It can be really confusing and sometimes stressful to know how best to look after your precious new bundle.

Humans are designed to learn new skills by watching others first; we talk to our children and they mimic us back learning to make sounds; we walk around and our toddlers start to copy us, learning how to stand up, balance and then walk.

How do new mothers learn to breastfeed, or learn what is ‘normal’?

Our society doesn’t live in tribes with other women anymore, and we rarely actually see a baby attach on to the breast; often women are covered up when they feed their baby in public. So how can we learn to breastfeed? This is why breastfeeding can be challenging at the start for many women, this is ‘normal’ and it is OK. You will learn gradually over the first few weeks and will eventually feel confident and happy breast feeding.

One of the most common reasons women report for choosing to stop breast feeding or to start introducing infant formula is the feeling that there is not enough milk for their baby or they think their baby is feeding too often and that their milk supply is not satisfying enough.

Studies show that about 95% of the female population can produce enough milk for their baby/babies. The breasts are amazing, they work on a supply and demand system, (or rather baby demands and the breasts supply!). Every time your baby breastfeeds, this sends a message to your brain to make sure you produce this feed again tomorrow. Therefore your milk supply can continue for as long as you want or need it to. In order to make more milk you just need to feed or express more frequently, to reduce your supply you feed less. A simple, but clever system!

So why are so many mothers feeling that they do not have enough milk?

Our ‘norm’ of how often a baby should feed is based on studies looking at babies who formula feed. Formula milk is made from cows milk and is designed to keep calves well fed (they are much larger than a human baby!) so formula takes longer to digest than human breast milk. Babies fed on formula will often require less frequent feeds. Many mothers feel that because their baby feeds more than every 3-4 hours this means their baby is too hungry and may start to give formula milk to “fill baby up more”.

What actually happens if formula milk is introduced to baby’s diet without a medical need? A baby will start to feed less often. When baby feeds less often this reduces the messages to the brain and interferes with the natural ‘demand and supply’ milk making system. The brain and the breasts then believe they need to wean and will gradually reduce the milk supply.

Once the milk supply decreases the breasts may feel a little softer and many mothers introduce more formula. The increase in formula means fewer breastfeeds and the more this interferes with the ‘demand and supply’ system, rapidly decreasing milk supply until it stops altogether. Mothers’ often feel that their breasts were at fault but really it was just the weaning system was switched on!

What is normal?

A recent study from the University of Western Australia looked at babies from 1 month–6 months old and showed us that there is a big difference in how often breastfed babies feed.

• On average babies aged 1 – 6 months old will feed between 4 - 13 times every 24 hours
• Babies drink between 54ml - 234ml at each feed
• Two thirds of babies up to 6 months old feed at night
• 20% of a baby’s total food is drunk between 10pm-4am
• In the first month your baby and breasts are laying down the foundations for you to produce lots of milk, so babies will need to feed a minimum of 6 times in 24 hours
• Around 4-6 weeks your breasts will feel less full, this is also normal. Don’t panic that your supply has disappeared!

How do I know my baby is getting enough?

• Listen to your gut instinct, is your baby mostly happy and content?
• Do you have to change at least 5 heavy wet nappies and at least 2 yellow pooey nappies every day?
• Does your baby settle after feeds (it’s normal for most babies to need some help settling down first)?
• Is your baby breastfeeding between 4 -13 times a day once aged 1-6 months? (6-13 times in the first month of life)?
• Is your baby gaining weight well? Do you notice new fat rolls forming on your baby’s legs and arms!
• Is your baby otherwise healthy and the nurses and doctors are happy with their progress?

If yes, then no matter whether your baby feeds frequently or your breasts have recently settled down and no longer feel full….You have great milk supply! Keep doing what you’re doing.

If no, go and have your baby and your breastfeeding technique checked with a Maternal Child Health Nurse or Lactation Consultant. Often simple adjustments to how you are feeding baby can make big differences. Remember this is a new skill and takes time to learn, it is normal to keep having ‘lessons’ with a health professional or through an Australian Breastfeeding Association group until you feel confident with breastfeeding. Seeking help makes most women feel so much more confident and happy with breastfeeding. Don’t be afraid to ask!

References:
Kent, J.C. et al. Volume and frequency of breastfeeds and fat content of breast milk throughout the day. Pediatrics 117, e387-e395 (2006).
Kent, J.C. et al. Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Breastfeed Med 8, 401-407 (2013).