7 Signs Your Baby is Getting Enough Breast Milk

This is a question I am asked often:  I am expecting my first baby and I want to breastfeed but how will I know if he is getting enough milk? How do I know if he is even getting ANY milk at all for that matter?

How many of you have asked that question before? I know I have been asked that question even as milk has been running out of the cheeks of a very contented breastfeeding baby.

Its just hard to know when it’s not something we can easily measure, right?

And even though breastfeeding is a normal and natural process, it is not necessarily easy. And it doesn’t FEEL easy or natural in the beginning for anyone.  

If you heard my own breastfeeding story, you know I can relate.

So, let me help you out with 7 Signs you can look for to know that your baby is getting  enough breastmilk.

1: You put the baby to the breast as soon after delivery as possible and are keeping the baby with you 24 hours a day.

Ideally the baby should attempt to breastfeed in the first hour after delivery while the baby is in the alert phase. Sometimes that can’t happen and I understand that.  But that first hour when the baby is alert, before anything else is done is so important, it is called The Golden Hour! Try to get the baby to latch on and attempt to feed before any procedures are done.

Also, putting the baby skin to skin and breastfeeding as often as possible helps to establish good breastfeeding patterns for you and the baby. I cannot emphasize enough the importance of skin to skin contact. So breastfeed as often as possible and try to avoid any interruptions to your breastfeeding in the first days.

2:  You’ve been feeding your baby every 1-3 hours

One of the most important ways to ensure that your baby is getting enough milk is to feed your baby often enough. Somewhere between 3-5 days, your colostrum will change over to mature milk. You will notice when you express your breast that a milky white liquid has now started coming from your breasts.

You may also notice that you hear the baby swallowing. It’s a tiny little gulp. Or easier to notice is a difference in the baby’s sucking pattern. When a baby is feeding well, you will see the baby start out sucking fast then when the milk lets down switch to a longer slow deep sucking pattern with the jaw opening wide with pauses for swallowing. This is true feeding as opposed to laying on the breast but not sucking or a shallow little fluttery pacifier suck. Observe your baby's suck to determine the difference. 

You will probably notice that your breasts become fuller. It is very important when your breast milk comes in that you feed very frequently - at least every 2-3 hours. Do not let your baby go longer than 3 hours between feedings  in these first 2 weeks or so as your breastfeeding is getting established. We time feedings from the start of a feeding to the start of the next feeding;  so if the baby feeds at 2:00, he will feed again at 4:00. -5:00.  

Breastfeeding is an ingenious design of supply and demand - the more milk you feed your baby  the more you signal to your body that you need to make more milk. If you don’t feed your baby often enough or you skip feedings and feed formula, you are telling your body you don’t need milk for that feeding. Then your body produces less. 

Some moms get all nervous in the hospital about their milk coming in and want to use a breast pump to get it to come in faster. It is not necessary to use a breast pump to try to get your milk to come in faster and, in fact, doing so may make your nipples sore, make you more tired, and may waste the valuable colostrum that should be going to the baby. Just put the baby to the breast every 1-3 hours and your milk will should come in as expected and in the perfect timing for the baby.

3: Baby is pooping and peeing

You will know if your baby is getting enough breast milk if s/he will start to have wet and poopy diapers. There should be 1-3 wet diapers a day in the first 2 days of life. After day 3, your baby should have 4-6 wet diapers. After day 5, your baby should have at least 6-8 wet diapers a day.

The poopy stools will transition. On the first day there will be one or two. These will be really black and sticky and hard to clean off. On days 2-3, the stools will transition to dark brown to greenish and should have at least 3-4 a day. By day 5 the baby’s stools should have transitioned to mustard yellow, and curd like or seedy looking and very loose. The baby should have at least 4 poopy diapers a day but it is not unusual for breastfed babies to have a bowel movement with every feeding.

If you are having a hard time telling if your baby has a wet diaper put a cotton ball in the diaper - the cotton ball will soak up the urine and it will be easier for you to notice. Disposable diapers hold a lot of urine and newborn babies don’t often have that much urine. If a baby is feeding well, he will have wet and poopy diapers.

This is the most important thing to pay attention to. If a baby is not having poop and pee, a baby is not getting enough breast milk - even if a baby is on the breast for hours at a time and seems to be feeding ALL the time.  Milk in - poop and pee out. If your baby isn't peeing then your baby is not getting enough milk and will get dehydrated. Get your baby to the doctor right away if he is not having the right number of poops and pees on the right  day. 

4: Baby Shows Signs of Hunger before and is Content After Feeding

Your baby will sleep alot and may only wake to eat and sleep. But you should notice that the baby shows signs of hunger. You don’t want to wait until your baby is squalling with hunger before you feed. So, learn to look for early signs of hunger.

A baby who is getting enough breast milk should have some brief periods of alertness.  S/He  should also stir and show signs of hunger. You will see the baby’s eyelids start to flutter, S/he will start to stir - wiggle around, chew on his/her fist.  

Begin to recognize these signs and get the baby up to feed then. It is easier to get a baby to latch on at the early signs of hunger than when a baby has passed this stage and is crying in hunger. Crying is a late sign of hunger. Please remember this. Once a baby has gotten to the crying stage, you will have a really hard time getting her to settle down and be patient long enough to latch on.

Another sign that a baby is getting enough to eat is that a baby should be content after a feeding. You will know this by his falling asleep at the breast and sleeping for 1-3 hours until the next feeding cycle. If a baby is falling asleep at the breast but he wasn’t really feeding, he will still be hungry when pulled off of the breast - like he’s saying “Wait! Wait! I wasn’t done yet!” He will not still seem hungry after a feeding or waking up earlier if he has fed well. He should not be inconsolable after a feeding or pulling off the breast and not be content

A baby who is feeding well at the breast has a wide open mouth, his entire jaw and ear are moving when he is sucking, and you will see little pauses and may hear little gulps when he swallows. That baby is full and content when you take him off the breast.

The baby who is just sleeping at the breast looks like he is sucking on a pacifier. He may be asleep on the breast. When you take him off the breast, he wakes up and cries. He is still hungry because he was not getting milk from the breast. 

5: Baby is Gaining Weight

Of course, the easiest way to tell if your baby is getting enough breast milk, if you are not supplementing with formula, is if your baby is gaining weight . Babies should gain between 1/2 oz - 1 oz /day after an initial loss of weight immediately after birth.  Babies should regain their birth weight by 2 weeks of age.  

It is important to make sure baby has a check up within 3-5 days of discharge from hospital. This is to make sure that the baby is healthy, and that no problems have developed, such as jaundice or heart problems. It is very important to check that feeding is going well and monitor the baby's weight and check that dehydration has not developed.

Most often the baby has lost weight from their birth weight at this visit. That is completely normal. Do not distress over this. There is an amount that is normal,  usually less than 8% of their body weight is acceptable but different health care providers have different norms. It is important to make sure that the baby is within that acceptable range though. I usually think that if a baby has not lost weight someone probably weighed them wrong!!!

This visit is a good opportunity to get some help if feeding is not going well or if you are struggling. Or if the baby has lost too much weight at this point. This does not necessarily mean that the baby needs to be supplemented with formula. This just means that a good assessment needs to be done to determine what the problems are and very good assistance, plans and followup are necessary. 

Babies have a followup visit again at 2 weeks of age. At this visit feeding should be going well and babies should have regained back to their birth weight. This is another important opportunity to be reassured that baby is getting enough breast milk.  It is very helpful for parents to see that baby is gaining weight. If you are having any difficulty, you should ask for help at this visit, if you have not gotten help already.  

6. Baby is latching on well at the breast

A baby who is getting enough breastmilk shows signs of a good latch, without pain to the mom and no trauma to the mom's breasts. Like I mentioned earlier, The baby is sucking and swallowing well during the feeding. The baby who is just sleeping at the breast looks like he is sucking on a pacifier

You may have questions about this too. How do I know the baby is latching well? A good latch does NOT hurt. I don’t know how many mommies think that it is supposed to hurt. You should not be suffering through your breastfeeding. There may be some momentary discomfort at the first moment when the baby latches on but as the baby begins to suck this should resolve. So, if  you are truly in pain, then you do not have a good latch. Here are some tips: 

• Make sure baby is Tummy to Tummy with you, with head, back and bottom all in a straight line.
• Make sure baby opens mouth really wide before you pull her onto the breast.
• Don’t push the breast into the baby’s mouth - pull the baby onto the breast.
•  If you want to watch an example of a good latch check out this video by Dr. Jack Newman 

Another way to know if you have a good latch is to inspect your nipples after a feeding. If your nipples are cracked, scabbed, bleeding, bruised, or compressed into a flattened shape then your baby is not latching on correctly.  You need to adjust so that the baby is taking more of the breast into his mouth.

Remember that milk does not come from sucking on the  nipple - it comes from the baby’s mouth compressing the milk ducts that are farther back on the breast. If you don’t have a good latch, chances are, the baby is not getting a good feeding. If the baby is just sucking on your nipple like a pacifier, he is not getting enough milk.  So, don't think that you will just suffer through the pain for your baby,  you must correct the latch in order for your baby to get enough milk. 

So, you need to troubleshoot: ask an experienced breastfeeding friend for some help, or get some professional help. You can call your baby’s healthcare provider’s office, or your OB’s office for recommendations for a lactation consultant. Your birthing center may also have Lactation support available. If you are not successful there, La Leche League may have volunteer support available in your area. Look for assistance on their site at WWW.LLLI.org or find a certified lactation consultant in your area at ILCA.org .

7: Your Breasts feel full before a feeding and less full after

Once your milk comes in - usually after the third day postpartum, you should feel your breasts start to get full. If you are feeding regularly, it may not be a dramatic occurrence. But in a few days, you should notice that your breasts will feel fuller before a feeding. After the feeding, your breasts will feel less full. This lets you know that you have transfered milk to the baby. Sometimes when you are feeding the baby on one breast, the other breast will leak. That is a good sign as well. 

So, in review, if you put the baby to the breast within an hour after birth and practice as much skin to skin contact as you can in the first few days of life you will be off to a great start. Put the baby to the breast at least every  2-3 hours, making sure that baby gets that nutrient rich colostrum.

 Look for early signs of hunger and feed baby when she is first ready to eat. Wake to feed if necessary. You will know baby is getting enough milk if she is having wet diapers and transitioning from meconium to normal seedy yellow stools.

And, of course, check to make sure your baby is latching on well at the breast without pain. schedule your baby for regular well checks and get help if you are struggling with your breastfeeding.

If you look for these 7 signs, you should be on the road to a good breastfeeding experience and feel more confident that your baby is getting plenty of breastmilk. If in doubt, don't ever hesitate to get some advice or a consultation. It is always better to be on the safe side. 

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