How Do I Know if My Breastfed Baby is Getting Enough Milk?
We love breastfeeding. It’s amazing. Baby benefits in innumerable ways and Mama gets health benefits as well. The warm snuggles, the happy milk drunk sleepy smiles. It’s beautiful.
Wait. Why is he crying? I just fed him, he nursed for a half hour! He wants more already?
We were nursing and everything seemed great and she just pulled off and started fussing and won’t latch right back on. What is going on? Did she even get any milk?
That is, it’s all roses and sunshine until you’re left wondering if your baby is getting enough milk. And it’s not just something that brand new moms wonder about. Whether it’s your first baby or your fifth, you’re going to want to make sure that your baby is getting fed enough. Even an experienced breastfeeding mom can be left worrying if her baby is hungry or not. So let’s talk a little bit about how to tell when things are going well.
The Early Days – Diapers
What goes up must come down and what goes in must come out. Let’s talk baby poop. The first one to three days are the lovely meconium diapers. Baby is clearing out some things that have been hanging around a while. It’s thick, it’s sticky, and it’s dark. Colostrum is going to help move things out and mature milk is going to start lightening things up. In about four to seven days baby is going to start having light brown/yellow “seedy” bowel movements. Think whole-grain mustard.
Colors can vary, texture can vary. What matters is that the bowels are moving and the meconium is passing. While breastfed babies can go several days without a BM, in the early days they will tend to be more frequent. If your baby is over six days old and still having a hard time passing the meconium, it’s a good idea to check in with your provider.
While we’re on the topic of diapers, you also want to monitor how wet they are. On day one of life, expect one wet diaper. Day two, two wets. And so on until day six where it levels out. Going forward, watch for six wet diapers a day. If urine is particularly dark, the wets aren’t happening, or you notice crystals in the diaper check in with your provider.
The Early Days – Watch the Baby
Watch baby when you’re nursing. You want to see that little jaw moving. Often times you can hear swallowing once your mature milk comes in. Dr. Jack Newman says to watch the chin. Watch baby when the milk is flowing and you will often see a pattern – suck, suck, pause. That pause is where baby is swallowing the milk. Check out his page of breastfeeding videos and play “Really Good Drinking.” We want to see several minutes of active drinking with each feeding. Falling asleep after a few sucks at the majority of feedings is a red flag.
How often is baby nursing? If baby is waking to feed on her own at least eight times in twenty-four hours, you’re doing well. Alternate the breast you offer first at each feed. In the early days, you can often feel a difference in your breasts – one will feel fuller than the other.
How is baby acting after nursing? Sleepy and content? If you’re wondering when baby has drunk enough milk and is sleepy enough for you to unlatch and make a bathroom run …. look at the hands. When baby has closed fists, they are probably not quite in that relaxed state and may startle if you try to move. When the hands let go and relax and baby seems to be doing some flutter nursing is a good time to unlatch and transfer.
IMPORTANT: Just make sure you’re breaking the seal, slip a clean pinky into the corner of baby’s mouth to slide away with your nipple intact.
What About Weight?
During the first few days and weeks there will be a lot of focus on baby’s weight. This number is not the be-all-end-all. We’re talking about it after other signs purposely. It is one more tool that can give us information on how baby is doing. In general, you want to see baby go back to birth weight ten to fourteen days after birth. By day five, you want to see that baby’s weight is on the uphill climb. After the first two weeks, an average baby will be gaining about six ounces a week according to the World Health Organization.
As Baby Gets Older
When your little one was a newborn, they slept most of the day (with frequent waking throughout the day and night, of course). As baby gets older they want to interact with the world more – they want to look and touch and put all of the things in their mouths. Many babies will also get more efficient at nursing. This can make you start wondering all over again if they’re getting enough milk.
Go back to the basics and take a look at baby. Is he meeting his developmental milestones? Does she seem generally content after nursing? Are the wet and dirty diapers still coming? Some babies will slow down on the bowel movements around six weeks, but they are still going to be peeing everyday. After four months they may urinate less frequently, but still a noticeable amount – look for four really wet diapers each day.
He Seems Fussier Now
Sometimes an older baby can begin to fuss at the breast. It may seem as though it’s coming out of nowhere. When they were a newborn and the milk wasn’t flowing fast enough, they may have just fallen asleep. Now that baby is growing and able to interact more, she may fuss when the milk isn’t instantaneously flowing. Stay calm, take a deep breath, comfort baby and try again. As baby grows, so does your breastfeeding relationship. If this is a consistent problem, reach out to your IBCLC to assess the situation.
Keep in mind that after the first few months your breasts will naturally regulate and they may feel soft around the clock. This is normal and not a sign that you aren’t producing enough.
Weight is another factor we want to consider after four months. In general a breastfed baby will double their weight by five months old. Your baby’s health care provider will probably be charting the weight on a growth chart to make sure baby is sticking to their growth curve. They may become concerned if baby is “falling off of the curve.” If there is another concern, such as a decrease in wet diapers or a delay in developmental milestones you and your provider will want to make a plan together. If it’s just the scale, take it with a grain of salt. Watch diapers, watch for development, and watch baby.
The Big Picture
Whether your baby is brand new or a few months old, it’s totally normal to wonder if they are getting enough milk or not. It’s easy to get caught up in the ounces and numbers. Instead, look at the big picture. Watch the baby and not the scale, watch the baby and not the chart. Remember that babies cry and fuss for many reasons. Consider that scales can vary between each other. If there is a consistent problem, or your mama gut is giving you a red flag, don’t hesitate to call up your IBCLC! Support is just a call away. Schedule a consult today.
Amanda is an RN, IBCLC (lactation consultant) who helps breastfeeding families through classes and home visits in the greater Baton Rouge, La area. Secure virtual visits are available for breastfeeding support no matter the location.
All information on this website is intended for educational purposes only and should not be construed as medical advice. Magnolia Lactation Consulting encourages all families to have close communication with the medical providers of their choice.