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How often should I alternate breasts?

To keep up your milk supply in both breasts — and prevent painful engorgement in one — it's important to alternate breasts and try to give each one the same amount of nursing time throughout the day. Again, that amount of time differs for every baby and every woman — some babies may be satisfied after 5 minutes on each breast, others may need 10 or 15 minutes on each side.

Some experts recommend switching breasts in the middle of each feeding and alternating which breast you offer first for each feeding. Can't remember on which breast your baby last nursed? Some women find it helpful to attach a subtle reminder — a safety pin or small ribbon — to their bra straps indicating which breast they last nursed on so they'll know to start with that breast at the next feeding. Or, keep a notebook handy to keep track of how your baby feeds.

Your baby may seem to prefer both breasts with each feeding and may be doing well. Or, your little one may like to nurse on just one breast with each feeding. Whichever way you choose, it's important for you to do whatever works and is the most comfortable for you and your baby.

How often should I burp my baby during feedings?

Let your baby breastfeed at one breast then switch to the other side. Try burping your baby when switching breasts and at the end of the feed. Often, the movement alone can be enough to cause a baby to burp.

As your milk comes in and your baby has established good latch-on, you can try burping as frequently as you think helps your baby. Some infants need more burping, others less, and it can vary from feeding to feeding depending on what the mother has been eating.

If your baby spits up a lot, you may need to try burping more frequently. While it's normal for infants to "spit up" a small amount after eating or during burping, a baby should not vomit after feeding. Vomiting after every feeding may be a problem that needs medical attention. If you have concerns that your baby is spitting up too much, call your doctor.

How can I tell if my baby's eating enough?

New mothers, especially breastfeeding moms, are often concerned that their infants may not be getting enough to eat. You can be assured that your baby is getting enough to eat if he or she:

  • seems satisfied and content after eating
  • produces about four to six wet diapers a day
  • has regular bowel movements
  • sleeps well
  • is alert when awake
  • is gaining weight

Your baby may not be getting enough to eat if he or she:

  • does not appear to be satisfied after feeding
  • seems hungry often
  • isn't making several wet and soiled diapers a day
  • is fussy or cries a lot
  • isn't gaining weight

If you're concerned that your baby isn't getting enough to eat, call your doctor. Breastfed infants should also be seen by their doctor 24 to 48 hours after a mother and newborn leave the hospital. During this visit, the baby will be weighed and examined, and the mother's breastfeeding technique can be evaluated. It's also an opportunity for nursing mothers to ask questions.

Even if a breastfed baby is doing well, the doctor will probably schedule another visit for around 2 weeks of age. Continue on with these postnatal checkups so that you can be sure that your baby is gaining weight and getting enough nutrients.

For your own piece of mind, it can help to keep a notebook or first-week breastfeeding log to write down each time the baby feeds, how long the baby fed on each breast, and each time the baby stools (poops) or makes a wet diaper.

If you're concerned or notice any signs that your infant isn't getting enough nutrients, call your baby's doctor.

What should my newborn's diapers look like?

Your baby's diapers are excellent indicators of whether your breastfed baby is getting what he or she needs. Because colostrum (the first milk your newborn gets) is concentrated, your baby may have only one or two wet diapers in the first 24 hours.

Your newborn's stools (or poop) will be thick and tarry at first and become more greenish-yellow as your milk comes in, which is usually about 3 or 4 days after birth. The more your baby nurses, the more dirty (or "soiled") diapers he or she will have; but it may be just one a day in the first days after birth.

After 3 to 4 days, here are some signs you should look for:

  • six or more wet diapers per day, with clear or very pale urine. Fewer diapers or darker urine may mean your baby's not getting enough to drink. If you see orange crystals in a wet diaper, contact your baby's doctor — these can be a sign of inadequate fluid intake or dehydration.
  • four or more yellow, seedy bowel movements per day, usually one after each feeding. After about a month, though, breastfed babies usually have fewer bowel movements and many may go a few days without pooping.

My baby wants to nurse for comfort. Is this OK?

If your baby seems to be getting enough milk, but continues to suck for an hour or more, he or she might be nursing for comfort rather than for nourishment. So, how do you know? Once your baby has fed vigorously, he or she may stay on your breast but show these signs of non-nutritive sucking:

  • seems satisfied
  • stops sucking and swallowing
  • plays with your nipple

Early on, it's OK to let your baby nurse for comfort, but it can become problematic as your little one gets older because he or she may need to nurse to take a nap or go to bed at night. So, at some point you may want to wean your baby off of sucking for comfort and make breastfeeding sessions about nourishment.

Instead of nursing, you might offer your baby his or her thumb or hand to suck on. You also could consider giving your little one a pacifier if your child doesn't seem to be hungry. Because of a lower risk of sudden infant death syndrome (SIDS), the American Academy of Pediatrics (AAP) now recommends letting babies go to sleep with a pacifier. However, you should only do this after breastfeeding is well established (usually after 1 month).

If possible, also hold off on introducing a bottle until breastfeeding is well established. Some babies have "nipple confusion," though the likelihood of this happening is much less after 4 to 6 weeks.

My baby is hungrier than usual. Is this normal?

As babies gain weight, they should begin to eat more at each feeding and go longer between feedings. Still, there may be times when your little one seems hungrier than usual.

Your baby may be going through a period of rapid growth (called a growth spurt). These can happen at any time, but in the early months growth spurts often occur at around:

  • 7 to 14 days old
  • 2 months
  • 4 months
  • 6 months

During these times and whenever your baby seems especially hungry, follow his or her hunger cues. You may need to temporarily increase the frequency of feedings.

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