Underfed babies respond quickly and dramatically when they are given extra milk. If not, the baby may be sick and should again be checked by a health-care provider.
1) Immediate changes
During the first day after supplements have been started, underfed babies show various feeding patterns such as:
- Starting with small amounts for the first one or two feeds as they get used to eating more.
- Asking for a lot of milk at the first supplement and then sleeping for one longer amount of time (for example, four hours).
- Feeding frequently (for example, every two hours) for several feeds.
As soon as the supplements are started, the baby should immediately:
- Be more content.
- Be happy when fed and held.
- Stop scowling.
Within 12 hours, the baby will:
- Start waking on her or his own every 2 to 3 hours.
- Have more quiet, awake time.
- Sleep better.
- Show regular hunger signs before feeds and not be frantic.
- Be contented after feeds.
- Possibly spit more.
- Have more tummy noises and cramping.
- Have normal pees and stools (poops).
Within a day, the baby will start taking in fairly similar amounts of supplement after each breastfeed until the breastfeeding problems are solved. They will also show predictable hunger signs. The hunger signs should then guide the amount of supplement. This process may take longer if the baby is premature.
Newborns should be regularly and carefully monitored and weighed every 24 to 48 hours until they have gained weight steadily and no longer show signs of low milk intake.
2) Later changes
Once underfed babies are supplemented, they show continuous good weight gain. Some who have lost a large amount of weight will gain very quickly, as much as 120 grams (4 oz) a day during the first few days.
3) Long-term options
Over time, it is often possible to reduce or end the supplements if the baby’s breastfeeding problems have ended and the mother has a full milk supply.
Newborn babies with latching problems may be able to breastfeed effectively with the help of a nipple shield. They may need to continue using one until they learn to latch. Other babies may never learn to latch and suck and will need on-going replacement feeds.
Some mothers have a low milk supply and their babies will need long term supplementing after breastfeeding.