What’s ‘normal’ when it comes to breastfeeding?

When you’re a new mum, it’s difficult to know whether your breastfeeding experiences are typical or not – so we asked an expert if there really is such a thing as ‘normal’ breastfeeding

What is normal in breastfeeding?
Medela expert Jacqueline Kent
Dr Jacqueline Kent , Research Fellow , Hartmann Human Lactation Research Group:
Having joined the research group at The University of Western Australia in 1986, Jacqueline completed her PhD in 1999. She’s currently investigating the biochemical and physiological aspects of breast milk synthesis and removal, focusing on scientific information that may help support mums to breastfeed for longer.

Dr Jacqueline Kent and her team have spent years researching breastfeeding and have found that it’s different for every mum and baby.

Which of your findings surprised you the most?

The variability – there is such a broad range of ‘normal’. We were so used to textbooks saying a baby should feed eight to 12 times a day and should gain 150 g (5.3 oz) a week. But babies haven’t read the textbooks – they do their own thing! Some babies grow more slowly and some grow very rapidly.

Our studies of exclusively breastfed babies aged one to six months showed they typically breastfed between four and 13 times a day, and for between 12 minutes and nearer to one hour during each feeding session.1

How much milk do breastfed babies drink?

Our studies showed that they can drink as little as 54 ml (1.9 fl oz) or as much as 234 ml (8.2 fl oz) of milk per feed.1

Sometimes mums think their baby has had a good feed, but are surprised to discover he only had a very small amount of milk. Other times he can be slipping on and off the breast, only feeding for a few minutes, and yet take 100 ml (3.5 fl oz). So being fussy doesn’t necessarily mean he’s getting less milk overall.

All babies are different, but they all take what they need. Some will be ticking along quite nicely on 500 ml (17.6 fl oz) a day, some drink up to 1,356 ml (47.7 fl oz) a day!

And did you know, on average, boys drink 76 ml (2.6 fl oz) more than girls each day? As long as your milk supply is adequate, your baby will set his own agenda.

Should mums offer one breast or both?

I advise mums to offer the second breast after feeding from the first. If your baby accepts, then great, he obviously wants more. But if he says no, don’t worry. Let your baby decide – he knows how full his tummy is. Our research shows that 30% of babies take exclusively from one breast, 13% always take from both, but most (57%) do a mixture of the two.1

How can a mum tell if her baby is getting enough milk?

In my experience, mums often feel guilty and worry they’re not producing enough milk. Ask yourself: Is my baby growing and putting on weight? Is my baby alert? Does he have good skin tone? Is he producing enough wet nappies and dirty nappies? If all of this is happening, then whether he’s having long or short feeds, be reassured you’re giving enough milk.

What’s the biggest misconception mums-to-be have about breastfeeding?

Mums tend to think that as their babies get older they will need more feeds and a greater amount of milk every 24 hours. They’re often very surprised when I tell them that between four weeks and 26 weeks, if everything is going normally, there’s no change in their total milk production.2

In the first few months, babies grow very rapidly and have a high metabolic rate. The milk they take in is mostly put into growth and maintaining their metabolism.

Then, from three to six months, their metabolic rate goes down and so does their growth rate, so the same amount of milk can satisfy them. This means your baby doesn’t need to increase his milk intake as he gets bigger. In fact, feeds start to become shorter and less frequent, and yet he’s still getting the same amount of milk as he feeds more efficiently.

Does your research show when breastfed babies start sleeping through the night?

Most babies feed at night. Their stomach capacity is not big enough to go all night without a feed, and breast milk is digested very rapidly. So of course, they wake up hungry in the night – and it’s likely to happen for at least the first six months. Night feeding is normal. When you’re awake at night feeding your baby, be reassured that other mums with babies the same age all over the world are probably doing the same thing – and hopefully it’ll only be for a few months.1

What do mums worry about most in the first few weeks of breastfeeding?

The most common concerns are whether the baby is latched on and sucking properly, and if the baby is satisfied after a feed. It’s usual for mothers to be concerned about nipple pain too. The key thing is getting breastfeeding positioning and attachment correct from the beginning because, anecdotally, it makes a lot of difference to both milk transfer and mums’ comfort.

When should a mum worry that breastfeeding isn’t normal?

The mother should reach full milk production by two weeks. If a baby hasn’t started to regain weight by five or six days after birth, alarm bells should ring. Parents should seek medical advice, and healthcare professionals need to make sure milk is being produced and its composition is changing from colostrum towards mature milk.

If you could give a new mum breastfeeding advice, what would it be?

Have skin-to-skin contact with your baby as soon as possible after birth. Breastfeed within an hour if you can, or at least encourage your baby to latch on. Get your positioning and latch monitored and corrected as soon as possible to make sure there’s no nipple damage.

Feed often. New mums can’t always read their babies’ cues and cries. Definitely feed on demand rather than at regular, set, intervals. Offer the breast as soon as there are any signs of hunger – babies usually feed better if they’re calm. If your baby’s crying it can be harder for him to latch on. If in doubt, offer the breast. Your baby will soon tell you if he wants it or not.

Infographic: What is normal in breastfeeding

For an overview of Dr Kent’s research findings, download the What is the range of ‘normal’ when it comes to breastfeeding? infographic or read it below.

References

1 Kent JC et al. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3):e387-395.

2 Kent JC et al. Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Breastfeeding Medicine. 2013;8(4):401-407.