How do I know if my baby is getting enough milk?
This is probably one of the top questions I get from new parents. It makes sense. You can’t see the milk going into their body so how do you really know? The good news is, there are definitely a few signs to watch for that will tell you if your baby is getting enough milk.
1. Looking or listening for swallowing
When a baby is taking in milk, they have to swallow it. 4-5 swallows per feeding of colostrum is what we’re looking for. When milk transitions, and the volume goes up, we’re looking for a 1:1 ratio of suck:swallow after let-down has been initiated. But what are you actually looking for? When a baby swallows milk, you will see their jaw drop slightly lower and pause momentarily. You can also have a look at your baby’s ears or the side of their face as you may notice the bottom of the ears move when the jaw drops down. This is a swallow. You can also listen for a swallow. A baby’s swallow sounds like a soft “kah” sound.
2. Generally content after feeding
Your baby should be alert prior to feeding and generally more sleepy and content after a feeding. Every baby is different and not all babies experience a milk coma right after feeding which is why we pay attention to their behaviour. If they are no longer showing those early hunger cues and seem relaxed, you can take it as a sign that they are content after the feeding. Many babies will also have their hands in fists prior to feeding and then relax to a more open hand afterwards. Sometimes their arms get really floppy after feedings too. This is just another sign they are full and relaxed after a feeding.
3. Diaper output is age appropriate
Newborns produce a lot of wet and dirty diapers. During the first week, we look for 1 wet and 1 dirty diaper for each day of life. On day 1, or within the first 24 hours we are looking for 1 wet diaper and 1 dirty diaper. Baby’s first poop is called meconium and is very dark, sticky and tarry. After this, on day 2, we are looking for 2 wet diapers and 2 dirty diapers. The poop will still be dark but may resemble a darker green than brown. As the days progress, by day 5 your baby’s poop should have transitioned to a mustard yellow in colour and you should be seeing 5+ wet diapers and 3-4 yellow dirty diapers. If there’s so many that you’ve lost track, chances are your baby’s diaper output is appropriate. It’s always important to track during that first week because it’s a question all lactation consultants will have for you. The first couple of poops your baby has should be about the size of a toonie or larger.
4. Your baby is gaining weight
This is a clear sign that milk intake is enough. What is most important though is that your baby is sticking to their own growth curve. The growth percentiles are not report cards. A baby in the 50th percentile is not doing poorly nor is a baby in the 95th doing better than others. This is just simply comparing their size and weight to other babies of that age. Humans are different sizes. It’s normal! We’re not all supposed to be the same size so the same goes for babies. Your doctor/pediatrician should be using the World Health Organization growth velocity charts. These charts take into account infant growth and development from all over the world and use the growth of a breastfed baby as the norm.
The new growth curves are expected to provide a single international standard that represents the best description of physiological growth for all children from birth to five years of age and to establish the breastfed infant as the normative model for growth and development
The World Health Organization
If you can see or hear your baby swallowing for a few minutes each feed, they seem content afterwards and are producing lots of wet and dirty diapers while gaining weight, your baby is getting enough milk.
If all the above are happening BUT you’re in pain or breastfeeding is not enjoyable or doesn’t feel sustainable, always reach out for support. Lactation consultants are detectives; always working to get to the bottom of every feeding issue. They are trained specifically in the area of human lactation and are the specialists when it comes to infant feeding.
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Last updated March 5th 2021
References:
Campbell, S.H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core Curriculum for interdisciplinary lactation care. Jones & Bartlett Learning.
Newman, J. & Pitman, T. (2014). Dr. Jack Newman’s Guide to Breastfeeding. HarperCollins Publishers Ltd.
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