How Do I Know My Baby is Getting Enough Milk?
Written by Kelli Bottolfson-Brown
A common concern for new moms is milk production. How do you know that you are producing enough milk to properly nourish your baby? This concern is likely rooted in the fact that we live in a bottle-feeding culture and as such, we have been taught to measure and control how much food a baby takes in during each feeding. Unlike when you feed a baby infant formula from a bottle, it is not possible to measure the volume of milk that your baby drinks when you are exclusively breastfeeding. This can lead to uncertainty about how much your baby is getting, especially if you have expectations about how long or how often your baby should nurse. But, when it comes to breastfeeding, there is no “normal”. Because babies are humans with individual personalities, nursing patterns will vary from baby to baby, even within the same family. Every baby is unique. One baby may be laid back and take longer to nurse than a sibling who seemed more intent on getting the job done.
It is important to keep in mind that all women, with a rare exception, can produce enough breast milk to exclusively breastfeed. Once all of the kinks are worked out and a solid breastfeeding routine is established, breast milk production becomes a simple case of supply and demand. The amount of milk you produce is directly related to the amount of milk your baby drinks at each feeding. When your baby nurses at the breast, it stimulates your pituitary gland to release the hormone, prolactin. Because prolactin is the hormone responsible for producing milk, the more often your baby nurses at your breast, the more prolactin you will produce, and the more milk you will make. But as you and your little one work together to establish a breastfeeding routine, there are a few clues that you can take note of to be sure your baby is eating enough.
Feeding Frequency and Duration of Feedings
Paying attention to the number of feedings per day and how long your baby stays at the breast at each feeding can give you a sense of how much your baby is eating. In the first few days of your baby’s life, you will need to nurse frequently, even as often as every ½ hour. Although babies are born with the need to suck, this reflex is not very efficient in the first days, and it may take a little while for your breast milk production to ramp up as you and your baby work together to learn how to breastfeed. Most newborns need 10-45 minutes to complete a feeding and restricting your baby’s time at the breast is not beneficial.
If your supply seems low in the early days, just know that as your breastfeeding routine becomes established, your supply will increase to meet your baby’s needs, especially if you nurse your baby frequently. As you move into the second and third month of your baby’s life, you should plan to nurse at least 8-12 times every 24 hours and not restrict your baby’s time at breast.
And, even when breastfeeding is well established you will notice that your baby will go through phases where he/she eats nonstop, and has other times when he/she doesn’t want to feed as frequently. Again, it is important to remember that there is no “normal” here, and each baby is different. But, babies generally go through growth spurts around 2-3 weeks, 6 weeks, 3 months, and 6 months, and during these growth spurts they will want to eat more. Babies tend to return to pre-growth spurt feedings in 3 to 7 days.
Also, as your baby grows, she will be able to take in more milk with each feeding, which will allow her to go longer between feedings. And, she will become more efficient at transferring milk and it will take her less time to complete a feeding.
Fluctuations in milk supply throughout the day and storage capacity of your breasts will also impact the frequency and duration of feedings. You may start to notice that your supply dwindles during the late afternoon, which may be mean your baby will feed longer or more frequently in the evening. Some moms have a large storage capacity which allows baby to take in as much as she can hold with each feeding. Moms with a smaller capacity will likely nurse more frequently than women with a larger capacity.
If you are concerned that your baby isn’t getting enough milk, you can keep track of how often and how much your baby is urinating. In the 1st 2-3 days of life, babies will wet 1-2 diapers per day. Once your milk comes in around the 3rd or 4th day, you can expect your baby to have 6-8 wet cloth diapers or 5-6 disposable diapers per day.
Suck Swallow Pattern
Following your baby’s suck-swallow pattern can give you some peace of mind that your baby is transferring milk from the breast and swallowing it. Try to pay attention to the quick sucks at the beginning of a feeding, which will stimulate let-down, followed by long, slow sucks with regular swallowing and a breath after every one or two sucks. If you can identify this suck-swallow pattern, then you will know that the baby is nursing successfully.
Crying after a Feeding
It is a common myth that crying after a feeding indicates that a baby is still hungry. But, actually, babies cry for a variety of reasons, and hunger is just one of them. If your baby is fussy after nursing, a well-meaning friend or family member may suggest offering a bottle of pumped milk or formula and then think it is proof that your milk supply is insufficient if baby takes the bottle. Again, it is important to remember that hunger is just one of the reasons your baby will cry. Babies get fussy from being tired or over stimulated, when their nervous system is unsettled, when they’re lonely, cold, hot, or generally out of sorts. Be sure to rule out all possibilities for the discomfort before offering a bottle, as this solution, even if it pacifies your baby temporarily, can undermine breastfeeding success by causing nipple confusion and/or decreased milk production.
Sleeping through the night
As surprising as this may sound, sleeping through the night can actually indicate that your baby is not getting enough to eat. Sadly, it has become an expectation in our culture that “good” babies (or those babies that have “good” parents) will sleep through the night by the time they reach 3 months of age. A baby who sleeps longer than 4 hours more than once or twice in a 24 hour period may, in fact, be sleeping to conserve calories because he isn’t getting enough to eat. Encouraging your baby to sleep through the night, because that is what is expected, can have detrimental effects on your milk supply. Babies may need to feed during the night to get in the calories missed during a busy day or due to a period of separation from mom, especially if mom has gone back to work.