A Nurse’s Guide to Knowing if Your Baby is Getting Enough Breast Milk

How Do I Know if My Baby is Hungry?

Babies are born with an ingrained rooting reflex when they are hungry. The following are signs that your baby is looking to be fed:

  • Making mouthing movements
  • Bringing hands to mouth and sucking on fist
  • Moving head from side to side
  • Smacking lips
  • Crying as the final hunger cue

Initiating a feeding will be much easier if you notice baby’s feeding cues and can get him latched on before she starts crying. Watching for baby’s hunger cues rather than the clock will ensure baby gets enough breast milk and will help you maintain your milk supply. This is called feeding on demand.

What if My Baby Won’t Wake Up To Feed?

Sometimes in the first weeks babies are very sleepy. This is a very common problem. As parents you may need to help your baby wake up for feeds to make sure they get enough breast milk. You can do this by:

  • Giving a diaper change
  • Stripping baby down to his/her diaper and placing baby skin to skin with you
  • Sometimes applying a cool wash cloth on baby’s feet
  • Expressing some breast milk and placing on baby’s lips
  • Compressing the breast to push milk into baby’s mouth to wake up a sleepy baby already on the breast, to continue the feed as long as possible

How Do I Know if Baby is Getting Enough Breast Milk?

Breastfeeding provides multiple benefits to your baby and family including helping mom bond with baby, immunity benefits, and cost savings. However, many mom’s worry whether baby is getting enough to eat in the first few weeks of life because they cannot see how much baby is taking as you would with a bottle. As new parents, you can be rest assured that baby is getting enough if baby:

  • Begins to gain her birth weight back during the first two weeks of life and continues to gain weight according to their growth curve
  • Is having enough pale and odorless wet diapers according to baby’s age (one per day of age, then six or more at day five)
  • Has transitional bowel movements by three days of age
  • Settles for at least a short period of time between feeds (does not cry when taken off the breast, and does not constantly fall asleep shortly after being put on the breast)
  • Your breasts feel softer after feeds (doesn’t always happen)

a nurse's guide to knowing if your baby is getting enough breast milk

Common Misconceptions That Mom is Not Producing Enough:

Some mom’s feel like they are not producing enough milk based on some inaccurate information, and may feel the need to switch to formula. The following are NOT signs that you are not producing enough milk:

  • Feeling like your breasts are soft before feeds – before feeds, some milk is stored in the mammary glands but some is also produced during feeds. How full your breasts are is not a good sign of how much milk your baby will receive. Once a mom’s milk supply is established a couple of weeks postpartum, it is normal to not feel engorgement or fullness of the breasts
  • You are unable to pump large amounts of milk – babies are much more efficient at removing milk from the breast than breast pumps. The amount taken during a pumping session is not a good indication of how much milk you are producing
  • Baby is wanting to feed hourly – it is normal for babies to feed 8-12 times in 24 hours, which means, depending on how long their nursing sessions are, baby could be showing hunger cues every hour after a feeding finishes. This is especially true when baby is cluster feeding
  • You are unable to express colostrum or breast milk from your nipple – some mom’s can express milk easily from their breasts, while others cannot. This is not a good indication of whether baby will be able to get enough milk

How Do I Know if Baby is Finished a Feeding?

Babies normally will display a few signs that they are full. They may:

  • Fall asleep at the breast or appear very relaxed with minimal sucking. This is only a good sign if baby shows signs of having a good feed prior to becoming sleepy, including strong and steady jaw thrusts and audible swallowing. Babies should be fed on demand and each baby is different in their length of feeds, but generally a newborn should have strong jaw thrusts and audible swallowing for at least a couple of minutes per feed in order to get both the foremilk (watery, given first) and hindmilk (fatty, given later in feed)
  • Take themselves off of the breast and appear content, no longer displaying signs of hunger
  • Refuse to take the second breast or be re-latched to the first when they come off

When Should We Get Help?

  • Baby won’t wake up for feeds at least 8 times in 24 hours
  • Baby is not wetting enough diapers or there is “brick dust” in the urine. A reddish tinge in your baby’s diaper is usually not blood, but rather the presence of uric acid crystals, which can be due to dehydration. Brick dust can be quite common in the first couple days of life as babies can lose up to 10% of their weight, but it can also be a sign that baby has lost too much weight. Take a picture or keep the diaper so you can show your health provider
  • Baby has more yellowing of their skin and whites of their eyes than when they were last seen by her health provider. This could indicate jaundice and should be seen immediately
  • You are concerned that baby may not be gaining weight
  • You are concerned with how your baby is acting (ie. limp arms and legs, not having periods of alertness, or she is excessively irritable)
  • Your nipples are cracked and bleeding, or there are signs of a possible infection (pain, swelling, redness, oozing)
  • You don’t feel that your baby is latching on to the breast properly, or if it hurts to breastfeed

Breastfeeding Basics

For additional information, you can view my other posts about breastfeeding tips and tricks, and breastfeeding complications and solutions.

If baby is alert and active, breastfeeding should be done on demand. If your baby is sleepy or there are health concerns you may need to wake them for feedings and monitor them more closely.

Newborn babies should be breastfed 8-12 x/day. If you are concerned about baby’s feeding, you can time their feedings from the beginning of one to the beginning of the next. For example, if you fed baby at 08:00 AM for 45 minutes, and baby wants to feed again at 10:00 AM, baby is feeding every two hours, not every hour and 15 minutes. Frequency and time taken for feeds should reduce as baby becomes more efficient. In the beginning you really will feel like your baby feeds all the time!

keep a log of frequency of feeds, alert periods, and wet/dirty diapers. It will prove to be very helpful when you are learning to breastfeed and are sleep deprived, especially when the nurse asks how many wet diapers your baby has had in the past 24 hours and you don’t even know what time it is!

During the first week, baby should have at least one wet diaper for each day of age. After day five, baby should have six or more wet diapers per day. How many wet diapers your baby has is a good indication of how much milk they are getting.

Baby’s stools should change from dark and tarry meconium to light brown transitional stools, and then to the yellow, seedy stools often seen in breastfed infants (sometimes they can also. Meconium should start becoming lighter by day three. This is a good indication that baby is getting enough to eat.

After birth, babies can lose up to 10% of her weight without any concern.

Most babies gain their birth weight back by two weeks of age.

When a baby is breastfeeding, you can tell she is swallowing by listening for puffs of air. It is normal for baby to stop sucking for short periods of time before she swallows. These inactive periods are necessary and does not mean that baby is done nursing or that they should be taken off the breast.

There should be no clicking noises. Clicking noises suggest there is not a tight seal to baby’s latch, which can cause baby to become dehydrated or excessively gassy.

Save your nipple when taking baby off your breast by putting a pinky finger in baby’s mouth to remove suction.

Your baby should be allowed to finish her feed on one breast before starting on the next. Make sure to burp baby between switching breasts and after feeds. Breastfed babies are not as gassy as formula fed but still need to be burped. Try burping for a couple of minutes before proceeding. Sleeping babies tend to be harder to burp than when they are awake.

Use a lanolin cream in between feeds to help prevent your nipple pain, cracks and bleeding. It is safe for baby to ingest and you can get it at any store that sells baby supplies.

Babies often cluster feed in the evenings (hourly), before a long sleep period, and during growth spurts. Growth spurts happen at roughly 3 weeks, 6 weeks, 3 months, and 6 months. This can vary from baby to baby. It is best not to fight with baby during these periods (you won’t win!) but rather to just hunker down on the couch and feed your baby until their tummy’s content.

Resources

International Breastfeeding Center (2008). Is My Baby Getting Enough? http://www.nbci.ca/index.php?option=com_content&id=23:is-my-baby-getting-enough-milk&Itemid=17

La Leche League International (2006). How Can I Tell That My Baby is Getting Enough Milk? http://www.llli.org/faq/enough.html

Kelly Mom (1996-2016). Is Baby Getting Enough Milk? http://kellymom.com/bf/got-milk/supply-worries/enough-milk/

Did I miss any important information that new parent’s should know about breastfeeding a newborn? Do you have a story about your early nursing experiences? Please share in the comment section below! Happy nursing, mama’s!

 

 

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TheMamaNurse

Hi! I am a Registered Nurse on a unit that encompasses labour and delivery, postpartum, medical, surgical and palliative care in a rural hospital in Ontario, Canada. I am a mom of two and am passionate about women's rights, mom and infant care, parenting and nursing. I hope to create an educational, entertaining and highly relatable resource for women around the world. Thanks for stopping by! Xo, The Mama Nurse

10 thoughts on “A Nurse’s Guide to Knowing if Your Baby is Getting Enough Breast Milk

  • January 10, 2016 at 8:49 pm
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    This was such an amazing, thorough article, thank you for writing it! With both of my babies, I worried constantly about whether or not they are getting enough milk. I wish I had read this first 🙂

    Reply
    • January 11, 2016 at 12:46 am
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      Unfortunately it is a very common concern! Thanks so much for your feedback Erin!

      Reply
  • Pingback: Formula Feeding Basics - The Mama Nurse

  • February 2, 2016 at 6:50 pm
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    Wow, I realllllllly wish I had found this when I first brought my baby home. We struggled with an undiagnosed tongue and lip tie for 3.5 months (yup, took 6 lactation consultants and 3 different pediatricians before I finally figured it out myself by reading The Womanly Art of Breastfeeding!) There is so much info in here that took me months to figure out. I ended up creating my own baby and mama wellness journal because I wasn’t finding what I needed in all the baby logs out there. So I made one that tracks allll types of feedings – breast, bottle, formula, pumping (or if you are like me, all of the above!). Check it out! http://www.duodiary.com

    Reply
  • July 13, 2016 at 9:08 pm
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    Oh my word! Thank you for this post! I’m about to have twins in two weeks and it’s been 3 years since I last nursed my son. This post was super helpful for me because my son had some weight issues in the beginning and one thing I kept noticing in his diaper was the brick dust but my doctor NEVER said anything about dehydration or it being connected to weight loss. I’m so happy I found this information because I couldn’t figure out what was going on and they didn’t know either! At least now I’ll know if my girls have the same issues! Thanks for a great- in-depth post.

    Reply
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  • August 28, 2016 at 12:59 pm
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    OMG ! really i searched many times on google to get like this post ! finally i got it……..!!!!!!! Thanks God & thanks TheMamaNurse website author.

    Reply
  • Pingback: Everything I Hope a New Mom Knows About Breastfeeding Before Going Home - The Mama Nurse

  • July 11, 2017 at 10:56 am
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    I had so many questions about breastfeeding when my son was born because I was lost and depressed because somehow it was very difficult for me. I felt that I won’t handle it. I was searching the net and I have found an awesome ebook HOW TO MAKE BREASTFEEDING PLEASANT AND EASY from this site http://www.parental-love.com It made me stronger and I knew I can deal with all these problems I had I am sooo happy to say that I made it! I was breastfeeding my boy for 18 months! I wouldn’t do it without this guide! I only regret I didn’t know about it and read it before my son was born

    Reply

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