Tips from an LC: Is Baby Getting Enough Milk? 5 Tips to Know

Transcript: Is Baby Getting Enough Milk? Top 5 Tips to Know

Many moms have asked the question "how do I know that my baby is drinking enough milk from my breast?" Over the first few days, it’s normal to only make small amounts. Then, from around 3 days after your baby’s birth, your milk volumes start increasing rapidly. This is why babies tend to lose weight at first and then start regaining it once they are drinking more milk.

It might also feel like your baby is always hungry, however, newborns are designed to feed frequently – quite likely 10 - 12 times every 24 hours! – as it’s nature’s way of stimulating your breasts, so that you can keep producing good volumes of milk.

Despite knowing this, it can understandably be an area where moms would really like to know that their baby is getting enough milk. We live in a world where everything is measured, and sometimes not being able to see the milk actually go into our baby may make us wonder things like "are they really drinking
enough?"

So, here are the main ways to know that your baby is getting enough milk, despite your baby feeding 8 times per day or, if they are on the other end of the scale, feed closer to 12 times per day:

Tip #1: Monitor Their Weight

As we said just before, it’s normal for babies to lose around 5 to 7% of their birth weight in the first 3 days. But once your milk comes in, we should start seeing that your baby is gaining weight again by day 4 or 5. And, your baby should be back to their birth weight or above - ideally by days 10 - 14.

From then on, babies normally gain somewhere between 150g (or 5oz) to 250g (or 8oz) each week until around 3 - 4 months of age. Your healthcare provider will help you track your baby’s weight, length, and head circumference while giving you support and advice if needed at any time point.

Tip #2: Monitor Their Dirty Diapers

The next tips are what you can see on a daily basis and can really help settle your mind to know that your baby is getting enough milk. The first one of these is looking at how many wet diapers they are having in 24 hours. Yes, we’re getting down and dirty into the diapers for this next section because this tells us everything! Think about it: what goes in… must come out! So, this is the perfect way for us to tell how much and how well our baby is drinking.

So, how many wet diapers should we be expecting?

• Day 1: 1 - 2 wet diapers. They are unlikely to be very heavy at this point, and they may even have a smear of something that looks reddish-brown in them, often described as looking like brick dust. This is known as urates, and is normal for babies to pass up until day 3. When they begin to drink more milk, this stops. If you keep seeing urates in their diaper after day 3, then consult with your healthcare professional as this may be a sign that he or she is not drinking enough milk.
• Day 2: 2 or more wet diapers.
• Day 3: 3 or more wet diapers.
• Day 4: 4 or more wet diapers, and now you should be noticing that they are getting heavier.
• Day 5 and Beyond: 5 or more heavy, soaked wet diapers. A good tip to know that your baby's diaper is really wet is to hold a fresh diaper in one hand and the dirty diaper in your other hand. You should be able to easily feel that the dirty one is much heavier than the clean one.

...But what about poopy diapers? Do they matter too? Absolutely! Oh my goodness, by the end of the first week, you’ll get so excited at seeing the different types of poos in their diapers, I cannot tell you! So, let’s take a look at what you should be expecting for an exclusively breastfed baby’s poo.

• Day 1: 1 or more poopy diapers. It’s not just the number of poopy diapers you get each day but, in these first few days, it’s actually what it looks like and its consistency! On the first day, babies will be pooping meconium. This is their first poo and it looks like black, sticky tar! As the milk starts to flow through them, their poos will change all the way to bright yellow.
• Day 2: We are expecting to see 1 - 2 poopy diapers, and now the consistency should be starting to change and become more brown and less sticky.
• Day 3 and Beyond: We are expecting to see 2 or more poopy diapers every day from now on, with a quantity similar to the size of a cherry tomato or a strawberry. From day 3 onwards, the poo should be more of a greenish-brown color, moving to brownish-yellow, and they should no longer be sticky.
• Day 4: This is where we should start seeing the real breast milk poos! I’m sure you’ve heard of them - And the best way I can describe them is to imagine English mustard mixed with wholegrain mustard, but with a more watery consistency! The perfect breast milk poo! Some moms worry that these poos are actually diarrhea, but they are not. Breast milk is so easy for the baby to absorb that they don’t have firm poos at this stage. As long as you can clearly see the poo on top of the diaper (and it’s not just water, which is soaked completely through underneath the layers), then this is a good sign that these are normal breast milk poos.
  
  If you notice any other colors or consistencies, then it is recommended that you contact your healthcare provider. Likewise, if your baby is not meeting these milestones in their diapers, then it can be a very clear sign that your baby is not drinking enough milk and it is important to seek support from your healthcare provider quickly.
  
  It is also important to note that from 6 weeks of age, breastfed babies will continue having 5 or more heavy, wet diapers each day. But, some babies will have a dirty diaper much less regularly. Some babies continue to poop daily while others may not go for a week - both variations absolutely normal! The consistency of the breast milk poos will look the same until you start introducing solid foods from 6 months old and on.

Tip #3: Watch Their Behavior and Whether They Seem Settled

Babies who are feeding enough will have quite a lot of sleeping time in the first few weeks. Often, all they seem to do is feed and sleep, with little interaction! A well-fed baby in those first few weeks falls asleep after a feed and is usually content most of the time. Do not be fooled by this, I do not mean that they won’t be feeding frequently! They are likely to be feeding 10 - 12 times every 24 hours, and each feed may last somewhere between 20 minutes - 60 minutes, so you will be very busy. But, after and in between those feeds, your baby should be content and asleep. Of course there are periods where they cry; this is normal for all babies. We also know that there are certain time periods where babies will have developmental growth spurts, where they want to feed much more than on the days before; they may do this for a few days and then go back to their previous feeding pattern. This is perfectly normal and, as we know, breastfeeding is not just about food; it's cuddle time, reassurance, and at times of teething and discomfort, it also acts as a pain reliever.

Watch and observe your baby. It is unlikely that they will have exactly the same feeding pattern every day for 6 months! But, you can reassure yourself that your baby is getting enough milk if they are having periods where they are calm and they sleep in between feeds, you are changing the correct amount of wet and dirty diapers, your baby actively asks for and looks for feeds, and they are growing at the expected rate. And remember: As they get older, from around 4 - 5 weeks, you will start seeing them stay awake for longer periods and having more interaction with you.

Tip #4: Know Your Breasts

Your breasts should be feeling softer after a feed.

Tip #5: Know the Difference Between Spit-Ups and Vomiting

It is normal for some positing or spitting up. Nearly all babies at some stage will have little vomits after they have fed. This is totally normal. Often, a tiny amount goes a very long way! It can look like the whole feed has come up, but it is highly unlikely that it has. It’s normally just a little bit extra that they thought they could fit into their tummy…but it turns out they couldn’t!

There are some signs of abnormal vomiting - this would be when the color doesn’t look like milk (i.e. it is green or orange). Or, if there is projectile vomiting, this is vomiting which will probably travel from one side of the sofa to the other. Normally if there is vomiting like this your baby would be unsettled and they wouldn’t be gaining weight effectively. These are all signs to seek immediate support from a healthcare provider.

If your baby is following along with these guidelines, it is more than likely that your baby is getting enough milk. But, as with all new skills, it is important to seek regular support from your healthcare provider and a local breastfeeding support group.

For additional support, check out some of our other videos and helpful resources:

• If My Breast Milk is Not Coming in, What Should I Do?
• Top 8 Tips if Your Baby Has Lost Too Much Weight
• Top 3 Tips if Your Baby is Unable to Breastfeed in the First Days or Hours After Birth
• Printable Feeding and Pumping Log - Available for Download in English and Spanish