One of the biggest concerns that new mothers have is wondering “is my baby getting enough milk?”.
This concern seems to be the most common reason for mothers starting formula supplementation, and also for early weaning from breastfeeding.
We live in a society that puts a lot of emphasis on measuring everything, and many of us (and our mothers) were bottle-fed so mums knew exactly to the milliliter how much milk the baby took in at each feeding. Unfortunately this self-doubt has continued with our generation and I am here to help you understand how to have the confidence and knowledge that your baby is getting enough breast milk.
The World Health Organization recommends exclusive breastfeeding for the first 6 months of your baby’s life and for breastfeeding to continue, with the addition of other foods, until 2 years or older. In Australia however we have very low rates of breastfeeding with only 39% exclusively breastfed to around 4 months; and only 15% are breastfed to the recommended 6 months.
I can assure you that nearly all mothers can produce an adequate milk supply for their baby. The human race would not have survived for millions of years if this weren’t the case. There is a very small percentage of women who just ‘don’t have enough milk’, but this is highly unusual, and is most often connected to some sort of medical problem, however many of these medical problems can be corrected and we can help increase your milk supply in the mean time.
Firstly let’s list what myths are out and about for breastfeeding:
Ok now that we have covered that, let’s talk about how you actually know your baby is receiving enough breast milk.
A baby should have at least 1 wet nappy on day one, at least 2 on day two, at least 3 on day three, at least 4 on day four and at least 5 on day five. From day 5 onwards though the information above is irrelevant. I usually tell mothers that a minimum of 6 wet nappies a day once your milk has come in is a good indication your baby is receiving enough milk.
Over the first few days, you may notice that your baby may have an orange-red stain in their nappy. This is called ‘urates’ and is the salts of uric acid in your baby’s urine. This is normal during this time. If you see this after day 4, consult your health care provider as once the milk is in there should be no more of this happening.
My thinking is if lots of stools come out, then lots of milk must have gone in, right?
In the first few days, infants’ stools gradually change from the sticky black meconium stools to green, then brown. Within a day or two of mother’s milk “coming in” they become “milk stools” which are yellow and seedy–the color of mustard and the consistency of cottage cheese.
Did you know that breast milk is a natural laxative? Most breastfed babies produce a stool with each feeding, which is a good sign that baby is getting enough milk. After the first month or 2, as the baby’s gut matures, the frequency of bowel movements decreases and that’s OK! At this stage, your baby may normally have only 1 bowel movement a day; some breastfed babies have one bowel movement every 3-4 days, yet are still getting enough milk. So don’t panic if you find your breastfed baby only poo’s 2-3 times a week. It is perfectly normal.
A newborn baby should breastfeed at least 8 times in 24 hours. Many newborns will breastfeed 10-12 times, which means your newborn can feed every 2 hours and that is completely normal. Don’t expect your baby to be on a 4-hour schedule – the average newborn will not gain enough weight that way.
You may need to wake your newborn up for feedings – newborns will often not demand to be fed often enough, especially during the first week or two, so if you feel your baby has not fed enough in the day light hours, wake your baby up by either changing the nappy or undressing the baby. You won’t have to do this too often as most babies will feed every 3 hours or so naturally but if you have a ‘lazy feeder’ you may have to.
Once your milk is in, your breasts should feel fuller before feedings and softer after you breastfeed. Changes in fullness will be less noticeable when baby is older and your breasts become more efficient at producing the exact amount of milk your baby needs. You will notice that your breasts at this stage will mostly be soft all the time as your body has worked out how much milk it needs to make for your baby.
If you feel your baby sucking vigorously, hear him/her swallowing through much of the breastfeed, notice your milk ejection reflex, and see your baby drift contentedly off to sleep, chances are your baby is getting enough milk.
The only way to be absolutely sure that your baby is getting enough milk is to check their weight regularly. Remember that it is normal for your baby to loose 10% of their weight on day 3. If for some reason your baby has lost more then 10% by day 3 the midwives will direct you where to go with your feeding from there. Often expressing breast milk post feed is a good way to increase your milk supply. Your caregiver will direct you what the best options are for you so follow their lead.
Babies who are getting adequate amounts of milk will weigh within 80 -100 grams of their birth weight when they go for their 2-week check-up. Some infants normally take a couple of weeks to regain their birth weight, especially if they lose a lot initially, however other babies will more than likely be back at their birth weigh, if not more then their birth weight by 2 weeks of age.
When you are discharged from the hospital, remember to ask the Midwife to tell you the baby’s weight. This is a figure your Child Health Nurse, Midwife or Doctor will want to know at your baby’s first check-up, since weight gain is measured from baby’s lowest weight, not the birth weight.
After regaining birth weight, the average infant gains 100-200 grams a week, or a minimum of 400 grams a month. Some babies gain weight quickly in the first months after birth; others gain more slowly, but are still within the normal range. Don’t be disheartened if your baby is a bit slow one month as I am sure the next month your baby will catch up. Believe in yourself. You are doing a GREAT job!
If you notice any of the following signs or symptoms in your baby contact your health care provider straight away.
Breastfeeding is a confidence game, and nothing undermines a mother’s confidence like being afraid her baby isn’t getting enough milk. If your baby is producing enough wet nappies and having bowel movements and is gaining sufficient weight, your baby is getting enough milk.
(This article contains general information only and is not intended to replace advice from a qualified health professional. All information is written from the experience and knowledge of the person writing the post).