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Milky Adventure
Is baby eating enough? Diapers, weight, and position at the breast
In episode 5, Lauriane Emond teaches you how to identify the signs that confirm your baby is feeding well: elimination, behavior, weight gain, and latch.
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Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
What you will learn in this episode
In this episode, Lauriane Emond shows you how to tell, from the baby's perspective this time, if your breastfeeding is going well. You will learn to read diapers, track healthy weight gain, identify a poor latch, and understand the guidelines for a non-breastfed baby.
- Counting diapers and interpreting stools to check for milk transfer
- Baby's behavior as a warning sign
- Why the French health booklet growth chart is not suitable for breastfed babies
- The latch: the key to pain-free feeding
- Feeding guidelines for a non-breastfed baby
💡 Key figures
A WHO study of over 12,000 infants led to the creation of specific growth charts for breastfed babies: the difference compared to the French health booklet charts can be up to 1000g in the first few months.
Source: La Leche League France, "Weight Gain in Breastfed Babies: New WHO Data and French Data," Breastfeeding Today.
___
During the first 4 to 6 weeks of life, an exclusively breastfed baby receiving an adequate amount of milk wets an average of 6 disposable diapers and has at least 3 medium-sized bowel movements every 24 hours.
Source: La Leche League France, breastfeeding resource documents.
Elimination, the first sign of milk transfer
Without a scale at home, it's impossible to weigh every feeding.
The most reliable indicator is what the baby eliminates. Within 24 hours, the baby should urinate. Within 48 hours, the baby should pass meconium, this first very dark, sticky, and thick stool, related to amniotic fluid.
Stools then evolve: first greenish-brown (transitional stools), then golden yellow and slightly lumpy, as milk supply increases.
Counting diapers, a simple method
Regarding urine, the rule is simple: one wet diaper per day of life until day 6 (1 diaper on Day 1, 2 on Day 2, etc.), then a minimum of 6 wet diapers per day. A wet diaper is roughly the weight of a hard-boiled egg 🥚
Regarding stools, aim for a minimum of 3 to 4 bowel movements per day, the size of the baby's palm, not just streaks.
Baby's behavior: a signal not to ignore
This reiterates what was discussed in the previous episode: a baby who no longer wakes to feed may lack energy. Lauriane uses the analogy of a car's fuel tank: there always needs to be a little fuel for the baby to have the strength to wake
A baby who sleeps too much, too early, isn't necessarily a 'good' baby; sometimes it's a baby who isn't getting enough intake and needs to be fed more.
Weight gain and the correct growth curve
Successful breastfeeding results in an average weight gain of about 30 grams per day. However, be aware: the growth chart in the French health record book is not the reference curve for breastfed babies. Breastfed babies gain more weight than formula-fed babies in the first few months, then the trend reverses. Using the wrong curve can mistakenly suggest a baby isn't gaining enough weight, or conversely, provide false reassurance. Lauriane recommends referring to the WHO growth charts, which are specific to breastfed babies, available for download online or via an app, and to insert them into the health record book.
Collaborating with highly specialized multidisciplinary professionals is precisely what helps avoid this kind of misunderstanding: no one can know everything about everything.
Mouth position: the key to pain-free feeding
Breastfeeding should not be painful. A slight hypersensitivity in the very first seconds of sucking can occur, but pain that lasts throughout the entire feeding, or cracked nipples, almost always signals a problem with the baby's mouth positioning. For a good latch: wide-open mouth, lips flanged outwards ("fish lips"), chin to the breast, an asymmetrical latch that includes the nipple and a good portion of the areola. This suction is what ensures good milk transfer.
What about a formula-fed baby?
A non-breastfed baby should receive approximately 120 to 150 grams of milk per kilogram per day, which, by about one month of age, amounts to approximately 800 to 900 ml per day. Even when bottle-feeding, including with expressed breast milk, it's important to follow the baby's cues rather than adhering to fixed quantities imposed by milk packaging, to avoid overfeeding and subsequent risks of obesity.
🔎 Useful definitions
Meconium : the newborn's first stool, very dark, sticky, and thick, usually passed within 48 hours of birth.
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Transitional stools : intermediate stools between meconium and mature stools, greenish-brown in color, indicating that milk transfer is starting to be effective.
___
WHO growth charts for breastfed babies : reference charts specifically developed from breastfed babies, different from those in the French health record book which tend to reflect the growth of non-breastfed babies.
🎯 Practical actions
- Monitor baby's output in the first few days:
- First urine within 24 hours, first meconium within 48 hours
- Track the evolution of stool color: black (meconium) then greenish-brown (transitional) then golden-yellow
- Simply count diapers:
- 1 wet diaper per day of life until day 6, then a minimum of 6 wet diapers per day (weight of a hard-boiled egg)
- Aim for a minimum of 3 to 4 stools per day, the size of the baby's palm
- Observe baby's behavior:
- Be concerned if baby no longer wakes spontaneously to feed
- Offer the breast more often if sleep phases become too long, too early
- Check weight gain on the correct chart:
- Aim for an average of about 30 grams per day
- Download the WHO growth charts specific to breastfed babies and insert them into the health record, rather than relying on standard French charts
- Consult a professional if pain persists beyond the first few seconds of nursing:
- Pain that lasts throughout the entire feeding or cracked nipples are not normal
- Check the baby's mouth position: wide gape, flanged lips, chin to breast, asymmetrical latch
- For a non-breastfed or bottle-fed baby (even with breast milk):
- Aim for 120 to 150g of milk per kg per day, which is approximately 800 to 900ml per day around 1 month of age
- Respect baby's cues rather than fixed quantities, to avoid overfeeding
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Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
_____
⭐ The Milky Adventure series is made possible thanks to the participation of Fizimed, a French company that develops innovative solutions for women's health, such as their Emy Pump portable breast pump.
What you will learn in this episode
In this episode, Lauriane Emond shows you how to tell, from the baby's perspective this time, if your breastfeeding is going well. You will learn to read diapers, track healthy weight gain, identify a poor latch, and understand the guidelines for a non-breastfed baby.
- Counting diapers and interpreting stools to check for milk transfer
- Baby's behavior as a warning sign
- Why the French health booklet growth chart is not suitable for breastfed babies
- The latch: the key to pain-free feeding
- Feeding guidelines for a non-breastfed baby
💡 Key figures
A WHO study of over 12,000 infants led to the creation of specific growth charts for breastfed babies: the difference compared to the French health booklet charts can be up to 1000g in the first few months.
Source: La Leche League France, "Weight Gain in Breastfed Babies: New WHO Data and French Data," Breastfeeding Today.
___
During the first 4 to 6 weeks of life, an exclusively breastfed baby receiving an adequate amount of milk wets an average of 6 disposable diapers and has at least 3 medium-sized bowel movements every 24 hours.
Source: La Leche League France, breastfeeding resource documents.
Elimination, the first sign of milk transfer
Without a scale at home, it's impossible to weigh every feeding.
The most reliable indicator is what the baby eliminates. Within 24 hours, the baby should urinate. Within 48 hours, the baby should pass meconium, this first very dark, sticky, and thick stool, related to amniotic fluid.
Stools then evolve: first greenish-brown (transitional stools), then golden yellow and slightly lumpy, as milk supply increases.
Counting diapers, a simple method
Regarding urine, the rule is simple: one wet diaper per day of life until day 6 (1 diaper on Day 1, 2 on Day 2, etc.), then a minimum of 6 wet diapers per day. A wet diaper is roughly the weight of a hard-boiled egg 🥚
Regarding stools, aim for a minimum of 3 to 4 bowel movements per day, the size of the baby's palm, not just streaks.
Baby's behavior: a signal not to ignore
This reiterates what was discussed in the previous episode: a baby who no longer wakes to feed may lack energy. Lauriane uses the analogy of a car's fuel tank: there always needs to be a little fuel for the baby to have the strength to wake
A baby who sleeps too much, too early, isn't necessarily a 'good' baby; sometimes it's a baby who isn't getting enough intake and needs to be fed more.
Weight gain and the correct growth curve
Successful breastfeeding results in an average weight gain of about 30 grams per day. However, be aware: the growth chart in the French health record book is not the reference curve for breastfed babies. Breastfed babies gain more weight than formula-fed babies in the first few months, then the trend reverses. Using the wrong curve can mistakenly suggest a baby isn't gaining enough weight, or conversely, provide false reassurance. Lauriane recommends referring to the WHO growth charts, which are specific to breastfed babies, available for download online or via an app, and to insert them into the health record book.
Collaborating with highly specialized multidisciplinary professionals is precisely what helps avoid this kind of misunderstanding: no one can know everything about everything.
Mouth position: the key to pain-free feeding
Breastfeeding should not be painful. A slight hypersensitivity in the very first seconds of sucking can occur, but pain that lasts throughout the entire feeding, or cracked nipples, almost always signals a problem with the baby's mouth positioning. For a good latch: wide-open mouth, lips flanged outwards ("fish lips"), chin to the breast, an asymmetrical latch that includes the nipple and a good portion of the areola. This suction is what ensures good milk transfer.
What about a formula-fed baby?
A non-breastfed baby should receive approximately 120 to 150 grams of milk per kilogram per day, which, by about one month of age, amounts to approximately 800 to 900 ml per day. Even when bottle-feeding, including with expressed breast milk, it's important to follow the baby's cues rather than adhering to fixed quantities imposed by milk packaging, to avoid overfeeding and subsequent risks of obesity.
🎯 Concrete actions
- Monitor baby's output in the first few days:
- First urine within 24 hours, first meconium within 48 hours
- Track the evolution of stool color: black (meconium) then greenish-brown (transitional) then golden-yellow
- Simply count diapers:
- 1 wet diaper per day of life until day 6, then a minimum of 6 wet diapers per day (weight of a hard-boiled egg)
- Aim for a minimum of 3 to 4 stools per day, the size of the baby's palm
- Observe baby's behavior:
- Be concerned if baby no longer wakes spontaneously to feed
- Offer the breast more often if sleep phases become too long, too early
- Check weight gain on the correct chart:
- Aim for an average of about 30 grams per day
- Download the WHO growth charts specific to breastfed babies and insert them into the health record, rather than relying on standard French charts
- Consult a professional if pain persists beyond the first few seconds of nursing:
- Pain that lasts throughout the entire feeding or cracked nipples are not normal
- Check the baby's mouth position: wide gape, flanged lips, chin to breast, asymmetrical latch
- For a non-breastfed or bottle-fed baby (even with breast milk):
- Aim for 120 to 150g of milk per kg per day, which is approximately 800 to 900ml per day around 1 month of age
- Respect baby's cues rather than fixed quantities, to avoid overfeeding
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