The following signs tell you that you and your baby need immediate help from a health care professional who knows how to help with breas/chestfeeding.

If baby:

  • Won’t go to the breast
  • Will only take a few sucks then falls asleep
  • Has less than 6 heavy wet diapers in 24 hours (day 4 onwards)
  • Has less than 4 yellow seedy stools in 24 hours (day 4 onwards)
  • Has hard stools that are not easily passed
  • Feeds less than 8 times in 24 hours (day 3 onwards)
  • Will feed if you wake them but will not wake up on their own to feed
  • Hasn’t regained birth weight by 2 weeks of age

If you:

  • Don’t feel breast fullness (day 4 onwards)
  • Have painful nipples that are not improving
  • Have cracked or bleeding nipples
  • Have nipples that are compressed or ridged after feedings
  • Don’t hear swallowing when baby feeds (day 3 onwards)
  • Have hard painful breasts that baby cannot latch on to

When supplemental feedings and feeding plans are needed

In some medical situations (for example a jaundiced baby or a baby that is having difficulty feeding at the breast) supplemental feedings and/or a feeding plan may be considered appropriate and necessary. You will be provided with a full explanation of why this is medically indicated and you will be involved in the decision about how to supplement your baby. If your baby needs to receive supplemented feedings, continue to have skin-to-skin contact with your baby to help improve milk supply and establish breast/chestfeeding.

Supplementation can be done using your own expressed milk, pasteurized donor human milk from a milk bank, or commercial formula.

Supplemented feedings can be given in a variety of ways including feeding tubes, syringes, a spoon, a small cup, or a bottle. Using methods other than a bottle may help your baby latch more effectively after the need for supplementation has ended.

If your baby cannot breast/chestfeed or is not feeding well, you will be shown how to feed your baby with a supplement and helped to establish or maintain your milk supply by removing the milk from your breasts at frequent intervals. You can use either hand expression and/or a commercial grade electric breast pump.

A feeding plan is a prescribed recommendation of how often (and sometimes how much) to feed your baby rather than following your baby’s cues.

If your healthcare provider has recommended supplementing or a feeding plan it is important to know when it can be discontinued. Further support may be needed to help you and your baby return to full breast/chestfeeding once the medical need for supplementation is gone.