How much water should Mom be drinking?

Hi everyone,

I'm new to misc.kids.breastfeeding and am looking for some advice. I
have a 9 day old little girl whom I'm breastfeeding. At 3 days old,
she had lost nearly a pound from her birth weight. But at her one-
week check up, she had gained back 5 oz. I was pretty pleased with
how things were going until the pediatrician said baby *must* be back
to her birthweight at her two-week check up and to that end, I was to
drink a gallon of water a day.

Is a gallon of water really necessary? I'm really trying to drink as
much as I can, but as much as I'd like to sit around doing nothing but
drinking water all day, it's just not happening. I wanted to see what
you experienced folks had to say about water needs when nursing.

Thank you!
-Steph

wrote:

I'm new to misc.kids.breastfeeding and am looking for some advice. I
have a 9 day old little girl whom I'm breastfeeding.

Congratulations on your baby!

[...] the pediatrician said baby *must* be back
to her birthweight at her two-week check up and to that end, I was to
drink a gallon of water a day.

Is a gallon of water really necessary?

What you need to do is drink to thirst, so don't
forget to drink because you are busy, but you
certainly don't have to drink a gallon just
because.

The other thing you need to do is nurse baby on
demand. Don't watch the clock and decide that
20 minutes per side is sufficient for baby. Nurse
her until she unlatches herself or falls asleep.

Having said that, many newborns fall asleep easily,
so make sure you keep her awake (tickle her feet,
unwrap her blanket, talk to her) so that she
nurses sufficiently.

Do not use the 3-4 hour between feedings as a
guideline. That is for formula. For breastfeeding
babies, the time between feedings (counted from start
to start) can be as close as 1 hour to 2.5 hours.
(Yes the 1 hour means that if nursing lasts 30
minutes, then you have 30 minutes before the next
nursing!)

-- Anita --

Irrational Number wrote:
wrote:

I'm new to misc.kids.breastfeeding and am looking for some advice. I
have a 9 day old little girl whom I'm breastfeeding.

Congratulations on your baby!

[...] the pediatrician said baby *must* be back
to her birthweight at her two-week check up and to that end, I was to
drink a gallon of water a day.

The paediatrician is talking rubbish. As long as her weight gain is
steady at an average of at least an ounce a day and she's otherwise well
& having wet and dirty nappies, it doesn't matter whether or not she's
back to her birthweight. She lost quite a lot, so it is likely to take
her a little longer to catch up, but that's OK - it's not a race and, as
long as her *rate* of gain is all right by then, the exact figure she's
reached by two weeks isn't that important.

Is a gallon of water really necessary?

What you need to do is drink to thirst, so don't
forget to drink because you are busy, but you
certainly don't have to drink a gallon just
because.

I agree with this. The thing to do is to have a bottle or glass of
water to hand all the time and keep reminding yourself to take a
mouthful or two - that way you won't get so preoccupied by taking care
of the baby that you end up ignoring your thirst signals. However, as
long as you're reminding yourself to drink and drinking as much as you
want when you do drink, I wouldn't worry about drinking X amount.

The other thing you need to do is nurse baby on
demand. Don't watch the clock and decide that
20 minutes per side is sufficient for baby.

Agree with this as well, but just wanted to disagree with the next bit...

Nurse
her until she unlatches herself or falls asleep.

The problem with this is that babies do suck for comfort. Nurse her for
as long as she's actively taking in milk, and then a few minutes longer
in case she's just waiting for the next letdown. And then, if she's
still awake, try her on the other breast in case she wants a bit from
that side. But if she's gone on for more than a few minutes just
comfort sucking, then that nursing session's probably over for then. No
reason at all why you shouldn't stay there and let her comfort suck if
she's happy, but it can get a bit much if you have a baby who wants to
suck non-stop, and if you want a break and she's reached the comfort
sucking stage, you can try giving her a pacifier instead and seeing
whether she'll take that. (If she doesn't, try her with different ones
in case she's fussy about the type of teat.)

So how do you tell the difference between comfort sucking and active
nursing? Look at her chin. If it's moving up and down as she sucks,
then she's taking in mouthfuls of milk. If it's just quivering on the
spot, then she isn't taking in milk. She may, as I said, be just
waiting for the next letdown, so don't whip her off the second her chin
starts moving - but if she's been sucking in this way for a few minutes
with no sign of moving back to an active nursing pattern, then it looks
like she's gone to comfort sucking. When that happens, try her on the
other breast to see if she wants anything from that side - if not, you
can choose whether to let her keep comfort sucking on you or try a paci
instead.

Having said that, many newborns fall asleep easily,
so make sure you keep her awake (tickle her feet,
unwrap her blanket, talk to her) so that she
nurses sufficiently.

Do not use the 3-4 hour between feedings as a
guideline. That is for formula. For breastfeeding
babies, the time between feedings (counted from start
to start) can be as close as 1 hour to 2.5 hours.
(Yes the 1 hour means that if nursing lasts 30
minutes, then you have 30 minutes before the next
nursing!)

One other useful piece of info which you may or may not have been told
is that you don't have to wait for her to start crying before you nurse
her. Newborns will signal their hunger for about half an hour before
they get to the crying stage, by turning their heads to the side and
making rooting motions with their mouths. If you look for those signs
and nurse her when you see them, this has several advantages - she is
not only likely to nurse better at that stage, but also she's starting
to learn that she doesn't have to cry to get what she wants, which is a
useful lesson for any child to learn. ;-)


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

"That which can be destroyed by the truth, should be" - P. C. Hodgell

So how do you tell the difference between comfort sucking and active
nursing? Look at her chin. If it's moving up and down as she sucks,
then she's taking in mouthfuls of milk. If it's just quivering on the
spot, then she isn't taking in milk. She may, as I said, be just
waiting for the next letdown, so don't whip her off the second her chin
starts moving - but if she's been sucking in this way for a few minutes
with no sign of moving back to an active nursing pattern, then it looks
like she's gone to comfort sucking. When that happens, try her on the
other breast to see if she wants anything from that side - if not, you
can choose whether to let her keep comfort sucking on you or try a paci
instead.

I agree, Sarah, about the no need to carry on nursing once it's
definitely comfort sucking, at this stage supply is strongly hormone
driven, so unless there are any suggestions that supply is an issue
(highly unlikely - nothing the OP says suggests it), then there isn't
much benefit to it, what I disagree on is the use of a pacifier at this
moment in time - we simply don't know enough about this baby, she may
have a perfect latch and good strong suck and even if she did, at this
stage if at all possible you want to avoid adding anything that might
change that.

In terms of the weight, she's gained 5oz in 6days, if she carries on at
that rate, it will take her another 12ish days to regain birth weight,
i.e. at 21 days old. She does not need to regain all the lost weight by
2 weeks old. I wonder if you were on a drip at all in labour, this can
artificially inflate the birthweight and thus as the extra fluid has
passed out of the body make it seem as if a significant amount of weight
has been lost - when in reality the baby has lost an entirely normal
percentage of body fat.

Everything I've seen points to humans needing a lot more water in
general than most actually drink I'm not sure that breastfeeding women
actually need more though many do feel thirsty at each feeding and end
up increasing intake, plus I think the effects of not drinking enough
are more likely to be felt, but it shouldn't decrease milk supply as the
first symptom. Feeling thirsty can inhibit let down, but this seems to
be far more of an issue a few weeks down the line if trying to pump
milk. I don't know where you are, but if you're in a hot place, it's
entirely possible that a gallon is a reasonable amount to aim for,
wherever you are, you're looking at 2 quarts minimum. In the early days
nursing my 2nd I was being careful to drink plenty of water, but not for
nursing reasons, but for the reason that the more you drink, the more
dilute your urine and the less it's likely to sting down there! First
time around, I neglected this and often had to run a shallow bath to pee
in and I was slightly constipated, 2nd time around, despite the exact
same tear and some new damage to the rectum, I had no problems. I had
several sports top bottles that were around a quart and I kept them in
the fridge and tried to keep on top of refilling them, so there was
always one in easy reach. I think I got through 6-8 in 24 hours and at
least 2 would be during the night, when I'd never usually drink.

Cheers
Anne

suck non-stop, and if you want a break and she's reached the comfort
sucking stage, you can try giving her a pacifier instead and seeing
whether she'll take that. (If she doesn't, try her with different ones
in case she's fussy about the type of teat.)

I agree with most of the advice here, but I would hesitate to use a
pacifier until it is clear that a baby is maintaining good growth.

If a baby is growing well, fills up on milk and wants to continue
sucking, but is frustrated by additional letdowns, a pacifier may be
the solution.

If a baby is not growing well, it can be a good idea to avoid a
pacifier and work on improving latch/milk supply.

Between these extremes, there are advantages and disadvantages to
pacifier use. Some advantages are, lower SIDS rates, baby may be OK
with waiting a bit to nurse in a situation where it is necessary etc.
Some disadvantages are, pacifier use statistically correlates to
earlier weaning, baby may "need" pacifier to be happy. Providing a
clean one and putting it back in each time it is dropped can be a
bother etc.

--Betsy

Lets not think in gallons per day yet. The usual recommendation is a
12 oz glass every two hours. Now assuming that include a glass when
you want to nurse in the middle of the night, that works out to 120 oz.
I think that is just 8 oz shy of a gallon. Now, that said, I think
you ped is being an alarmist. If your baby is gaining so well already,
I see no reason why your ped should make such a statement to scare you!

I suggest you try to make the 12 oz glass every 2 hours, and see how it
goes.

Larry

In article .com,
says...
Hi everyone,

I'm new to misc.kids.breastfeeding and am looking for some advice. I
have a 9 day old little girl whom I'm breastfeeding. At 3 days old,
she had lost nearly a pound from her birth weight. But at her one-
week check up, she had gained back 5 oz. I was pretty pleased with
how things were going until the pediatrician said baby *must* be back
to her birthweight at her two-week check up and to that end, I was to
drink a gallon of water a day.

Is a gallon of water really necessary? I'm really trying to drink as
much as I can, but as much as I'd like to sit around doing nothing but
drinking water all day, it's just not happening. I wanted to see what
you experienced folks had to say about water needs when nursing.

Thank you!
-Steph

And I want to halfway disagree with Sarah.

In article ,
says...
Agree with this as well, but just wanted to disagree with the next bit...

Nurse
her until she unlatches herself or falls asleep.

The problem with this is that babies do suck for comfort. Nurse her for
as long as she's actively taking in milk, and then a few minutes longer
in case she's just waiting for the next letdown. And then, if she's
still awake, try her on the other breast in case she wants a bit from
that side. But if she's gone on for more than a few minutes just
comfort sucking, then that nursing session's probably over for then. No
reason at all why you shouldn't stay there and let her comfort suck if
she's happy, but it can get a bit much if you have a baby who wants to
suck non-stop, and if you want a break and she's reached the comfort
sucking stage, you can try giving her a pacifier instead and seeing
whether she'll take that. (If she doesn't, try her with different ones
in case she's fussy about the type of teat.)

First on the pacifier part. I agree with Anne and Betsy that pacifier
should not be introduced at this time.

Now on to comfort nursing. I think I know where Sarah is coming from,
in that some babies are very "needy" in terms of comfort nursing, and
she is concerned that is the mom doesn't get a break for constant
demands, she may fail to keep breastfeeding, or may become sore and have
difficulties. I agree you should watch for this and try to avoid it,
but not all comfort nursing is bad, and not all mothers are bothered by
a reasonable amount of comfort nursing. It is also true that in the
first 4 months after birth, comfort nursing will help to increase a
mother's supply. So take Sarah's advice with a grain of salt. If
necessary, follow it, but if things are going well, comfort nursing is
OK.

Larry

On Aug 9, 2:08 pm, betsy wrote:

Some disadvantages are, pacifier use statistically correlates to
earlier weaning, baby may "need" pacifier to be happy.

There's very little research that attempts to tease out whether
correlation is causation here, but what little there is indicates that
pacifier use is a *marker* for breastfeeding difficulties or lack of
commitment to breastfeeding, rather than a *cause* of it. A
randomized controlled trial in a hospital that had half the moms
strongly warned to avoid pacifier use and the other half given the
regular postpartum information about pacifiers found no impact on
breastfeeding rates or success. There's been at least one other study
that addressed the issue that indicated increased pacifier use was a
marker of trouble, not cause of it. Both studies were small and not
the greatest in the world, but I've found no research that indicates
pacifier use plays a causal role in breastfeeding problems. It seems
that if babies are smart enough to figure out comfort sucking vs.
feeding sucking, they're smart enough to figure out how to treat a dry
piece of plastic differently from the boob.

To the OP, your pedi is either nuts or meant that less emphatically it
sounded. Back to birthweight at 2 weeks is a general rule of thumb,
but usually gets bent a bit for babies that lose a lot at first as
long as they're gaining appropriately from their low point. Three oz
every 2-3 days (20-30g/day) is appropriate weight gain and it sounds
like she's nicely on track for that. I'd find it painful to drink
that much water. Drink generously to thirst and it should be fine.

Kate, ignorant foot soldier of the medical cartel
and the Bug, 4 years old

Larry Mcmahan wrote:
And I want to halfway disagree with Sarah.

In article ,
says...
Agree with this as well, but just wanted to disagree with the next bit...

Nurse
her until she unlatches herself or falls asleep.
The problem with this is that babies do suck for comfort. Nurse her for
as long as she's actively taking in milk, and then a few minutes longer
in case she's just waiting for the next letdown. And then, if she's
still awake, try her on the other breast in case she wants a bit from
that side. But if she's gone on for more than a few minutes just
comfort sucking, then that nursing session's probably over for then. No
reason at all why you shouldn't stay there and let her comfort suck if
she's happy, but it can get a bit much if you have a baby who wants to
suck non-stop, and if you want a break and she's reached the comfort
sucking stage, you can try giving her a pacifier instead and seeing
whether she'll take that. (If she doesn't, try her with different ones
in case she's fussy about the type of teat.)

First on the pacifier part. I agree with Anne and Betsy that pacifier
should not be introduced at this time.

Now on to comfort nursing. I think I know where Sarah is coming from,
in that some babies are very "needy" in terms of comfort nursing, and
she is concerned that is the mom doesn't get a break for constant
demands, she may fail to keep breastfeeding, or may become sore and have
difficulties. I agree you should watch for this and try to avoid it,
but not all comfort nursing is bad, and not all mothers are bothered by
a reasonable amount of comfort nursing.

Er, yes, Larry. That would be why I said "No reason at all why you
shouldn't stay there and let her comfort suck if she's happy" and said
that the pacifier was to try "if you want a break" and finished off by
saying "you can choose whether to let her keep comfort sucking on you or
try a paci instead".

It is also true that in the
first 4 months after birth, comfort nursing will help to increase a
mother's supply.

That's useful to know, yes. What evidence is there? I'd be interested
to see it.

So take Sarah's advice with a grain of salt. If
necessary, follow it, but if things are going well, comfort nursing is
OK.


My advice was for her to decide for herself whether she wanted to
comfort nurse or not. I've no objection to you giving her more
information about the pros and cons to help her make that decision. I
do object to the idea that advice to a mother to make her own decision
on a particular matter should be taken with a grain of salt, and to the
implication that I tried to suggest that comfort nursing wasn't OK when
I suggested no such thing.


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

"That which can be destroyed by the truth, should be" - P. C. Hodgell

Trying to answer coherently, with not much time to do it...

In article ,
says...

First on the pacifier part. I agree with Anne and Betsy that pacifier
should not be introduced at this time.

Now on to comfort nursing. I think I know where Sarah is coming from,
in that some babies are very "needy" in terms of comfort nursing, and
she is concerned that is the mom doesn't get a break for constant
demands, she may fail to keep breastfeeding, or may become sore and have
difficulties. I agree you should watch for this and try to avoid it,
but not all comfort nursing is bad, and not all mothers are bothered by
a reasonable amount of comfort nursing.

Er, yes, Larry. That would be why I said "No reason at all why you
shouldn't stay there and let her comfort suck if she's happy" and said
that the pacifier was to try "if you want a break" and finished off by
saying "you can choose whether to let her keep comfort sucking on you or
try a paci instead".

My concern that in the context of the overall message even with those
"disclaimer" a person could read it as advice to stop nursing when milk
stopped flowing and that comfort nursing was never useful. Not that you
intended it this way, just that it could be read this way.

It is also true that in the
first 4 months after birth, comfort nursing will help to increase a
mother's supply.

That's useful to know, yes. What evidence is there? I'd be interested
to see it.

I don't have the cites (yes, several) not the time to look it up right
now, but I believe it was either the MIT Lady (Carol Novak?) or Beth K.
that first posted the information. I will summarize the results of the
studies. One (or more) studies showed that past 4 months of age, milk
supply was dependent only on the volume of milk removed. That is, the
more milk that was taken per unit time, the more milk was produced, the
less milk taken per unit time, the less produced. Also shown (perhaps
in the same, perhaps in different studies) was that prior to 4 months,
and particularly for newborns, total length of nursing sessions was also
a factor in increasing milk supply. That is: before 4 months, longer
nursing sessions also increased production, even if milk volume did not
increase. I think this would fit the category of "comfort nursing."

I will be a wimp, and ask that anyone who can remember the studies to
post the references. I think they are 5 or 6 years old.

So take Sarah's advice with a grain of salt. If
necessary, follow it, but if things are going well, comfort nursing is
OK.


My advice was for her to decide for herself whether she wanted to
comfort nurse or not. I've no objection to you giving her more
information about the pros and cons to help her make that decision. I
do object to the idea that advice to a mother to make her own decision
on a particular matter should be taken with a grain of salt, and to the
implication that I tried to suggest that comfort nursing wasn't OK when
I suggested no such thing.

My concern was not that you intended to say that comfort nursing wasn't
OK, but that it could easily be read to say that it never useful, and
therefore of little value to anyone. I was not objecting to what you
intended to say, but to any erroneous conclusions the reader could draw
from it. Must be the different accent across the pond. :-)


All the best,

Sarah

Best regards,
Larry