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What to Expect During the Early Weeks of Breastfeeding

Newborns nurse frequently

What to Expect During the Early Weeks of Breastfeeding

Normal Breastfeeding Routines
Each baby is a unique individual, with his or her own nursing habits. Breastfed babies can thrive within a wide range of normal feeding patterns. Even in the same family, mothers observe that different siblings have different nursing styles. Some babies breastfeed at closer intervals than others or take longer to complete a feeding. Some like to nurse leisurely, while others get right down to business. Mothers often find a nickname for their baby's particular nursing style, ranging from the "nibbler" to the "barracuda."

While no two babies are alike, the following typical feeding routines should let you know what to expect, help you recognize the ranges of normal, and give you guidance about when to seek help.

Breastfed newborns nurse frequently, at least eight times each twenty-four hours. In fact, ten or twelve feedings a day are not uncommon during the early weeks. On average, your baby will awaken to breastfeed every two to three hours. Feedings are timed from the beginning of one nursing to the beginning of the next. After your baby finishes a feeding, she'll probably be ready to nurse again within the next two hours. In fact, don't be surprised if she sometimes wants to nurse only an hour or so after her last feeding. Babies often cluster several nursings close together, especially in the evenings, and then sleep for a longer stretch at other times, such as the middle of the night.

Many new breastfeeding mothers are not prepared for the normal frequency of feedings. They assume they must not have enough milk because their baby wants to feed so often. New breastfeeding mothers often complain, "It seems like all I do is breastfeed." My response is, "Good for you. Frequent breastfeeding is the most important thing you can do right now!" Getting breastfeeding off to a successful start is indeed a high priority; everything else can wait.

To better understand your baby's needs, try writing down everything you eat or drink for one day, including full meals, snacks, and even sips of water. I'll bet you make at least eight to ten entries. Well, some nursings are more like sips or snacks, while others are full meals. Human milk is digested more rapidly than formula, so the breastfed baby is hungry sooner. Unfortunately, many contemporary parents, grandparents, and even physicians, are more familiar with the typical three- to four-hour feeding schedule of formula-fed infants. Despite the appealing convenience of an infrequent feeding schedule, it's simply unrealistic to expect a breastfed baby to thrive without frequent, round-the-clock nursings.

The best advice is don't focus much attention on the clock. Instead, follow your baby's cues about how often she needs to nurse. If she just fed an hour ago and is acting hungry again, respond to her signals and offer your breast. Feeding frequently during these first weeks is the principal way your milk supply becomes adjusted to meet your baby's requirements. This is known as the breastfeeding law of supply and demand.

Generally, babies can be counted on to let us know when they are hungry. Some babies, however, need to be awakened to nurse because they just don't demand as often as they should. During the daytime, if three and a half to four hours have elapsed since your baby last nursed, you should gently arouse her to feed. Pick her up, change her diaper, and remove some of her clothing to try to awaken her to breastfeed. At night, don't let her sleep longer than five hours without breastfeeding until she's at least a month old. To assure she breastfeeds often enough each day, don't allow more than a single four- to five-hour interval without nursing during each twenty-four-hour period.

WHEN TO SEEK HELP: If your baby often sleeps through feeding times, seldom demands to be fed, or frequently needs to be awakened to nurse, contact her physician. If your baby nurses more than twelve times each day and acts perpetually hungry, arrange to have her weighed promptly to see if she is obtaining enough milk. Ask to be referred to a lactation consultant who can evaluate your breastfeeding technique and make suggestions for improving your baby's intake of breast milk.

Helping baby latch on and swallowBreastfed newborns should latch on correctly to both breasts and suck rhythmically for at least ten minutes per breast at each feeding. By the time you arrive home, you should be comfortable latching your baby on to each breast. It's not uncommon for a baby to prefer one side or to have an easier time latching on to one breast. However, you need to keep trying to get the baby to take both breasts well. Unsuccessful attempts to nurse don't count as a feeding.

Once your baby is latched correctly, allow her to suck for as long as she wants. She may pause periodically and need some gentle prodding, but, in general, she should suck rhythmically throughout most of the feeding. Allow her ample time at the first breast to help assure that she gets the rich, high-fat hindmilk. She'll probably start sucking less vigorously, fall asleep, or come off the first breast after ten to fifteen minutes. This is a good time to burp her, change her diaper, and help arouse her to take the second side. A baby usually obtains more milk by nursing at both breasts than by taking one side only. Thus, it's generally preferable to nurse from both breasts at each feeding whenever possible. Allow her to stay at the second side as long as she wants, although a baby may nurse only five minutes at this breast, which will probably be less well drained than the first. An infant nurses more vigorously at the first breast and usually takes more milk from that side. Thus, you should alternate the side on which you start feedings, so both breasts receive about the same stimulation and emptying. A lopsided milk supply can develop in a matter of days if you consistently start feedings on the same breast.

WHEN TO SEEK HELP: If your baby is unable to latch on to one or both breasts or latches briefly but does not suck effectively, try the these strategies. If these techniques don't remedy the problem promptly and allow your baby to start feeding well, seek assistance right away. It's not only distressing and frustrating to have a newborn who doesn't feed well, but it can place your baby's welfare at risk. Furthermore, if your breasts don't get drained sufficiently, they can become uncomfortably engorged, and your milk supply may be jeopardized. Don't allow your baby to miss feedings and don't allow your breasts to go without regular stimulation and removal of milk. If the latch-on problem can't be remedied quickly, your baby will need to be fed by another method until she learns to breastfeed effectively. In addition, your breasts will need to be pumped at regular intervals in order to keep your supply from declining. The expressed milk can be fed to your baby.

Both very short or extremely long nursing sessions can signal a feeding problem. If a baby suckles too briefly (less than ten minutes per feeding), she probably won't receive enough milk. On the other hand, if nursings last more than about fifty minutes, or if your baby often seems hungry again shortly after feeding, it could mean that she is not being satisfied. Infants who need to nurse almost continually may not be obtaining adequate volumes of milk. The problem can be due to either ineffective breastfeeding technique or low milk production. Often it is a combination of both. Contact your baby's doctor and have your infant weighed promptly.

Breastfed babies should swallow regularly while nursing. A baby first starts nursing with short, fast bursts of sucking. As milk flow begins, the sucks get longer and slower. Swallowing is triggered when the mouth fills with milk. Before your milk comes in abundantly, your baby may not swallow often during nursing, as the volume of colostrum is rather low. Once your milk starts increasing in volume (usually on the second to fourth day), you should start to hear your baby swallow after every one or two sucks. Swallowing is indicated by a soft "kaa, kaa, kaa" sound when a baby exhales. When your milk ejection reflex is triggered, your baby may swallow after every suck in order to handle the rapid flow of milk. You should hear suck, swallow, pause, suck, swallow, pause. Audible swallowing after every couple of sucks should continue for about ten minutes. As milk flow slows down, the frequency of swallowing will decrease. When your baby goes to the second breast, rapid swallowing should begin again. Other signs that your baby is getting milk include seeing milk in her mouth or dripping from the opposite breast while she nurses.

WHEN TO SEEK HELP: You should be concerned if you don't hear frequent swallowing when your baby nurses, especially when you have other reasons to suspect your baby isn't feeding well. Infrequent swallowing may be due to a low milk supply or ineffective sucking that prevents your baby from obtaining adequate milk. Signs that your baby is sucking incorrectly include opening and closing her mouth in rapid tremorlike movements, making a clicking sound or dimpling her cheeks while nursing, or frequently coming off the breast. Contact your baby's doctor if you think your infant is not swallowing much milk. The problem needs to be remedied quickly.

Hunger cues; demand feeding; nix the pacifier

Breastfed newborns should appear satisfied after nursings. Generally, a well-fed baby is a contented baby. In the first two days, when the volume of colostrum is relatively low, your baby may act hungry very soon after the last nursing. By the third day, however, when your milk starts to come in abundantly, your baby should appear more content after nursings. Breastfed newborns usually fall asleep at the second breast and act satisfied between feedings.

Sometimes new parents don't recognize their baby's hunger cues because they mistakenly assume that an infant who just finished nursing must automatically have obtained sufficient milk. The surprising truth is that an infant can go through the motions of breastfeeding, nurse from both sides, and still not consume much milk. Several explanations are possible. Perhaps the baby has been latched on incorrectly or has a faulty suck. Maybe the milk ejection reflex wasn't triggered, or the mother's milk production is insufficient. Obviously, the first thing to do when a baby appears hungry after nursing is to return him to the fullest breast for another chance at feeding.

Of course, not all fussiness in a breastfed baby is due to hunger. Babies need human contact as much as they need food. An infant may cry because he wants to be held and doesn't want to be separated from his mother. Even a well-fed baby may want to be carried and held to make him feel safe and secure.

WHEN TO SEEK HELP: Breastfed infants who appear hungry after most feedings (e.g., crying, sucking on their hands, rooting, requiring a pacifier to be consoled) may not be getting enough milk. Signs of apparent hunger in an infant should not be ignored, even if the baby is feeding on a proper routine. Contact your baby's doctor and have your infant weighed. If your baby really isn't getting enough to eat, the sooner the problem is recognized, the more readily it can be remedied.

Demand feeding should mean frequent feeding. Decades ago, when bottle-feeding was the predominant method of feeding infants in the United States, scheduled feedings became popular. Babies were fed by the clock, usually at four-hour intervals. A baby who showed signs of hunger sooner than four hours often was made to wait until the appointed feeding time. Because such rigid scheduling of feedings didn't account for babies' unique needs, some experts began to advocate more flexibility in feeding infants. The term demand feeding was used to describe feeding a baby whenever he showed signs of hunger instead of feeding by a rigid schedule.

In recent decades, feeding babies on demand has become the norm. Certainly, feeding a baby when she shows signs of hunger seems appropriate and empathetic. However, some well-meaning parents misapply the concept by allowing a sleepy, nondemanding baby to feed too infrequently. Feeding on demand was meant to give a parent permission to nurse again if their baby seems hungry sooner than expected. A newborn shouldn't be allowed to sleep five or six hours without feeding just because he "hasn't demanded." Nor should "demand feeding" be used to justify a newborn going all night without breastfeeding, even if he is willing to sleep through. In summary, demand feeding reminds us to feed hungry babies more often than we might expect them to need to be fed. It shouldn't be misinterpreted to let sleepy babies go too long without nursing.

Postpone pacifier use for breastfed newborns. The use of pacifiers is a widespread childrearing practice, both in the United States and in other countries. Although many experts have cautioned that early pacifier use can undermine the successful establishment of breastfeeding, little scientific evidence has existed to support this claim. Now several recent studies have confirmed that early pacifier use is linked to early weaning. In one study, infants using pacifiers at one month of age were three times more likely to have discontinued breastfeeding by six months of age. The risk of early weaning was greater for "frequent" users (during the whole day and night to help them fall asleep) as compared to "partial" users.

Based on my experience, I agree that early pacifier use before breastfeeding is well established can sabotage long-term breastfeeding. A baby who is "corked" or "plugged" with a pacifier may not learn to nurse as effectively as the baby who does all, or most, of his sucking at the breast. While some hungry babies will spit out their pacifier and vociferously demand a feeding, other underfed infants are more passive. They fool us by acting content to suck nonnutritively on a pacifier when they really need to be obtaining milk. The younger the infant, the harder it is for parents to interpret their baby's cues. It's just not possible in the early weeks to reliably distinguish when a baby only needs "comfort sucking" and when the infant needs "nutritive sucking." Once a pattern of consistent weight gain has been achieved, it is much less risky to introduce a pacifier. After four to six weeks of successful breastfeeding, a mother will have acquired much experience in interpreting her baby's cues. She will be more adept at recognizing signs of hunger and evaluating the quality of a feeding and will be less likely to confuse hunger with the urge to suck.

Elimination patterns & problemsInfant Elimination Patterns
During the early weeks of breastfeeding, the contents of your baby's diaper will be of surprising interest to you. The fact is that your baby's early elimination patterns can provide a powerful clue to the success of breastfeeding. In the first few weeks, it can be very helpful to keep a daily record of his wet diapers and bowel movements.

Breastfed babies should urinate six or more times a day. In the first two days, your baby may wet only a couple of times in twenty-four hours. As your milk comes in more abundantly, the number of wet diapers steadily increases. By the fourth or fifth day of life, your infant should urinate after most feed-ings, producing at least six to eight wet cloth diapers each twenty-four hours. The urine should be colorless (dilute), not yellow (concentrated).

Because disposable diapers are so absorbent, it can be difficult to tell whether or not your baby has wet. Even if you anticipate using disposable diapers in the long run, you might want to have your baby wear cloth diapers for the first week or two. Or, you can place a piece of tissue paper in your baby's disposable diaper to help tell whether she has urinated. To get an idea of how a wet diaper feels, you can pour one to two ounces of water onto a dry diaper.

A red or pink "brick dust" appearance on the diaper suggests your baby is not getting enough milk. "Brick dust" on the diaper results when uric acid crystals form in concentrated urine. It is not an uncommon occurrence among breastfed infants during the first day or two, when the quantity of colostrum the baby drinks is low. Once your milk starts increasing in abundance, however, a breastfed baby should be able to consume sufficient volume of milk to produce clear urine.

WHEN TO SEEK HELP: The presence of uric acid crystals in a baby's urine after the fourth or fifth day raises the suspicion of inadequate milk intake. Unfortunately, both parents and health professionals often misinterpret this valuable clue and mistake it for other phenomena. For example, little girls sometimes have a slight amount of vaginal bleeding a few days after birth as a result of the mother's high hormone levels during pregnancy. When handling a telephone inquiry, a health professional might attribute a parent's report of a reddish color in a little girl's diaper to slight vaginal bleeding. If a boy baby has been circumcised, urate crystals on the diaper might be confused with blood from the circumcision site. If your breastfed baby has a "brick dust" appearance in the diaper after your milk has come in, contact her physician and ask to have her weighed to determine whether she is getting enough to eat. You also should notify your baby's doctor if your infant has fewer than six wet diapers each day after the fourth or fifth day, or if her urine is dark yellow or scant in quantity.

A breastfed baby's bowel movements should start to turn yellow in color by the fourth or fifth day of life. These yellow "milk stools" appear shortly after your milk comes in abundantly and your baby is consuming generous quantities of milk. The movements are loose, about the consistency of yogurt, with little seedy curds. Some people describe their appearance as a mixture of cottage cheese and mustard; others liken them to butterscotch pudding. Milk stools generally are a large cleanup job, not just a dot or streak.

WHEN TO SEEK HELP: If your baby is still having dark meconium or green-brown "transition" stools by five days of age and has not yet had a yellow bowel movement, this is a probable sign that she is not getting enough milk. Contact your baby's doctor and arrange to have your baby weighed.

Breastfed babies usually pass four or more sizable bowel movements each day for at least the first month of life. Many breastfed newborns will pass a yellow milk stool with every nursing during the early weeks of life. This frequent stooling pattern is not diarrhea. It is entirely normal and suggestive of adequate milk intake.

Beginning around one month or so, the number of bowel movements usually starts to decrease. By a couple of months of age, it is not uncommon for an exclusively breastfed infant to go days-even a week or more-without having a bowel movement. This pattern is not considered constipation because when a stool is finally passed, it often is loose and large (indeed, a mudslide!). Unfortunately, some parent education materials I have read inappropriately blur the two distinctly different stooling patterns of younger and older breastfed infants. Parents often are taught that breastfed infants can stool as often as every feeding or as infrequently as once a week. While both extremes can be normal, they are normal at different ages. The breastfed newborn has the frequent stooling pattern, while the older fully breastfed baby may go days without a bowel movement.

WHEN TO SEEK HELP: If your newborn is having fewer than four stools each day, or if the bowel movements are scant in amount (just a stain on the diaper), it could mean she is not getting enough milk. Contact your baby's doctor and arrange to have her weighed. I am impressed that parents typically are excellent observers of the contents of their baby's diaper. But health professionals don't always do our part in communicating to parents what's normal and what's not. The simple observation of a baby's stooling pattern is a valuable, yet often overlooked, clue to a baby's nutritional well-being.

Changes in the breastsExpected Changes in the Nursing Mother's Breasts
Your breasts will change significantly during the first week after giving birth as they begin their job of making and releasing milk. As stated previously, a wide range of normal exists for when milk comes in abundantly, the amount of milk women produce, the magnitude of breast enlargement or firmness that occurs, and the ease of milk flow. Make it a point to pay attention to your breasts and the clues they can offer about the success of breastfeeding. The following guidelines will let you know what to expect and when to seek help.

A mother's milk usually starts being produced in abundance two to four days after delivery. Colostrum, the early milk produced by the breasts, is present in relatively small amounts, beginning months before delivery and continuing for the first few days after giving birth. The process of abundant milk production (known as lactogenesis) begins approximately two to four days after delivery. In the past, lactogenesis occurred while a mother was still in the hospital. At the time of a mother's discharge, her milk already had increased and the nurses assisting her could be reasonably certain whether breastfeeding was off to a satisfactory start. Today, however, most women are already home when lactogenesis occurs. They may encounter unexpected discomfort or difficulty latching their baby on correctly when their breasts are engorged.

A woman's breasts become larger, firmer, heavier, warmer, and even uncomfortable when her milk starts increasing in volume. While these changes are more dramatic in some women than in others, the large majority of mothers can readily tell whether their milk has come in abundantly. The scant clear or yellow colostrum changes in appearance to whitish milk and greatly increases in quantity. The sudden increase in milk production may be evident by spontaneous leaking from the breasts or by seeing milk in the baby's mouth.

Most often, increased milk production begins two and a half to three days after delivery. Milk tends to come in earlier among women who have given birth previously and those who delivered vaginally, compared to first-time mothers or women who had C-sections. Occasionally, however, milk starts coming in abundantly as late as five to seven days. Often the delay is due either to medical problems in the mother or to severe emotional upset. For example, I have seen lactogenesis be delayed or diminished in some women with high blood pressure, excessive blood loss at delivery, serious infections, severe pain, or extreme emotional stress.

For many women, postpartum breast engorgement is uncomfortable, and in a few it is downright miserable. For most women, it is an unmistakable occurrence, but for a small minority, it is barely perceptible. While some women who scarcely notice whether their milk has come in go on to breastfeed successfully, I consider lack of significant postpartum breast engorgement to be a red flag worthy of investigation.

WHEN TO SEEK HELP: In a tiny percentage of women-sometimes those who are very ill postpartum-milk fails to come in normally and full lactation is not possible. Such a woman may experience little, if any, breast engorgement, and her milk production may not climb sufficiently to nourish her baby. That's why I never ignore a mother's statement, "I'm not sure if my milk ever came in." If your baby seems hungry after most feedings and you do not think your milk has come in by four days postpartum, you should contact your baby's doctor and have your infant weighed to make sure she has not lost excessive weight from birth.

If you experience severe breast engorgement, with hard, painful, swollen breasts, you should also be concerned. Severe engorgement makes it difficult to get milk flowing well, and the resulting pressure can lead to decreased milk production (believe it or not!). Excessive engorgement can also cause extreme discomfort, problems getting the infant latched on, sore nipples, and poor milk intake by the baby. Contact your own and/or your baby's doctor if your breasts are severely engorged. Ask to be referred to a lactation consultant who can help you obtain and use an electric breast pump to express milk and soften your breasts.

A mother's breasts usually feel full before each feeding (suggesting milk is present) and become softer after the baby has nursed (suggesting that milk has been emptied). Earlier, I recommended that you alternate the breast on which you start feed-ings. Some counselors advise women to move a safety pin from one bra strap to the other to remind them on which side to begin. Successful nursing mothers usually admit that they need no such reminder because the fuller breast is so obvious to them. Try to learn to pay attention to such changes in your breasts as long as you breastfeed.

After your longest night interval between feedings, your breasts should feel particularly full. Often, a woman will leak milk onto her bed sheets or become so full that she awakens before her baby demands. These are additional indicators of plentiful milk production.

WHEN TO SEEK HELP: Generalized breast fullness that doesn't decrease with feeding could suggest that your baby is not extracting the milk effectively. On the other hand, soft breasts that don't feel fuller before nursings could imply that little milk is available at a feeding. Patchy, or localized, breast fullness also can suggest a problem. Obviously, these observations are rather subjective and are less precise in predicting a problem than many of the other breastfeeding criteria described in this chapter.

A mother's nipples might be mildly tender for the first several days of nursing. Nipple tenderness usually is present only at the beginning of feedings and subsides as the feeding progresses. Discomfort should not interfere with feedings and usually improves once milk starts to come in abundantly. By the end of the first week, breastfeeding is usually comfortable.

WHEN TO SEEK HELP: Severe nipple pain that makes you dread nursing your baby, pain that lasts throughout a feeding, or pain persisting beyond one week all are considered abnormal. Most likely, your baby is not breastfeeding correctly. If your infant isn't latched on properly or sucking correctly, not only will your nipples hurt, but your baby may not obtain sufficient milk. Thus, if you have severe sore nipples, you should obtain help with your nursing technique and have your baby weighed. Severe cases might require using a hospital-grade rental electric breast pump until your nipples are healed.

After two or three weeks, nursing mothers usually notice the sensations associated with the milk ejection, or milk let-down, reflex. One of the hormones released from your pituitary gland during nursing is known as oxytocin. Oxytocin is important to the success of breastfeeding because it causes tiny muscle cells around the milk-producing glands to squeeze milk out of the glands and into the milk ducts. This propelling of milk from the milk ducts is called the milk ejection reflex or the let-down reflex. Oxytocin release helps milk produced in the glands become available to the baby. Once a woman's milk supply is well established, the milk ejection reflex causes noticeable breast sensations, such as tingling, tightening, stinging, burning, or a pins-and-needles feeling. It can take a couple of weeks to perceive these breast sensations. When your milk ejection reflex is triggered, your baby may start to gulp milk, and milk may drip or spray from the other breast. Just hearing your baby cry or holding your infant can cause your milk to "let-down," even before your baby latches on.

WHEN TO SEEK HELP: Although many women breastfeed just fine without noticing signs of the milk ejection reflex, failure to perceive the typical let-down sensations by three weeks postpartum could mean that your milk supply is low. Generally, the more abundant the milk supply, the more dramatic the signs of let-down, but this is not a hard-and-fast rule. If you are in doubt about your milk supply, have your baby weighed.

Normal weight patternsNormal Weight Patterns in Breastfed Newborns
The most reliable indicator of the success of breastfeeding is your baby's weight. A baby who is thriving is sure to be getting enough milk. On the other hand, a baby who has lost excessive weight or who is gaining too slowly most likely is consuming too little milk. Not only is the baby's welfare of immediate concern, but the mother's milk supply can decline rapidly if her baby isn't removing the milk from her breasts effectively. Use the Successful Breastfeeding, Breastfeeding Chart and Weight Loss and Weight Conversion Chart to make sure you and your baby are feeding often enough.

Infant weight loss after birth. All babies lose some weight in the first days after birth. On average, breastfed babies lose a little more than bottle-fed infants. This is probably because the volume of colostrum, or early milk, is relatively low before mother's milk comes in abundantly. Many health professionals consider it acceptable for babies to lose up to 10 percent of the original birth weight within the first three days after birth (see Weight Loss and Weight Conversion Chart, below). I consider 10% to be the very outer limit of acceptable loss, as most babies will not lose this much weight before they start to gain. Larger babies can lose a greater number of ounces than smaller babies, yet still be considered to fall within the range of normal.

WHEN TO SEEK HELP: If your infant loses more than 8 to 10 percent of his original birth weight or continues to lose weight beyond four days, it is very probable that he is not obtain-ing sufficient milk by breastfeeding. If a baby doesn't take sufficient milk, a mother's breasts won't continue to make sufficient milk. Your baby's doctor should evaluate your infant, assure that he starts to receive adequate nutrition, and help you obtain assistance with breastfeeding technique and proper breast emptying.

Rate of Weight Gain
An infant should stop losing weight once the mother's milk comes in. At this point, a baby should be consuming adequate quantities of milk to begin steady weight gain. Young breastfed infants gain weight at a surprisingly rapid rate, especially during the first six weeks of life. Most will regain their lost weight and surpass their birth weight by ten to fourteen days. Although every baby's growth pattern is unique, an average weight gain of an ounce each day (beginning by four or five days) is typical during the first three months of life. Between birth and three months, most babies will gain two-thirds of a pound to one pound (ten to sixteen ounces) every two weeks. Thereafter, the rate of weight gain tapers somewhat.

WHEN TO SEEK HELP: If a breastfed baby is under birth weight by two weeks of age or has not started to gain at least five to seven ounces a week once the mother's milk comes in, the infant should be evaluated and breastfeeding assistance provided. Inadequate weight gain is a strong indicator of low milk intake by a baby and requires prompt investigation. Taking a wait-and-see approach can lead to diminished milk supply and an underfed, unhappy baby.

In-home Weighing of Your Baby
Several commercial electronic infant scales are available for in-home weighing of your infant. In the past, new parents commonly used in-home baby scales, even though some were notoriously inaccurate. Many contemporary health professionals discourage the use of in-home scales because they assume they are still inaccurate. Some of the modern instruments, however, are accurate to ten grams (just one-third of an ounce) and even to two grams. While a few parents find an in-home scale to be intimidating, most who have used the new, state-of-the-art, digital instruments report that they can breastfeed with greater confidence knowing their baby is gaining weight. As mentioned earlier, your baby's weight is closely linked to the adequacy of breastfeeding. The early recognition of inadequate infant weight gain not only protects your baby's well-being but also improves your chances of succeeding at breastfeeding by identifying potential problems early. Of course, a scale can never substitute for visits with your baby's doctor, but it can provide valuable information about the success of breastfeeding and alert you to the need for medical attention or additional assistance with breastfeeding. Lightweight, user-friendly, affordable, accurate baby scales can be rented for home use.