Why Weigh and Feed?

The most common task done during a lactation consult is weighing the baby. Often the baby is weighed before and after feeding. This practice is called many things: pre and post feed weights, PC/AC weights ( pre-consumption, after consumption), or weighted feeding. The purpose of this weighing is to determine how much milk the baby is transferring for that feed.

Human milk has roughly the same weight per volume as water: 1 gram per milliliter. We use this 1:1 ratio to get a pretty good idea of how well the baby is drinking at the breast. A baby who gains about 2oz after a feed too in about 2oz of milk from the breast.

The sensitivity of the scale used if a factor in determining the accuracy of the weighted feed. In this episode, Danielle meets up with Katherine Morrison IBCLC, CLC of Atlanta Lactation and Christie Coursey IBCLC of Breastfeed Atlanta to discuss scales, weighs, and how to decide on volumes to supplement based on weighted feeds.

Key takeaways from the video:

  • every baby should be fed to satiety at every feed
  • scales can give good data that needs to be examined along side data like diaper count and growth patterns
  • stool frequency and volume are important indicators of intake when scales are not available

Enjoy the video! Subscribe to our YouTube channel and comment to let us know what videos you’d like to see!

 

Advertisements

7 Things You Can Do Right Now with a Fussy Baby

When you have a fussy baby, the minutes feel like hours and it’s easy to panic. Don’t panic! Take control of the situation and help your baby adjust to life outside the womb. Set aside worries about allergies, diet restriction, and milk production. Get the baby calm, help mama get calm, and then call your lactation consultant.

Hop in the Bath
Babies love baths. Mommies often need one too. Co-bathing can calm and focus your baby. Babies who are frustrated at the breast often respond well to nursing in the bath. Bath tub nursing can halt a nursing strike, help a baby with a shallow latch relax and open wide, and help a mom who is having let down trouble. Safety tip: have another adult present to pass the baby in and out of the tub to mom to avoid slip and fall risk.

Magic Baby Hold
It’s magic. Hold the baby like this. Magic Baby Hold with Bill

This is a variation of the common tummy massages like bicycling legs, rubbing the tummy clockwise, or burping. This can help pass gas or ease a baby who seems constipated. Remember: constipation is hard dry stool, not infrequent stool.

Swing and Sway
Not just the baby swing. Babies calm faster in arms. Swing with your baby on your lap on your porch swing or glider. Wrap your baby in a sling or carrier and walk through the house. Babies like to be near a heart beat. Being skin to skin while swaying through the house is extremely soothing.

Nurse in a Carrier
Nursing in a carrier allows the baby to be upright and compressed. This helps with reflux symptoms and gas. Upright feeding can also ease the stress of fast milk flow or over-active let down. Babies with tongue or lip ties can often open wider because of the firm back support carriers provide while the head can move more freely. Sucking also helps relax babies and their GI muscles. More nursing helps them poop.

Play with Temperature
Take some frozen milk out and spoon feed it to your baby or put it in a mesh feeder. The cold is exciting and different for older babies, especially teething babies. Older babies may like to hold a frozen teething toy or a warm teething toy.

Get Outside
Even if the weather is crummy, just standing on the porch may change things. If you’re able to carry your baby for a walk, this is usually better than a stroller. The upright position and being near an adult care giver are more relaxing than a stroller.

Play with Texture
Let your baby touch something interesting and new. A tooth brush or cotton ball or sand or salt. Watch that these things stay away from the mouth. Novel sensory experiences can change your baby’s outlook pretty rapidly.

Syringe and Cup Feeding

Bottles may be the most common way we see babies fed, but aren’t the only way to feed a baby off the breast. Some mothers want to avoid bottle preference or choose an alternate feeding method to help the baby get back to the breast. Please visit this article on proper techniques for bottle feeding human milk.

Syringe feeding is often employed by families whose babies need short term supplementation while they develop breastfeeding skills. Syringe feeding is sometimes done in tandem with oral exercises under the supervision of an LC, SLP, pediatrician, or other specialist. Oasis Lactation Services prefers curved tipped periodontal syringes for this feeding method. Theses syringes are generally sold in 10-12 cc volume, which is about 1/3 ounce.  It is important to know if the syringes you are using are precision measured or an estimate.

syringe

General Guidelines for Syringe Feeding Your Baby

  1. Fill syringe with expressed breast milk (or formula if supplementation is required).
  2. Sit baby upright on your lap with baby’s head supported, at a 45 degree angle or taller. Baby should not be flat on back.
  3. Stroke baby’s face to stimulate gape response. Gently drag finger down from tip of baby’s nose to the chin. When baby opens wide, offer finger to suck, pad side up.
  4. Once baby begins to suck, introduce syringe to the corner of the mouth. Point the tip of the syringe into the cheek. The tip is rigid. Do not allow the tip of the syringe to touch the gums.
  5. Responsively depress plunger as baby is sucking on finger. The baby is only able to swallow small amounts. The baby needs time between pulses of milk to coordinate breathing. One pulse of milk should be followed by a swallow and two or three sucks.

Cup feeding for supplementation off the breast may be a good choice for several reasons. Cups are easy to sterilize unlike rubber nipples. Cup technology is available around the world in all cultures. Cup feeding teaches baby oral skills that he will use for a lifetime. Babies who are cup feeding learn tongue extension, which is a useful skill for drawing the breast deep into the mouth to nurse.

General Guidelines for Cup Feeding Your Baby

  1. Sit baby upright on your lap with baby’s head supported, at a 45 degree angle or taller. Baby should not be flat on back.
  2. Use a small medicine cup or shot glass.
  3. Place the edge of the cup gently on baby’s lower lip.
  4. Bring the liquid to baby’s lower lip so baby will lap it up like a cat drinking milk from a bowl. Do not pour the liquid in baby’s mouth
  5. It is important to maintain the level of the liquid as best as possible so baby can continually lap it up.
  6. Go slowly as the two of you learn how to do this. Eventually, this can become a very fast and efficient way of feeding until baby learns to take the breast, and this is a good method to use to avoid artificial nipples and teats. This method also encourages tongue extension which is helpful training for babies who have had tongue tie revision or therapy for shallow latching.

%d bloggers like this: