6 h between breastfeedings during the first few days. Feedings should be on demand rather than by the clock, and feeding duration should also reflect newborn needs. Newborns discharged within 48 h, especially breastfeeding ones, should be seen by the physician within 7 days to evaluate progress, particularly if the mother is a primipara. Although the infant's sleeping for long periods between breastfeedings may be a sign of a good milk supply, it can be associated with inadequate supply and starvation. A normal newborn wets 6 to 8 diapers a day or more, defecates daily at least 3 times, and has a vigorous cry, good skin turgor, and a good sucking reflex.
Weight gain confirms adequate feeding.
By 7 days, the weight should plateau, and by 10 to 14 days it should be back to birth weight. Birth weight should double by age 4 mo. Breast engorgement, which occurs during early lactation and may last 24 to 48 h, may be minimized by early frequent feeding. Manually expressing milk during a warm shower may provide comfort. The mother may have to use warm compresses and express her milk manually just before nursing to allow the newborn to get the swollen areola into his mouth.