Basic Breastfeeding Instructions for Normal Newborns

Feeding Goal: 8-12 feedings in 24 hour period until the baby is back to birth weight or better

Nursing every 1 ½ – 3 hours for 10 – 20 minutes on at least one breast (offer both). Switch breasts if baby wants to nurse longer than 25 minutes.

Normal Output: Record on feeding logs for first 7-10 days and take logs to doctor visits.
BOWEL MOVEMENTS: BMs change from dark, black meconium to greenish/brown transitional then to yellow seedy stools by day 5 of life. Expect 1 – 2 (or more) every 24 hours

WET DIAPERS: Tear open diaper to avoid missing wet diapers. All urine should be light yellow.

  • 1 – 2 days old expect 1 – 2 or more
  • 3 – 4 days old expect 3 – 4 or more
  • 5 days old and older expect 6 – 8 or more

Waking Techniques

Newborns are often sleepy. Every 2 – 3 hours, wake them by:

  • placing skin-to-skin for 20 minutes;
  • changing the diaper; removing the blankets and/or T-shirt;
  • baby sit-ups;
  • gentle side to side roll;
  • firm baby massage of back, legs, and feet;
  • cool washcloth.
  • At night you can let them sleep up to 4 hours, but newborns need 8 – 12 good feedings per 24 hours.

Feeding Cues

Hand to mouth movements; sucking on hands, fingers, or sleeves. Rooting – opening mouth and turning head as in search for food; tongue thrusting. Becoming more alert and moving extremities. Succession of short whimpers. Crying is a late sign of hunger!

Signs Feedings Are Going Well

  • Baby is alert and active (not lethargic).
  • Baby is latching well and you can hear or see swallowing during feedings.
  • Baby is content after feedings and sleeping between feedings.
  • Output is adequate.
  • Baby loses less than 7 – 8 percent of his birth weight during the first week of life and is then back to birth weight or better by 2 weeks of age.
  • Baby starts to gain 4 – 7 oz. per week.

When to Seek Help Immediately

  • Unable to wake baby for feedings.
  • Baby is not latching correctly or is unable to latch due to full or engorged breast.
  • Baby shows no sign of swallowing.
  • Baby is restless and fussy after feedings.
  • Baby is having less than 3 wet diapers every 24 hours by day 3-5, or less than 6 wet diapers every 24 hours by day 6 or after.
  • Baby has not had a bowel movement in 24 hours, or stools are still black and tarry meconium at day 5.
  • Baby has not regained birth weight by 2 weeks of age.
  • Breasts are not feeling softer after feedings once milk comes in.
  • Mother is experiencing nipple abrasions or trauma or nipple soreness lasting longer than 7 days.
  • Mother is having flu-like symptoms with a temperature of 101 or greater and/or tender breast area (possible mastitis).