How to Know If Your Baby Is Getting Enough Milk

  Adriana Lozada:

Hello, mighty parents and parents to be. I’m Adriana Lozada and you’re listening to Birthful, and today, just like every other week, I’m on my own talking directly to you for about 10 minutes about a topic that I really want to dive deeper into, and this week it’s how to know if your baby’s getting enough milk. Now, in order to answer that question, first we need to look at how your milk changes from the moment of your baby’s birth. During those first three to five days after birth, before your milk actually comes in, you produce this amazing substance called colostrum, and so colostrum is a little thinner than breast milk, it’s golden in color, and you produce really small amounts. It’s been called liquid gold and in terms of how to tell if it’s there, unless you can hand express colostrum during pregnancy, you don’t really quite know that it’s there, but your well-latched baby with frequent skin to skin will send the signals to make it happen and will be able to extract it. 

In terms of how much your baby is gonna get, we’re talking very little, a half a teaspoon to a teaspoon if that. Their tummies are teeny, tiny when they’re born. On average, it’s about the size of a marble, although each baby has their own unique stomach sizes. So, how do you know if your baby’s getting enough if you can barely see if you have anything in your breasts at all? You look at what they’re doing. You want to make sure they’re gaining weight and gaining weight on their own curve, making sure that the growth charts that are used as reference are the ones for human, milk-fed babies, not for formula-fed babies, because those are different growth charts. 

It is completely normal for your newborn to lose weight right after birth, and they lose about 5% to 7% of their birth weight in those first few days. That is expected. Even 10% could be okay, but between 7% and 10%, there might be signs that something is up in terms of the latch or how they’re breastfeeding. Usually, they regain that birth weight by two weeks, more or less.

So how to tell if your baby’s getting enough, well, first of all, they’re gaining weight. Another way to tell if baby’s getting enough is you want wet and dirty diapers to come out. What goes in comes out, so if you’re having enough wet diapers and enough dirty diapers, then that’s a sign of knowing if your baby’s getting enough milk. Usually, you’re looking at one of each on the first day after birth, two of each on day two, three of each at day three, and then four of each and day four, and after that they stabilize at about a minimum of 10 diapers per day. 

And then, of course, your baby should seem more content after feeding, and your breasts will be soft. You won’t really feel your breast getting hard while you have colostrum. That comes later, when your milk comes in. 

So, what do you do those first three to five days? You feed, feed, feed, feed, feed your baby. 10 to 12 times per day. You can’t nurse your baby too often. If you provide unlimited time at the breast while they’re sucking actively and then offer the other breast, then that’s a great way of doing on-demand feeding and letting your baby communicate with your body to say, “Hey, we’re here. We’re eating. We need lots of milk.” Those first few days are days of calibrating how much milk they’re gonna need. 

So, feed on demand, or if the latch is not great, see if you can hand express and then feed them with a little tablespoon. Do mind your nipples during those first few days and stay hydrated, and if you’re having any problems at all, seek the help of a lactation consultant right away. Have them assess it and just give you a once over, make sure everything’s looking great. 

So, that’s during the time that you have colostrum. Then, around day two to five, your milk’s gonna start to come in, and that’s gonna be gradual, or it might be very sudden, and the milk is gonna change from that clear yellow to a more creamy white substance. So, how do you know if it’s happening? If your milk is coming in, your breasts are gonna get engorged. They’re gonna fill up. This you will feel, and it’ll be hard, tight, and uncomfortable. So, what do you do about that engorgement? The best thing is let your baby nurse often with a good latch and let them finish one breast before moving to the other. And that will definitely help release the tightness and release the milk. 

You could also use cold compresses between feedings, just to lessen the discomfort, and if the area is too overfull from engorgement and is causing difficulties for your baby to latch, because the areola is more rounded, then doing some reverse pressure softening, so taking your hand and massaging around your areola, trying to release pressure, or hand expressing some milk to soften the area and then relatch baby, that can really help. 

A question that a lot of people ask is should you pump at this time. You don’t necessarily want to pump as that will affect the supply-demand process and tell your body that you need more milk than what your baby is asking for. You don’t want to do long pumping sessions if you do pump, if you feel that you can’t hand express. Alternatively, you could use the hand silicone pumps, or also known as milk savers, that just provide a little bit of pressure to get milk out and soften your breast without telling your body you need to produce more milk.

Just a heads up, though, if you do pump, know that pumping is not a good indicator of how much milk your baby is getting. Babies are way more efficient at the breast if they have a good latch and also you don’t respond to a pump as you do to your baby. So, if you see that you only get a little bit of milk from the pump, that doesn’t mean that your baby is only getting that little bit. They’re probably getting a lot more. 

Now, this engorgement is not gonna be your new normal. After a few days, your breasts are gonna regulate and normalize and you will actually feel that they are different, not engorged all the time, and actually around six to eight weeks, they’re gonna be softer and less full between feedings. You still have milk, that’s just your body adapting and adjusting. 

So, how do you know once your milk’s come in if your baby’s getting enough? They should be eating 8 to 12 times per day or more, like on demand. They do cluster feedings. And they should be gaining weight on a constant basis, especially after those two weeks when they regain their birth weight. You should get about five to six wet diapers per day and about three to four dirty diapers, and you should hear while your baby’s feeding, you can hear them swallowing. That’s gonna tell you that they’re actually getting milk. You’ll hear the swallow. It’ll be an audible, as opposed to when they’re just sucking for comfort where there’s no swallowing happening. 

And this is a special trick that babies do when they’re super content, and have fed, and they’re relaxed. Usually, when they’re feeding, their hands are in the shapes of fists. When they’re content and relaxed, then they’ll open their hands and that’ll tell you like, “Oh, I’m kind of done. I’ve eaten enough.” 

So, bottom line, what you want to do is look at your baby. Does it seem like they’ve had enough? Does it seem like they’ve eaten and are content? That’s what you want to aim for. Also, remember that just like you don’t always want to have a full meal, your baby doesn’t either. Sometimes they just want a snack. If they snack, they might want to eat again sooner rather than later. That’s another benefit of feeding them on demand. It is satisfying their needs and not going by a schedule. 

And I want to close with a few fun facts about breast milk. Breast milk is gonna change colors and compositions depending on what you eat and your baby’s needs, so sometimes it will be more bluish in color, sometimes it’ll be more creamy white. That’s totally fine. Do consider that breast milk is not just for nutrition, but it’s also medicine. You will produce antibodies and if you come in contact with a virus, your body’s gonna produce antibodies to that virus and put them in your breast milk for your baby. So, yeah, how cool is that? 

And then if you are pumping and stashing your milk, make sure you write down the time that you pumped that milk, because night milk has more tryptophan than morning milk, and that is because tryptophan helps your baby sleep. So, if you’re giving pumped breast milk to your baby, try to match the time of day from your stash to when you’re giving them that milk.

Lozada: Birthful was created by me, Adriana Lozada, and is a production of Lantigua Williams & Co. The show’s senior producer is Paulina Velasco. Jen Chien is executive director. Cedric Wilson is our lead producer. Kojin Tashiro mixed this episode. You can connect with Birthful on Instagram @BirthfulPodcast and to learn more about Birthful and my birth and postpartum preparation classes, go to Birthful.com. Thank you for listening to and sharing Birthful. Be sure to subscribe on Apple Podcasts, Amazon Music, Spotify, and everywhere you listen, and come back next week for more ways to inform your intuition. 

CITATION: 

Lozada, Adriana, host. “How to Know if Your Baby Is Getting Enough Milk.” Birthful, Lantigua Williams & Co., April 7, 2021. Birthful.com.