How do I know if my baby is getting enough breast milk?
This is the question almost ALL new mums ask me! Here are some signs that your baby is thriving on breast milk:
- Wet nappies and bowel movements: An exclusively breastfed baby should average six to eight wet nappies and two to five plus bowel movements in 24 hours after the first 3 days of life. (Before that time, she should have at least one bowel movement per day of life. Example: 1st 24 hours = 1 BM, 2nd 24 hours = 2 BMs, etc. in addition to wet nappies.) Remember that disposable nappies can hold several wets in each. If you want to be sure, simply place quarter of a cup of water in a disposable nappy and place it next to the changing table. You can 'weigh' a nappy to estimate how many wets are in it. You will also notice a change in the colour and consistency of bowel movements as your mature milk comes in. They will change from the 'tarry' meconium to a mustard coloured (or green) cottage cheese consistency - this is the breast milk stool. It will be very loose, sometimes just a smudge on the diaper, and have a sweet odour.
- Frequency of breastfeeding: In the early days, babies should be breastfed an average of every two to three hours during the day and at least every four hours at night. Nursings usually last approximately 30 minutes. Don't be surprised if your baby doesn't fall into the 'average' category. She may very well want to nurse more often and that is just fine. We do get worried when a baby is going for long stretches between nursings (more than four hours during the day) because usually these babies do not nurse well once they are put to the breast. Often termed 'sleepy babies', these babies are at most risk of getting insufficient milk. Don't be afraid to wake your baby to nurse. Again, don't be afraid to wake your baby to nurse! In time, these babies will begin to self-wake to feed, but you may need to coax them a bit in the beginning. We also look for other signs of breast milk transfer such as swallows during nursing and the baby acting satisfied at the end of the feeding. But remember that wet nappies and bowel movements are a more accurate way of judging how much your baby is getting. There are some babies who just come out being very efficient nursers who can get all the milk they need in a short amount of time.
- Weight gain: On average, babies usually gain approximately 100-170 grams (4-6 ounces) a week during the early weeks. There are also other signs of growth such as length and head circumference. Also, genetic factors can play a part here. If you and/or your partner are thin/tall, then your baby may follow along your same path and grow quicker in length than in weight. Illness can also affect weight gain. It is very important to look at the entire picture when there is concern over weight gain. If a baby is otherwise doing well, with plenty of dirty nappies, then there is little reason to worry.
If you ever have a concern that your baby isn't getting enough milk consider using a Supplemental Nursing system or supply line, talk with your health care professional before you reach for the formula. Often times, it is the mother's perception that the baby isn't getting enough, rather than fact. This is particularly true during growth spurts that occur around 2 weeks, 6 weeks, 3 months and 6 months. All of a sudden a baby will ask to nurse more often and the mother may think baby is not getting enough when in fact baby is simply trying to get the milk supply ready for the spurt.
Also, pop in to your Early Childhood Health Centre for a weight check if you need to. Anything that is going to give you the security you need to be sure your baby is doing well is fine. And remember that you know your baby best. There are many things that can be done to increase your milk supply should it become necessary.