Which is the best indicator that breastfeeding is going well in the first 24 hours of life? This is important information all new parents should know, but it can also be confusing. The correct answer is B, a baby’s ability to latch well. This question was tricky because there are several things breastfeeding mothers are told to look for as an indication that breastfeeding is going well. Many call this the three P’s: Poop, Pee, and Pounds. In other words, since we cannot see exactly how much the baby is getting when breastfeeding, the way we know they are getting enough is by the amount of wet and dirty diapers and changes in the baby’s weight.
The three P’s are important for breastfeeding parents to keep track of when assessing how well their baby is doing. The most reliable of these is the weight, however this is not true in the first 24 hours of life. Virtually all babies lose weight initially. Babies are born with excess amniotic fluids that their bodies get rid of once born. After the first few days babies begin gaining weight. Babies should be back to their birthweight by 10 days of life, and continue to gain about 1 ounce per day for the first 4 months. Healthcare providers consider 5-7% weight loss on day 4 a sign that breastfeeding is going well. Contrarily we now have studies to show that this is not always reliable. Currently most women give birth in hospitals with medical interventions. This includes IV fluids. When mothers receive large amount of IV fluids in labor the babies are born with excessive amounts of fluids in their system. This results in higher urine diaper output and a larger percentage of weight loss the first day after birth. This is not an accurate indication of how well breastfeeding is going.
Many babies are extremely sleepy after birth. It is not unusual that the most challenging aspect of breastfeeding on day 1 is getting the baby to wake up and eat. After all, the only person who works as hard as the mother during labor is the baby, and they need recovery time. Breastfed babies should eat a minimum 8 times daily, with 10 or more being more ideal. This is unlikely for a baby within the first 24 hours after birth. So feeding frequency is a good sign overall that breastfeeding is going well, but not reliable the first 24 hours of life.
For my clients, the main concern is that the baby is able to latch well and efficiently. It is good news if a newborn baby has good newborn responses and latches causing minimal to no discomfort to the mother. When the baby latches soon after birth with a wide open mouth, flanged lower lip, and good jaw motion that is the best sign to go off of that breastfeeding is off to a good start!