Usually term babies should be able to dictate their feeding frequency and amount. However, we try to avoid keeping the interval between feeds any longer than 4-5 hours. Kindly note that term babies in their third trimester build their glycogen stores in liver and brown fat around their body. These are utilised for the first 1-2 days to generate calories and energy when mothers milk has not kicked in. Hence, some babies may be not much interested in breast feeding during this period. However, usually by day 3 of life babies wake up with hunger and start to have good go at breast feeding. This is nature’s way of stimulating and hence, ensuring mothers milk production. Also, remember that babies stomach is small to start with and it gradually grows over time to tolerate more amount of milk. Usually, mother’s produce colostrum for first ~ 3 days after birth before they start producing milk. Colostrum is available in small amounts but is rich in fat and proteins.
Infant of Diabetic mother have risk of having low blood sugar level due to high amount of mother’s insulin transferred across the placenta especially when the regular blood supply of sugar is cut off after clamping the umbilical cord. Hence, these babies may need more than usual amount of calories to maintain the blood sugar levels. This also depends on how well the diabetes was controlled during pregnancy and whether we needed only dietary changes or did we also required insulin during pregnancy. We usually, check blood sugar levels in these babies pre 2nd and 4th feed to ensure their blood sugar levels are maintained within normal levels on breast feeding. We may consider commencing them on formula feeds top ups to provide extra calories for the first few days to tie over the crisis. But remember that we usually encourage topping your baby with formula feeds preferentially after breast feed to avoid displacing them from breast.
Preterm babies lack the glycogen stores and brown fat and hence are more vulnerable for having low blood sugar levels and getting dehydrated. Hence, preterm babies would require feeding more often like every 1-2 hourly or sometimes require to be on continuous nasogastric feeds as they