Why and How to Keep a Breastfeeding Journal
By Teri Brown
New motherhood is filled with challenges and uncertainty. How often should you change the baby? How often should Baby be bathed? When will Baby’s umbilical cord drop off?
If you breastfeed your baby, you may have additional worries and concerns. Am I doing this right? Is Baby getting enough to eat? Do I have enough milk? One way you can minimize these concerns is by keeping a breastfeeding journal.
Laura Rees of Columbus, Ohio, found that keeping a breastfeeding journal helped. “It was very helpful because it helped me keep track of which side to start on,” she says. “It also helped me monitor how much the baby was eating, since I had a good record of how many times he had eaten during the day – and night.”
Begin by tracking your baby’s wet diapers and bowel movements
For Laureen Hudson of Vallejo, Calif., keeping a journal helped her keep track of a baby with food sensitivities. “My older boy is sensitive to corn, dairy, artificial colors and flavors and citric acid,” she says. “I figured all this out from journaling about what I ate and how he reacted. My younger boy didn’t have half the health problems the older did because of all I learned from the process.”
Why Keep a Journal
Brenda White, a register nurse and international board certified lactation consultant (IBCLC) at The Washington Hospital Center and Saphia Lifestyle Beverages for pregnant women, believes that breastfeeding journals can be vital to breastfeeding success. According to White, current studies show that approximately 65 percent of new mothers choose to breastfeed their babies prior to discharge from the hospital, but that most discontinue during the first six weeks postpartum. Why such a high number?
“Studies have found that new mothers are overly concerned that their milk supply is not sufficient to meet their baby’s nutritional needs and may introduce a bottle prematurely when everything is, in fact, going well,” White says. “The initiation of a daily breastfeeding journal during the immediate postpartum period and after discharge will heighten your awareness and ability to assess whether breastfeeding is going well and whether you need to contact a lactation consultant or other healthcare provider.” White believes the journal is also a valuable source at subsequent visits to the pediatrician, who can quickly summarize how breastfeeding is progressing by tracking your journal entries.
What Should Be Tracked?
White suggests that you begin by tracking your baby’s wet diapers and bowel movements, starting with the very first day. This is a more accurate account of how much milk your baby is getting than timing how long baby is feeding, because there are times Baby nurses for comfort and isn’t really suckling that hard.
“Each time you feed or change your baby, note the time,” White says. “In a 24-hour period, your baby should wet at least one diaper for each day of age, and after day one, have two or more bowel movements. For example, if your baby is 3 days old, he should wet at least three diapers in 24 hours and have two or more bowel movements. Once the baby is 6 days old, he should wet between six and eight diapers and have at least two stools in a 24-hour period. By day 5, the stools should be mustard-colored. Bowel patterns may change after the first month. If your baby is not having this many stools or wet diapers, you should inform your health care provider. You will find keeping a journal very helpful in deciding if your baby is receiving enough milk.”
According to White, your daily breastfeeding journal at between birth and the 5th day should note the following:
- Approximate time (to the nearest hour) that the feeding started
- Duration of feeding in minutes
- Whether you could hear Baby swallowing
- If Baby is having bowel movements and urinating daily and what the color and consistency is
You might also want to develop a fuss food list of possible food sensitivities. Jot down what you ate when your baby exhibits behaviors such as colic, bloating, severe constipation or diarrhea and restless sleep. “If you suspect your baby is reacting to a particular food, eliminate it from your diet for at least a week,” White says. “For example, if you want to be sure [that] corn is the culprit, try eating a small portion and gradually increase and note if your baby’s symptom’s reappear. If so, scratch it from your diet while breastfeeding. Your journal should note the suspected food, observed behaviors and results after one-week elimination from your diet.”
You don’t have to keep your journal forever. Goodness knows, new moms have enough to do. But look at it as a tool to help you succeed. The crucial time in breastfeeding is during those first two months; once you get past that, you are virtually home free.
“Daily journalizing will heighten your awareness and give you a more accurate picture of your baby’s progress,” White says. “If you have a question or concern, jot it down in your journal and keep it with you at all times to get answers from your health care provider. Remember, breastfeeding is a learned skill; it requires patience and practice. [Journaling] your way through this precious time is time well spent and builds a bond and memories that will last a lifetime.”
How’s It Going?
White suggests that Mom evaluate progress when Baby is between 5 and 7 days old by asking herself the following questions and taking note of the answers:
- Is breastfeeding going well for me now?
- Can I see an increase in my milk supply?
- Is my baby able to latch onto my breasts with her mouth covering my entire nipple and some of the dark area?
- Is my baby swallowing at least 5 minutes at each breast?
- Is my baby nursing at both breasts with each feeding?
- Is my baby nursing at least eight times in a 24-hour period?
- Does my breast feel full before feedings?
- Are my breasts soft after each feeding?
- Does my baby appear to be gaining weight?
- After the feeding, does my baby still seem to be hungry.
- Do I feel any sore, tender areas in my breast?
Discuss the answers with your lactation consultant or health care provider.