and how do I know if it’s enough?
Updated March 7th 2023
Are you constantly wondering if your baby is drinking enough breastmilk? Do you find yourself on Google trying to figure out how much they should be eating? If you are, you’re not alone! I am frequently asked about this subject especially from first time breastfeeding moms. I know you just want to make sure your baby is getting enough so let’s take a closer look.
This a common worry among those nursing because you can’t see the milk going into your baby. So there are things you want to be looking for and paying attention to when your baby is nursing. They include how your baby is feeding and whether or not they are swallowing milk, what their demeanour is after feeding, how many diapers they are producing in 24 hours and their weight gain. Taking notes of these things will help you determine if your baby is getting enough milk.
1. Looking and 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 (the flow of milk) has started.
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 (if you’re Canadian) 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 (WHO) growth velocity charts and not the CDC 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.
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.
But how many ounces should they drink?
If you’re doing any pumping at all (even if you’re not) you may still have this question. This is something that’s going to be different for each and every baby, though there are averages. After 1 month, breastfed babies consume an average of 24-32 oz in 24 hours. Some babies needs less than this, some need a little more and many fall right within this range. Prior to one month, they are eating less.
For a baby eating 8-10x per day this averages to about 3-4 oz (90-120mL) per feeding. Now, some feeds they may only take 2.5oz (70ML) and some feeds could be up to 5 oz (150mL).
This volume doesn’t change in the first 6 months! Whatever you produce after the first month (assuming you’re exclusively breastfeeding and not experiencing low supply or over supply) will be what you continue to produce*
The reason for this is quite cool (but I’m an IBCLC so think human lactation is really interesting). Your body changes your milk to meet your baby’s needs! This is how a 2 month old and 5 month old still only need about the same amount of milk in a 24 hour period.
Yes, even if you exclusively pump your body will still be changing the antibodies and make other adjustments to your milk because you and your baby are sharing the same environment.
So what about after 6 months?
I said that the volume of milk a breastfed baby will consume in 24 hours stays the same for the first 6 months. This is because around 6 months, solid foods are introduced. These foods are complimenting what your baby is getting in milk so the volume of milk stays about the same and their increase nutritional needs are being met by the small volume of solids.
Your baby’s milk intake will remain fairly constant for a few months before it gradually starts to decline as they consume more solids. When solid foods are introduced, breastmilk remains their primary source of nutrition. It’s not until they’re about 12 months old that solids will make up most of their daily intake of calories and nutrients. Many toddlers (12+months) may still consume 12-19oz of breastmilk daily in addition to their solid foods (meals and snacks) as well as water.
Learn more about starting solids here
*If you are having challenges and are not producing enough (supplementing with donor milk or formula) you may be able to increase your supply depending on the underlying cause. An IBCLC can help you with this.
Motherhood has its challenges and breastfeeding can bring more of its own challenges.
But breastfeeding isn’t all or nothing. No ones breastfeeding journey is exactly the same as another but all mothers share in their love of their babies. You don’t have to navigate this journey alone. We are in this together.
The Bumps + Breastfeeding Academy is your new mom breastfeeding survival guide. You will get the answers to your burning questions and help you need to breastfeed with ease from a lactation expert.
If any of this has you worrying about your milk supply, connect with an IBCLC for a full assessment. You deserve expert lactation support. You can learn more about working with me here.
References:
Bonyata, K. (2018 January 15). Hunger cues: when do I feed my baby? Kellymom.com. https://kellymom.com/bf/normal/hunger-cues/
Hetzel Campbell, S., 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. Harper Collins Publishers Ltd.
Wilson-Clay, B., & Hoover, K. (2017). The breastfeeding atlas (6th ed.). Manchaca, Tex.: LactNews Press.