Expert: Sally Wendkos Olds - 5/4/2004

Question
My daughter is 10 weeks old and has started sleeping through the night for about 7 hours. Is this too long of a period for her to go without nursing? How does this affect my supply of milk for her during the day. I am still home on my maternity leave, and during the day she feeds about every 3-4 hours and takes both breasts at each feeding and then cluster feeds for close to one and a half hours before going to sleep. Even though I have BF 2 other daughters before, this is the first one who has slept for an extended period during the night. Your advice is appreciated. Thank you.

Answer
Dear Mary Beth,

First, congratulations for giving your children the best start in life by breastfeeding them. (I have 3 breastfed daughters too, along with 5 breastfed grandchildren.)

It is unusual for a baby this young to sleep through for about 7 hours, but it does happen. The important thing is to see whether she seems to be gaining weight adequately and showing in other ways (like urine and bowel output) that she is getting  enough nutrition.

I give a number of ways to judge adequate nutrition in THE COMPLETE BOOK OF BREASTFEEDING (Eiger & Olds, 3rd ed., 1999, Workman Publishing & Bantam Books). I'm attaching an excerpt below. I hope it's helpful.

Good luck.

Sally Wendkos Olds
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  IS MY BABY GETTING ENOUGH MILK?

This is the big question to which every nursing mother wants a resounding YES! answer. Fortunately, there are some solid criteria so you may be able to answer the question yourself. The following checklist is the one that I (Dr. Eiger) have suggested that my patients follow.
  Your baby is probably getting enough to eat if you can answer yes to all of the following questions. If you cannot, call your baby's doctor right away.

Your Baby's Urine and Stools
The evidence in your baby's diapers is the most important sign of his or her adequate milk intake.
  * Does your baby have the number, color, and size of stools described in the Table below, at the appropriate ages?
  Your baby should be having regular bowel movements in a quantity of at least 1 tablespoon (1/2 ounce) or more. After the first few days, they should be yellow and loose, with small curds. They may smell and look like yogurt, or like a mix of cottage cheese and mustard. If a baby over five days old is passing dark stools or fewer than those listed in the table, this is a sharp warning that she is probably not getting enough nourishment.
  
  JUDGING INTAKE BY OUTPUT
DAY OF BABY'S LIFE      STOOLS PER DAY      COLOR OF STOOL
  1 to 2         1 to 2         blackish, tarry
  3 to 4         3 to 4         brownish-blackish
  4 to 6         4 to 6         brownish-yellowish
  6 to 30         8 to 10         yellowish
           (normally 1 after
           each feeding)
  30 and later   may be infrequent       yellow
           (up to 10-14 days
            without a stool)
  
* By the third or fourth day, does your baby have six or more wet diapers per day, with colorless or very pale urine?
  Since today's disposable diapers are so absorbent that they don't feel wet, you can check for urination by putting a piece of toilet tissue inside the diaper and then feeling that. Or pinch the bottom of the diaper; if the padding does not spring back to its original shape, the diaper is wet. Also, if it's wet it will feel heavy. Or you could use cloth diapers for the first few weeks. (You could let it be known that diaper service would be a wonderful baby present.)

Your Baby's Appearance and Behavior
  * Does your baby seem satisfied and content for an average of 2 to 3 hours between feedings in the first month or two?
  * In the first month or two, does your baby nurse 8 to 12 times in every 24-hour period, for 10 to 20 minutes on each breast?
  * After 3 days of age, when you open your baby's mouth during a nursing session, can you see milk inside and is the inside of your baby's mouth pink and moist?
  * Is your baby's skin soft and supple?
  * Does your baby have bright eyes and an alert manner?
  * By the third month is your baby nursing 6 to 8 times in a 24-hour period and seem contented for up to 5 or 6 hours, at least once during the 24 hours?