A postpartum woman telephones about her 4-day-old infant. She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well. Effective breastfeeding is indicated by the newborn who:

Choice A reason:

Choice A is the correct answer because the number of wet diapers a newborn has per day is a reliable indicator of effective breastfeeding. When a baby is breastfeeding well and getting enough milk, they will have an adequate number of wet diapers, typically at least six to eight per day. The frequent wet diapers indicate that the baby is adequately hydrated, and their body is eliminating waste products as expected.

Choice B reason:

Choice B, having at least one breast milk stool every 24 hours, is not the most reliable indicator of effective breastfeeding, although it is an important consideration. The frequency of bowel movements can vary among breastfed infants, and some babies may have several bowel movements a day, while others may have fewer, even skipping a day. The number of wet diapers is a more consistent measure of sufficient milk intake.

Choice C reason:

Choice C, sleeping for 6 hours at a time between feedings, is not an accurate indicator of effective breastfeeding in a 4-day-old newborn. Newborns typically feed frequently, at least 8-12 times in 24 hours, and they may not sleep for extended periods between feedings at this age. Frequent feeding is essential for establishing a good milk supply and ensuring the baby receives enough nutrients.

Choice D reason:

Choice D, gaining 1 to 2 ounces per week, is also not the most reliable indicator of effective breastfeeding in the early days after birth. Weight gain can vary significantly in newborns, and a 4-day-old baby might not show the expected 1 to 2 ounces per week gain yet. Moreover, weight gain can be affected by factors other than breastfeeding, such as birth weight, initial fluid loss, and individual growth patterns.