A new mother told us she had two items on her wish list. The first was a fill line on her breasts to help her judge her milk supply. The second was an empty/full gauge on her baby’s tummy. Considering that the most common reason women stop breastfeeding is their belief that they don’t have enough milk, we think these requests have some merit!
Since we cannot grant this mom’s wish, we’ve come up with the next best thing, a list of 4 “good” ways and 4 “not so good” ways to tell if baby is getting enough milk. We follow those lists with some tried and true strategies for increasing milk supply.
1. Check baby’s weight
The most reliable way to know your baby is getting enough milk is to simply check his weight. Compare weights taken several days apart to get an idea of your baby’s weight gain pattern.
Babies typically lose weight for first three days of their life. After that, they should gain at least 15- 30 grams (1/2 – 1 oz.) per day. We like them to be back to their birth weight by the time they are 1 ½ to 2 weeks old.
At about four months old, babies weight gain slows to about 15 grams (½ oz) per day.
If your baby is gaining normally on your breast milk alone, rest assured, you have enough milk!
2. Look at wet diapers
When babies are first born, they pee small amounts of dark yellow urine. There may be some pinky-orange or reddish colored crystals mixed into baby’s urine (sometimes called brick dust).
By five days of age, babies are drinking larger volumes of milk and should have heavy wet diapers. Their urine should now be pale yellow or almost colorless. If your baby continues to have the darker colored pee or brick dust in the diaper, your baby may not be drinking enough.
3. Count baby’s bowel movements
For the first day or two, a baby should have at least one bowel movement every 24 hours. After the 3rd day of his life, a baby should have at least 2 or 3 stools larger than the size of a quarter coin each day. It is not unusual for a breastfed baby to have a bowel movement every feeding.
By 2-4 months old, the bowel movement patterns can be varied. Some babies will continue to poop several times a day while others will have only one larger bowel movement every 5-7 days.
If your baby is not stooling every day, you may want to check baby’s weight to make sure he continues to gain well.
4. Watch your baby
Once your milk supply is established, you should hear your baby swallow every suck for at least part of the feeding. A swallow of milk sounds like a soft “cah” noise. Your baby should be relaxed and content after feeding.
If your baby still seems to want to suck, is fussy, or not settling, it usually means that he needs more milk. Try putting your baby back to the breast.
If the fussiness persists, have your baby weighed or contact your healthcare provider for an assessment.
Weight, diaper counts, and baby’s behaviour can be good indicators that baby is getting enough milk. You may be tempted to judge baby’s intake by the following things, but don’t be fooled; these ARE NOT good ways to know if baby is getting enough milk.
1. Length of feeds
The length of a breastfeed varies widely. We have seen well-nourished babies finish a feed within 5 minutes; others take an hour! The amount of time a baby spends at the breast does not tell you how much milk he received. Rather than focusing on the time, focus on how your baby is feeding. Is the your baby actively nursing or just "hanging out?" Are you hearing swallows of milk? (Read about timing breastfeeding here.)
2. Pumping your breasts to see how much milk you have.
The amount of milk you can express is NOT a good indicator of the amount of milk available for your baby. Your baby is much better at extracting milk from the breast than any pump.
3. Breast fullness
By the time your baby is 10 to 14 days old, your milk supply will have adapted to his needs. Your breasts may not feel as full as they did in the first week. This causes some women to worry they have “lost” their milk. This change in fullness, however, is normal.
4. Offering a bottle after breastfeeding
You may assume that a satisfied baby will not take a bottle after breastfeeding. Not true! A baby will almost always suck on a bottle and take at least ½ oz., even if he is full.
If the “good” ways to tell if your baby is getting enough milk has you doubting your supply, here are the best ways to go about increasing it.
Note: Most cases of low milk supply are due to things that interfere with breastfeeding and therefore, can be fairly easily fixed. With good information and support, most women can make enough milk for their babies. (Note: A very small percentage of women, likely less than one percent, may have an underlying medical condition that prevent them from producing enough milk.)
1. Breastfeed more!
This is the very best way to increase milk supply. Offer the breast whenever you think the baby may be willing, both during the night and day. You may need to call upon your supports so you can take a break from other household duties.
You are going to hate us for suggesting it, but if your baby sleeps a long stretch at night, try waking baby to feed. Prolactin, one of the hormones that helps your body to make milk, is higher at night, making this an ideal time to stimulate milk supply.
2. Nurse on both breasts at every feed.
If you are trying to increase your milk supply, try to nurse on both breasts each feed.
Keep baby on the first breast as long as he will actively suck. When his swallowing slows, try using breast compressions. When baby will no longer suck, despite breast compression, switch to the second breast. Switching back and forth between breasts several times in a feeding provides extra breast stimulation and helps to build up milk supply.
3. Discard the pacifier.
Try to meet all of baby’s sucking needs at the breast, rather than using a pacifier. More sucking at the breast will help your body to produce more milk.
4. Hand express or pump after feeds.
Your baby is better than a pump at building up milk supply. If, however, you cannot convince your baby to nurse longer, you could try a bit of hand expression or pumping after feeds. This mimics baby sucking at the breast, increasing breast stimulation. Expressing frequently, for short periods, will stimulate your supply better than pumping once or twice a day for a longer time.
5. Avoid bottles if at all possible.
If you need to give your baby extra milk, try to do it at the breast with a tube (see a photo in this post). Receiving extra milk at the breast will keep baby actively sucking for a longer period of time, thereby stimulating your breasts to produce more milk. In addition, it may be easier to get baby off the supplement if you do not use a bottle.
6. Take care of you.
Caring for young children is one of the most demanding jobs in the world (there are definitely no uninterrupted coffee breaks)! Try to focus on resting and skin-to-skin snuggling with your baby. Enlist the help of friends or family members to give you some uninterrupted time with baby. This is definitely a time to let the housework go.
Best wishes on your nursing journey!
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