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Warnings against infant starvation related to breastfeeding have been circulating on the internet lately. Some have even recommended supplementation with formula for the first few days, just to be sure. Is it true that breastfeeding exclusively can lead to starving your baby? Is it possible? Is it likely? How can you be safe?

The American Academy of Pediatrics recommends “exclusive breastfeeding for about 6 months, followed by continued breast-feeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.” And most lactation experts recommend against supplementing with a bottle, especially early on, because it can both lower the maternal production of milk and confuse the infant. But is there really a danger that the mother’s milk won’t appear and the baby will starve?

Yes, it is possible. It’s rare, but it’s possible. Some mothers do not produce adequate milk, and for suchIs Breastfeeding dangerous, breastfeeding, bard and didriksen pediatrics situations, formula is the best, if not only, option. The difficulty comes from the fact that the first days of breastfeeding are exceptional, and it is easy to assume something is wrong.  Mothers are exhausted, nervous, inundated with advice and it is true that the baby doesn’t get a large volume of milk right away. The first milk to come in is colostrum. It is lower in volume, but higher in nutrients than the milk to follow so it is harder to gauge what the baby needs. This is why it is crucial that if you have any questions, you contact your pediatrician immediately.

But once the milk does come in, and those tricky first few days have passed, how can you be sure that your baby is getting enough milk to thrive? What is normal?

  • Breastfeeding babies nurse every two to three hours. They wake up hungry and go back to sleep more or less satisfied.
  • Expect six or more wet diapers a day and at least a couple of poopy ones.
  • Urine should be pale and fairly odorless.
  • Poop should be very soft and yellow.
  • Your baby should regain his or her birth weight by two weeks, and continue growing.
  • When eating, you will probably see and hear your baby swallowing, but not always so don’t worry if all the other signs are good, but your baby is a polite eater.
  • Mom’s breasts should feel full before feedings, and noticeably softer afterwards, although this too varies.

What are some warning signs that your baby may not be getting enough to eat?

  • Anything that differs from the above list.
  • Jaundice, or yellow skin. Always have this checked, even though it doesn’t always mean malnutrition.
  • A malnourished baby can be too lethargic to wake up, or too miserable to sleep. Again, check with your doctor because there are many other reasons for a cranky baby.

In short, breast is best in the vast majority of cases, but just in case, keep in close touch with your doctor. Formula may be a better choice for your baby. Some mothers feel that they have failed if they are unable to breastfeed. Not true. Anything that keeps your baby safe, healthy and happy is a success!