How do I know if my baby is getting enough breast milk?

How do I know if my baby is getting enough breast milk?

I am revisiting this topic because it is the number one question I hear from every parent. And it is true that if we don’t know the answer and feel comfortable in our understanding of it, we might question breastfeeding altogether. 

We actually have a solid, reliable list of signs that our babies are receiving enough breast milk. Here is the list.

1. Adequate weight gain
2. Back to birth weight by day 10 of life
3. Lots of wet and dirty diapers
4. Nursing 8-12 times every 24hr
5. Content between feedings
6. Nipples are not damaged
7. No pain with nursing

So let’s dive into these in some detail.

Weight gain: Babies should get back to their birth weight by day 10 of life. They should gain one ounce a day or more for the first 4 months of life. Yup they gain 2 pounds a month! This is a very accurate way to check on their progress. If you are concerned with your baby’s intake, you can ask for a weight check at your Pediatrician’s office. This is preferred to weighing your baby on your own. Home scales may or may not be accurate. User error is also common. But when you see your Pediatrician they can do an exam, counsel you and provide referrals if needed. 

Diapers: What goes in, must come out! Your baby should have 6+ wet (urine) and 3-4 + poop diapers every 24hr. In order to count, a poop should be the size of a quarter. In the first week, it is helpful to use diapers that have a ‘pee’ line. It will turn from yellow to green when the baby pees. If you see less than the required number of diapers, you should call your Pediatrician.

Nursing 8-12X every 24hr and baby being content between feedings: You may have that day when your baby eats 13X or so especially if they are going through a growth spurt. But if you are struggling and feeding your baby 17X a day, every day, this is a sign to reach out for support from an IBCLC. On the other hand, if your baby is sleepy and you cannot get up to 8 feeds every 24hr, you should also reach out. In general, babies need to eat a minimum of 8+ times every 24hr to gain weight regardless of feeding methods. We also should define a feeding. There is a range of normal but if you are nursing for 60 minutes at every feeding, this is a reason to reach out for help. Some parents will say, “ I feel like I’m always feeding my baby” or “My baby is hungry right after nursing or wakes up 15 minutes later for another feeding”.

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Healthy nipples and pain free nursing: That’s right! It’s not supposed to hurt. It's possible that in those first few days, your baby latched improperly for a brief period of time and caused some damage. This should heal and not recur with a deep, correct latch. Reach out for help if you are not able to attain a comfortable latch prior to leaving the hospital or birth center. Pain and nipple damage point to a shallow latch. When babies have a shallow latch, they will remove less milk than needed. Over time, this can lead to poor weight gain or weight loss. It will also lead to lowered milk supply if not corrected. The milk supply is dependent on how much milk your baby removes while breastfeeding. So if there is a challenge to this, the milk supply can decrease. You can combat this by reaching to an IBCLC to figure out the cause and by pumping to increase your supply. 

You will also see that when your baby is full, their body relaxes, their little fist will become an open palm and you may see some milk on their lips. You are the expert on your baby and your experiences. Trust your gut as a parent. If you are worried about your baby’s intake, contact their doctor and an IBCLC (International Board Certified Lactation Consultant). IBCLC’s are uniquely qualified and positioned to assess breastfeeding difficulties and offer a care plan that aligns with your goals. You don’t need to measure anything to figure out if your baby is getting enough milk. You now have the knowledge to evaluate their milk intake. 

Cathy Walker, MA, RNC, IBCLC