"Diane doesn't like my milk!" the young mother declared. "It must not be strong enough for her. I guess it's time for formula."
Her words were a surprise to me. Three-week-old Diane had regained her birth weight in just ten days and was growing at a great, 1/2-ounce-a-day clip. I could see her cheeks beginning to fill out, and she was "filling" her diapers with gusto. Why did this mother think that her breastfeeding was going poorly?
"She just doesn't seem satisfied," Diane's mother said. "Diane doesn't act like she's happy."
As a lactation specialist, I am trained to note weight gain, to identify the sound of milk being swallowed, and to document the number of wet and stooled diapers. Hearing this mother, my suspicion was that Diane's mom was responding to non-feeding infant behavior and projecting those concerns onto her breastfeeding experience.
In addition to noticing the physical signs of breastfeeding success listed above, I also am aware that research shows that a mother will see her baby as "satisfied" when she observes particular newborn behaviors. She wants to see her baby become alert and gaze deeply into her eyes. She wants to calm her baby effectively and doesn't want her baby to appear irritable or difficult to console. Mom wants to enjoy cuddling with her baby and to know that her baby likes to cuddle right back.
Understanding this, I picked up the baby to play some newborn "games." First I swaddled Diane to bring out the best in her ability to play. Next, I swayed Diane gently until her eyes became bright and alert. Then I shook a rattle and watched as Diane followed the toy intently with her eyes. She watched closely as I moved the rattle without a sound. Diane's mom giggled and glowed with the words, "She's really smart, I guess!" With my encouragement the young mother called her baby's name. Diane turned slowly in her mom's direction. With a big grin the mother lifted the baby from my hands and snuggled her face into the crease of the baby's soft neck. One of mom's hands went to her breast to suppress the unexpected let down of milk.
Now Diane's mom is a breastfeeding star and an advocate for other new moms. She comes to our breastfeeding class to discuss the challenges and joys of breastfeeding. "Babies are little people who have special ways of communicating," she says. "Don't just count their pees. Learn to speak their language, and you'll soon know how much they love your milk!"