Is Baby Getting Enough Milk?

One of the biggest sources of anxiety for nursing mothers is the inability to determine exactly  how much milk their baby is getting. I get more calls about this than anything else, and I understand it. It’s an awesome responsibility, feeding a little person and being their sole source of nourishment. It doesn’t help that newborns want to nurse frequently, further convincing a tired woman that surely her baby isn’t getting enough to eat. Unfortunately, this anxiety will rear its ugly head over and over again throughout the nursing experience.  My hope is to teach Moms how to recognize the positive signs that things are going well, recognize when there is an issue, and most importantly, get help if they need it. 

I am constantly reminding the women I care for to look at the big picture. If you assess each data point and feeding individually, you’ll drive yourself crazy.  Some feedings will be good, some won’t. Here are the important questions to ask yourself:

Is your baby pooping and peeing? We are looking for at least 8 wet diapers daily and 3-5 stools for a newborn. The amount of stool a baby passes gets fewer with more time between (sometimes days!) as your baby gets older. But the volume gets larger when it happens, and it is often lovingly referred to as a “blowout.” This is perfectly normal and usually starts to happen at about 6 weeks. In addition, your baby should be gaining weight each time you go to the pediatrician.

The next question to ask yourself is if your baby is having periods of sound sleep? It will most definitely not be as much sleep as you want, but they should behave like a drunken sailor after most feedings and give you some longer stretches during the night.

Then ask yourself, is your baby mostly happy?  No baby will be 100% happy all the time. Babies often have at least one period daily, which usually settles into the evening hours, during which you just can’t seem to satisfy him. This fussiness is actually neurologically based, and written about by Dr. Weissbluth is in his book Healthy Sleep Habits, Happy Child.  Nursing is often very soothing to babies at that time, and the feeding frenzy can make even a confident Mom feel that their baby is starving. But again, look at the big picture. If you can answer yes, to the questions above, you are doing just fine.

Two other situations often make Mom’s doubt their supply.  The first is a growth spurt, which happens predictably at 3 weeks, 6 weeks and 3 months. During this time, your baby will nurse insatiably, having frequent quick sessions that often end in sleep.  Your baby will then wake immediately when you put him down, and demand to nurse again. It is exhausting and usually lasts for about two days, but the frequent feeding helps to increase your supply.   It is particularly concerning at 3 weeks, when the breasts that were overflowing with milk two weeks prior are now deflated, soft and feeling close to their pre pregnancy state. Your baby has now grown into your supply.  The good news is you should no longer be walking around like Dolly Parton. It might have been fun for a while, but do you really want to feel that way for a year?

Pumping also can undermine a Mom’s confidence in her ability to produce enough milk to feed her baby.  The most important thing to remember is that you should NEVER judge your supply based on what you get out of a pump.  There are too many variables to consider-what pump are you using? Is it new or did your girlfriend use it for her 3 kids?  Is it working properly? Did you just feed the baby? Are you pumping between feedings? Did you skip a nursing session altogether to pump? Are you stressed?  Working? Eating and drinking well? Pumping regularly? Occasionally? Have you been away from your baby for a long time? I am sure you understand what I mean.  When pumping, always remember that the pump just gets what is in the breast at that moment in time. When nursing, you are having a wonderful hormonal response that causes milk to be continually produced as long as the baby is taking it out.  This doesn’t happen with a piece of machinery.

What if you can’t answer yes to all my questions? Most often, the problem is easily fixed. Many times the baby is not nursing effectively, and once we fix the latch, the baby becomes a happy camper, and Mom notices an increase in her supply.  If it is truly a supply issue, there are many ways to fix that as well and it often can be rectified very quickly. The important thing is to get help as soon as you sense there is a problem. Please know that we are here for you, just to reassure you that you are doing great or assist with problems as they arise.  My guess is that you are doing much better than you think!