Q: How do I know when my baby is getting enough breast milk?

These are signs that your baby is getting enough milk (refer to chart below):

  • Your baby feeds at least eight times every 24 hours.
  • Your baby has enough wet and dirty diapers according to his age.
  • Your baby is active and has a strong cry.
  • Your baby has a wet, pink mouth, and bright eyes.

To make sure your baby is getting enough milk during the first week, keep track of the number of wet and dirty diapers in a 24 hour period. In the beginning it can be hard for new parents to know if their baby has a wet diaper:

  • A very wet diaper is heavier than a dry diaper.
  • If you want to know what a very wet diaper feels like, pour 30 milliliters  (two tablespoons) of water on a dry diaper.
  • Your baby’s urine (pee) should be clear or pale yellow, and it should have no smell.
  • If a dirty diaper is heavy, count it as both a wet diaper and a stool.
  • If your baby does not have enough wet and dirty diapers, get help right away!

Source: Best Start Resource Centre

Weight Gain

  • Babies lose an average of 7% of their birth weight in the first three days after birth. For example, a seven pound baby will lose about 230 grams or ½ a pound.
  • From day four onward your baby should gain 20 to 35 grams (⅔ to 1 ⅓ oz) per day and regain his birth weight by 10 to 14 days.
  • During the first three to four months your baby should continue to gain 20 to 35 grams (⅔ to 1 ⅓ ounces) per day.
  • If your baby is not gaining enough, wake your baby for more feedings, and get help to make sure your baby is feeding well.
  • Always breastfeed your baby when he seems hungry.
  • Up to about three weeks of age, breastfed babies should have three or more large, soft, seedy stools per day.

Around one month of age some babies will have only one to two stools per day. Some have one large stool every few days. This is normal as long as your baby is feeding well, seems content and his stools are soft. If your baby is not feeding well, is more fussy than usual or has not had a stool in more than a week, seek help from a public health nurse or your family doctor.

Your Baby’s Stomach Size

Your baby needs to feed often, because his stomach is small. When your baby is born, his stomach is about the size of a cherry and holds about five to seven milliliters. By day three, your baby’s stomach increases to about the size of a walnut and holds about 22 to 27 milliliters. Around seven days old, your baby’s stomach is about the size of an egg and holds about 60 milliliters.

What if I don’t have enough breastmilk?

Most women have more than enough milk for their babies. Here are some things you can do to make sure you have plenty of milk for your baby:

  • Start breastfeeding as soon as possible after your baby is born.
  • Breastfeed your baby often, at least eight times in 24 hours or more.
  • Hold your baby skin-to-skin as much as possible.
  • Offer your breast whenever your baby is fussy or shows feeding cues.

Growth Spurts

Babies have some days when they seem hungrier than usual. These times are called growth spurts and commonly occur at around 10 days, two to three weeks, six weeks, three months, and six months of age. When this happens, some mothers worry that they do not have enough milk. There is no need to worry. The more you feed your baby, the more milk you will produce.

Question – How do I know when my baby is hungry?

Breastfeed your baby often. Most babies feed at least eight times in 24 hours. Watch for your baby’s cues. Your baby will tell you when she is ready to feed and when she is finished. Your baby will show that she is ready and eager to feed. She will show some signs called feeding cues.

Early Cues: “I’m hungry.”

  • Stirring, moving arms.
  • Mouth opening, yawning or licking.
  • Hand to mouth movements.
  • Turning head from side to side.
  • Rooting, seeking to reach things with her mouth.

Mid cues: “I’m really hungry.”

  • Stretching.
  • Moving more and more.
  • Hand to mouth movements.
  • Sucking, cooing or sighing sounds.

Late cues: “Calm me, then feed me.”

  • Crying.
  • Agitated body movements.
  • Colour turning red.

If your baby shows late feeding cues, it is time to calm your baby before feeding her. You can do this by:

  • Cuddling
  • Skin-to-skin holding
  • Talking or singing
  • Stroking or rocking

At the start of the feed, your baby will have shallow and quick sucks. When your milk starts to flow, the sucks will become deep and slow. You will notice a pause during the suck when your baby’s mouth opens the widest. Your baby is drinking milk during this pause and you probably will hear or see her swallowing.

Question – How often should I breastfeed and for how long?

Most newborn babies feed at least eight times in 24 hours. Breastfeeding provides food for your baby to grow and develop. It is also comforting and helps you and your baby develop a close emotional connection. Some babies feed regularly and establish a routine quickly, others like to have short feeds very often especially in the evening or at night. This is called cluster feeding. It is very common in the first few weeks.

Feed your baby whenever he shows feeding cues. Feed him as long as he wants to feed. When he stops feeding on the first breast, burp him and offer the second breast. This will ensure you have a good milk supply as your baby grows. Some babies feed for 20 minutes, others take much longer.

You do not need to time his feeds or worry about him as long as your baby:

  • Feeds often, at least eight times in 24 hours.
  • Feeds with strong sucking and swallowing.
  • Has plenty of wet and dirty diapers.
  • Gains weight appropriately (see the chart above).

Remember: watch your baby, not the clock.

As babies get older they may change how long or how often they feed. Follow your baby’s cues. Your baby knows when he is hungry and when he is full. Whenever your baby wants to feed, start with the breast that your baby did not feed from. If he fed from both breasts, start with the breast from which your baby fed last. Let your baby feed as long as he is interested.

Switch to the other breast:

  • Once the first breast feels softer.
  • Your baby is no longer sucking actively.
  • Your baby lets go of the breast or falls asleep.

Make sure your baby feeds from both your breasts regularly. Some women keep track by putting a ribbon on their bra or a bracelet on their arm. Do whatever works for you and your baby.

Some babies release the breast, others don’t. If your baby has been pausing a lot and is no longer swallowing, you can take him off your breast. Slip a finger between your breast and your baby’s mouth to break the suction. Some babies always feed from both breasts, others don’t. Some babies have a short nap and then feed from the other breast.

Source: Best Start – Breastfeeding Matters

Question – What if I need help?