Safe Feeding and the Dangers of Underfeeding

I have discussed safe formula preparation and storage. However, there is another safety issue that I deal with very frequently – underfeeding.

It is extremely rare for an exclusively formula fed baby to experience complications from underfeeding, but many, many of the caregivers with whom I consult do not exclusively formula feed from birth. A lot of different things lead caregivers to use formula and a potentially dangerous reason is due to insufficient breast milk intake. I describe this as dangerous because caregivers do not always notice that they are underfeeding and can fail to intervene in time.

The following informational verbiage is heavily borrowed from the Fed is Best Foundation — a phenomenal resource to help guide safe infant feeding practices:

In newborn babies, insufficient milk intake can result in dehydration, starvation jaundice, hypoglycemia, and hyponatremia, which can cause permanent brain damage and death.

Sometimes moms think they’re producing much more milk than they actually are. Other times, the milk is sufficiently present, but baby is not adequately transferring it.

Using small amounts of formula until you can rectify the problem can literally save your baby’s life and preserve her brain function. It is not uncommon to need to use some formula until your milk comes in. You will not sabotage future breast feeding. Exclusive breast feeding can be readily re-established. And it is most important that you preserve your baby’s health until your milk arrives in proper quantity.

Know the signs and do not hesitate to intervene with formula. This is a vulnerable time in your baby’s brain development and permanent damage can happen quickly and viciously.

Risk factors for underfeeding: 7% or greater loss of birth weight, exclusive breastfeeding, delayed onset of milk production

Early signs that baby is being underfed: baby is unable to sleep or rest peacefully, baby is inconsolable or crying non-stop, baby is attempting to nurse almost continuously

Late signs that baby is being underfed: lethargy, poor feeding, seizures, hypothermia (low body temperature), and bradycardia (slow heart rate)

If you are experiencing any of these signs, or have an intuition that something is not right – contact your baby’s pediatrician immediately.

Wet diapers are not a reliable sign of proper milk intake in a newborn. A baby can produce the desired amount of wet and dirty diapers from the fluid and stool they are born with.

The only way to know if an exclusively breast fed baby is eating enough is to do a weighted feed. Simply weigh baby on an infant scale, complete a feeding, and re-weigh her at the end. If she has not transferred enough ounces of milk, per the scale’s reading, then intervention is needed.

Questions about things like am I underfeeding my baby (call your pediatrician FIRST with this concern), how to be knowledgeable about the signs of underfeeding, how to strategically supplement with formula as to preserve breastfeeding, or pre-lacteal feeding (intentionally feeding formula before your milk arrives to avoid unintentional insufficient breast milk intake)? Contact us now

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