Breastfeeding the six-week-old

What should I expect when my baby is six weeks old?

By six weeks, feeds become shorter and more variable, about 10 to 15 minutes per side. Mothers with a large milk supply may find that their babies breastfeed a little more often, faster, and are less likely to take the second side. Babies become more effective at feeding and consume more milk, which may result in choking or tummy pain. They will start being interested in what is happening around them during breastfeeding and will let go of the breast to have a look. They spend more time awake and will occasionally need to be breastfed to sleep. Some babies have an evening fussy period, often followed by a five-hour sleep. Because of the evening fussies and decreasing breast fullness, some mothers mistakenly think their milk supply is decreasing at this stage and needlessly start to supplement their babies. 

A) Breastfeeding the six-week-old baby

Table: Typical Breastfeeding Patterns at Six Weeks of Age

(Links to more information about the topics in the above table: large milk supply; length of time on the breast; amount of time from the start of one feed to the start of the next; one or both breasts)

1) Breastfeeding patterns

As babies grow, they become more effective at breastfeeding and will feed faster (Sakalidis 2013). They also consume larger amounts of milk.

Feeds become more variable, some longer and some shorter.

Most babies need the second breast some of the time. If the mother has a large milk supply, babies tend to just want one breast at each feed and will feed more often.  With a more average milk supply, babies are more likely to need both breasts and will feed a little less often. Both are normal behaviours.

2) Nutrition and growth

The baby’s milk intake is stable between one and six months. 

Babies are now fleshy, with full tummies and thighs and a neck that is getting hard to clean.

3) Behaviour at the breast

Babies start being interested in what is happening around them at this stage. They are easily distracted and try to look away while breastfeeding, sometimes letting go to have a look and then latching back on by themselves.

While the baby may still choke, gulp, and pant at the start of the breastfeed, the baby is learning how to deal with the flow of milk and there is less drama while breastfeeding. Clicking does not bother babies and is normal at this age.

B) Behaviour patterns

1) Gut symptoms

The baby will have a lot of tummy pain during and right after feeds because of cramps caused by the gastrocolic reflex or needing to be burped. These are signs that the baby is taking in enough milk.  

Spitting usually starts around three to four weeks and is continuing, however not all babies are spitters.

2) Fussy behaviour

Babies still need to be held a lot at this age. Babies have more awake periods and will need to be breastfed to sleep.

Babies tend to be fussy around the same time each evening (typically 7 p.m. to 10 p.m. or 9 p.m. to midnight). This is followed by a sleep that can be as long as five hours.

Not all babies fuss in the evening and those that don’t are less likely to have a five-hour sleep. Rather they tend to breastfeed every two to three hours during the night.

C) Output

Stools (poops) will be less frequent and a little more pasty. They can be yellow or green, with or without seeds.

Babies will pee six to eight times each day.

D) Changes in the mother

1) Breast changes

The breasts are fuller before feeds and are only very full after the baby’s longest sleep. Overall, they notice less filling than previously.

Many mothers become concerned their softer breasts and the baby's “evening fussies” mean their milk supply is decreasing. It is not. These are normal changes. As long as the baby is growing well, mothers can be reassured that they are normal.

Some mothers needlessly start to supplement their babies with expressed breast milk or infant formula at this time. Mothers who have started supplementing for these reasons can consider decreasing or stopping this.

2) Milk changes

The milk has changed from the yellowish colour of transitional milk to the to the whiter colour of mature milk.

References

Sakalidis VS, Kent JC, Garbin CP, et al. Longitudinal changes in suck-swallow-breathe, oxygen saturation, and heart rate patterns in term breastfeeding infants. J Hum Lact. 2013 May;29(2):236-45