How to know if your breastfeeding baby getting enough milk?

Is your breastfeeding baby getting enough milk?

Here is a post I wrote for Eumom about how you know if you baby is getting enough milk. I have copied it under here for you to read if you can’t make this weekend’s breastfeeding workshop (best to go when your are pregnant but new mums very welcome). 

I remember vividly sitting in the waiting room at the Rotunda listening to a conversation between a midwife and a new mum. She was asking how often she should feed the baby as her husband was trying to get the baby into a routine. She said that she had read in a book about whispering to babies that routine was good.

The midwife professed that if she could burn that damn book she would. And I agree.

The notion that babies are going to fall into our 21st-century bid for routine is a stressor that new mums could do without. Of course as they get older this may change and patterns emerge. And as women need to return to work, babies need to work with our needs. Also mums need to sleep at some stage and a good night’s sleep is worth its weight in gold.

So with the knowledge that newborn babies and routine is a fallacy and that at some stage routines are necessary for sanity: What is the reality like?

When your newborn arrives, those first few hours and even the first three days are all about development and learning. The baby is born with feeding reflexes and skin-to-skin contact facilitates these reflexes to be developed.

Within the first few hours a baby will be nuzzling and sniffing and sometimes they are happy to latch on and take a drink. But here is the caveat, some babies are not yet ready to latch on. Especially those involved with a difficult or medicated birth (epidural, C-section, instrumental birth). They are just happy to be with mummy and sniff around your breasts.

Pressure in the hospital to get a successful latch and a 15-minute feed, in my opinion, is not a realistic goal. I have personally experienced this as a pressure to get the baby feeding.

In the next three or four days your milk supply will change from colostrum to a more fluid consistency and start to increase in volume. I don’t like to use the phrase “milk coming in”. Your milk is there – it just gets more plentiful.

So when should you feed your baby?

When the baby starts to wake up, you will see clear feeding cues:

  • tongue sticking out
  • head moving from side to side
  • hand to mouth
  • head-bobbing

At the first sign of them waking – get them on your boob. Don’t wait for more stressed feeding cues such as crying or frantic head bobbing. Get them on when they are all spacy and sleepy.

Remember, feeding is a reflex. You can even do it when they sleep!
Finish that boob if you can. If the baby is sleepy still, a little flick on the feet can wake them up. When they are finished on that side (breast feels softer, swallowing stops) – change sides. If they are really sleepy, this is a good time for a nappy change.

On the second side they may get tired and fall asleep. Once they give up and doze off into blissful booby contentment, it’s time for rest. Put a scrunchie on your wrist on the same side as that boob to help you remember which side they last fed from (you may think you will never forget this in the beginning but, trust us, you will!) get something to eat and sleep.
When the baby wakes again, start on the side with the scrunchie to help maintain an even supply and then move to the other breast as before. Move the scrunchie to the other side and so on.

This way you always start on the breast the baby finished on. It helps build up supply.
In reality at this stage your baby may be feeding every two to four hours for 10-40 minutes. You may start to see a pattern emerging until…
A growth spurt!!!!!!!!

During a growth spurt you will feel like the dairy queen stuck in a milking parlour. The baby is stuck to you. It can feel like they are feeding all day and all night and you will get very little time to do anything else.

Surrender! Stay in bed, call for help in the form of nutritious food for you and with domestic chores.

While it is natural to have doubts and worries at this stage about your supply and whether the baby is getting enough, the important things to watch out for are:

Wet nappies

  • A baby who is getting enough milk will have on average four to six wet nappies a day by the fourth day after birth (six to eight wet nappies if you’re using cloth – which hold less).
  • To learn what a wet nappy feels like, put two tablespoons of water on a clean nappy. Cloth nappies will be more noticeably wet than super-absorbent disposables.

Bowel movements

  • 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.
  • Between week one and week four, babies who are getting enough hindmilk will produce at least two to three yellow, seedy stools a day. Because breastmilk is a natural laxative, some breastfed babies produce a stool with each feeding, which is a good sign that baby is getting enough milk. When a baby has only two or three bowel movements a day, expect to see a substantial amount in the nappy – more than just a stain.
  • After the first month or two, as the gut matures, the frequency of bowel movements decreases. At this stage, your baby may normally have only one bowel movement a day; some breastfed babies have one bowel movement every 3-4 days, yet are still getting enough milk. (You’ll see other signs of adequate growth.)

Weight gain

  • Most infants, whether breastfed or bottle-fed, will lose an average of five to seven percent of their birth weight in the first days of life, due to the loss of excess fluid. How much they lose depends on the plumpness of the baby and individual variations in fluid retention, as well as on how well they are feeding.
  • After regaining his birth weight, the average infant gains 4 to 7 ounces a week, or a minimum of one pound 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 get too hung up on weight gain, an alert growing baby is what you are really looking for.

Cluster feeding at night

  • If after a couple of months you find your baby is sleeping for long four-hour-ish stretches during the day but frantically trying to feed in the evening and into the night, this is where I would go ahead and wake them for a feed during the day.
  • About every two hours, wake your baby (changing a nappy is a good time), and tank them up on milk during the day. This way you hopefully build up their fuel for a better evening’s rest and more sleep during the night.
  • Do not expect your baby to be sleeping through the night. Mine did not do that until well into their ninth month. This is normal. Those super mums who tell you about their 3 month old sleeping through the night…. just ignore those stories.

Finally, we need to start trusting the amazing power of our babies ability to feed. Their little mouths work very well and they will normally take just what they need. Trust your instincts.

If you have any concerns about your baby’s feeding, see a lactation consultant or join a breast feeding group for support.

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