Week Ten
Your baby is increasingly developing skills which are useful in a world filled with sights and sounds. Their hearing has developed and they are beginning to track the movement of objects with their eyes. Movements are less jerky and they are gaining control of their head and neck. You will soon see indication they are working on intentional movement of their hands and moving their hand to their mouth on purpose. The central nervous system is developing down their spine and begin the coordinated movements so necessary in the second six months.
You might be seeing a sight change in sleeping development. As the baby’s circadian rhythm begins to evolve, sleep cycles at night will gradually consolidate and those in the day do so less. That might look like a longer period of sleep in the dark hours and a shorter one in the daylight hours. This development takes months and is not something your baby learns to do. If you are lucky enough to have a baby who falls into a day/night rhythm early remember that circadian rhythm is only one part of the complexity of sleep in the first year and you can still anticipate interrupted sleep for many mothers to come, even if your baby is sleeping long stretches right now. In fact, the original research done into infant sleep in the 1950s (which had many flaws yet is still held up by many as evidence) found that 75% of babies were “sleeping through”between 12 midnight and 5am however, the same study found those babies weren’t just weeks later! It turns out there is a calm before the storm around 3 months and its a rollercoaster after that!
In the very early weeks of breastfeeding, the frequency of poo is an indicator of good milk production. However, older babies will sometimes have less frequent bowel motions and might even go just once a week. It is very unusual that a healthy baby who is exclusively breastfed would experience constipation, although this can be common in formula fed babies. However, a full bowel needing to be emptied can be accompanied by a lot of farting and intense facial expressions. Babies can even be unsettled prior to doing a poo and if its been a few days the result can be a bit stinky! As long as the bowel motion is still soft and the typical breastfed poo mustard colour (or its greenish variations) then all is well. If your baby has other unusual symptoms or doesn’t seem their normal self, checking in with your doctor or nurse will rule out any medical causes. If you have recently introduced or changed formula, constipation can indicate it isn’t being easily digested. Again, your medical adviser can guide you on what to do next.
Breastmilk poo continues to be quite fluid until solids are introduced and some babies expel it rapidly or with such force it might shoot up the back of their nappy or out the sides! While alarming to experience if you are holding them at the time, it rarely does more than startle the baby, who probably feels much more comfortable after the event. If you have an over-abundant milk supply and/or a fast flow of milk, your baby might have very frequent liquid poo. This is typical and generally doesn’t distress the baby. In some babies, this might be an indicator of Lactose Overload (a different condition to lactose intolerance). Lactose is the sugar component of milk and moves quickly through the digestive system. The richer, fat components of breastmilk slow down the progress of digestion. When a baby gets lots of milk quickly in a breastfeed, the balance of sugar and fat might not be right to digest at the typical rate and the baby might experience digestive discomfort.
When left to sit, breastmilk separates into to distinct layers: the fat rises to the top. The high-fat milk looks like cream because it is! This rich milk is gradually released by the breast throughout the feed, increasing fat levels as the feed goes on.
(Shown is a remarkable level of milk from a mother with a non-typical supply)
We used to describe the milk early in a feed as foremilk and the later milk was called hindmilk. This wasn’t really an accurate description as the levels of fat vary from feed to feed and how long it has been since milk was last removed from the breast. The shorter the time, the higher the fat. You could measure the levels throughout a feed and not identify a moment when it switched from “foremilk” to “hindmilk. Poor understanding by health professionals led to education and resources suggesting a mother could somehow control the levels of each type of milk her baby took, through timing at the breast. This is no longer considered best practice.
When an imbalance is identified, a mother might be advised to “block feed”for a few days, as a way of putting the brakes on production. One breast is used for all feeds in a four hour period (+/-) no matter how many times the baby feeds. That breast is then rested while the other side is active for the following block of time. This is a short-term tool to regulate the supply and needs to be done carefully to reduce the risk of developing mastitis. Once things settle down, a normal approach of letting the baby finish the first breast and offering the second is resumed. The baby’s bowel motions can be a useful indicator that normal balance has returned.
A fast flow of breastmilk and a strong let-down reflex are often experienced by those who have an over-supply. One way to help reduce the impact is to use laid-back breastfeeding. A baby who feels overwhelmed by the strong flow of milk out of the breast can have more control if they can lift their head and release the breast.
