BREASTFED BABY'S MILESTONES

This chart is meant soley as a guideline. If you have any concerns about your child's growth and development, speak with your Health Care Provider.

AGE
NURSING FREQUENCY
STOOLING AND URINATION
BREASTFEEDING SKILLS
BREASTMILK COMPOSITION
PUMPING AND WEANING
OTHER
Days 2-5 8-15 nursings,1,2-3
usually 7-40 minutes in length.1,3

Baby should gain a half to one ounce per day during the first 6 weeks. Baby should be back to birth weight by the second week. But some may take 3 weeks4 and this is acceptable if baby is gaining 4-8 ounces per week. 1,2
As mom's milk comes in, stool turns more yellow in color and is less sticky (transitional stool).1,4 By day 5, your baby should be stooling at least 2-52  times a day with 6 or more wet diapers with clear colored urine. 1 Rooting and sucking reflexes are present to assist in helping the baby to nurse.3,4 It may help to have someone flare the baby's lips after they're attached at the breast. Release suction carefully by placing a finger in the corner of the baby's mouth. Milk changes from colostrum to transitional milk1,2,4Thecontent of this milk gradually changes. The levels of antibodies and protein diminish, while the levels of lactose (milk sugar), fat and calories rise.4 It is important to be aware that the composition of milk changes during a feeding also.1,4The first milk is called the foremilk, which is higher in water2 and protein1content. The end milk is called the hind milk which is higher in fat.1,2,4Babies usually need to nurse on the hindmilk to gain well.2 Allow baby to nurse as long as interested on the breast first offered.1,2 Pump if baby is too sleepy to suck and/or if suck is too poor to drain the breast. 1 Feed the pumped milk with a cup, spoon, or supplementer.1 Avoid bottles.1 It is too early to introduce a pacifier or bottles without possibly causing nipple confusion and/or interfering with the milk supply and causing premature weaning.1,2

Your baby has weaned from 8-30 feedings to 8-15 feedings

After feeding, some mothers like to express their milk onto the nipples and air dry them. Newborns sleep 16-18 hours per day.5 Nurse at the earliest signs of hunger such as licking and looking or mouthing, sucking, and limb movements.6 They are able to cry and vocalize animal-like sounds. Can move head side-to-side and lift it up. Baby should have the first check up and be weighed within seven days of birth.6
Days 3-14 8-15 times1,2usually for 15-40 minutes,1

2-3 growth spurts occur in the first 6 weeks of life. 1,2,4
After day 5, baby should have 2-52yellow, seedy, liquid stools per day. 1,4  Urinating clear urine 6 or more times per day.1 As baby becomes more alert, allow baby to end feeding as frequently as possible. Baby begins to learn to open mouth wide to feed. In mature milk, some factors that vary the amount of fat include: the time of day, length of time since the last feeding, and age of infant.4  Breastmilksupplies all the water your baby needs even in very hot weather.3 Do not supplement with water, artificial baby milk or juice.2 This interferes with your milk production and may lead to premature weaning.2 If baby falls asleep before the feeding is over, gently roll baby from side-to-side, burp baby and/or change diaper to awaken. Then resume the feeding.
BABY'S FIRST IMMUNIZATION IS BREASTMILK!
Copyright by Christine Betzold MSN NP IBCLC 2/00

References:

1.       Hertz GS. The Little Green Book of Breastfeeding Management 3rd edition. York: Pennsylvania, 2001, Pocket Publications.

2.       Morhbacher N, Stock J. The Breastfeeding Answer Book, Revised Editioin. Schaumburg, Illinois, 1997, La Leche League International.

3.       Riordan J, Auerbach KG. Breastfeeding and Human Lactation 2cd edition, Sudbury, 1999, Jones and Bartlett Publishers.

4.       Lawrence RA, Lawrence RM: Breastfeeding: A  guide for the medical profession, 5th  edition , 5,  St. Louis, 1999, Mosby.                                        

5.       Katherine Finn Davis RN, MSN, CPNP; Kathy P. Parker PhD, RN, FAAN; Gary L. Montgomery MD Sleep in Infants and Young Children: Part One:Normal Sleep JPediatr Health Care 18(2):65-71 .............2004.                                                                                                                                               
6.       American Academy of Pediatrics Policy Statement: Breastfeeding and the Use of Human Milk, Pediatrics 100: 1035-1039, 1997.