Milk Supply: How Do I Know if My Newborn Baby is Getting Enough Breast Milk?

Once your newborn is at least 6 days old, there are some guidelines to help you be sure of your milk supply.  Note that insufficient milk supply is rare.  What is more common are practices that can hinder your milk supply or baby's feeding which I will detail at the end of this post.

To assess good milk transfer, answer the following:

1. Is the baby wetting 6-8 diapers in 24 hours? (Disposable diapers are so absorbent, that it might be hard to tell.  If you are unsure, take a clean diaper in one hand and the removed diaper in the other and you should be able to tell by the slight weight difference.)
   Yes  |  No
2. Is the baby having 3-4 bowel movements in 24 hours that are mustard yellow with curds in them? (These shold be silver dollar size or larger, not just a stain.)
   Yes  |  No
3. Do the breasts feel full before feeding and softer after feeding? 
4. Yes  |  No
5. Do you hear swallowing when the baby is breastfeeding?
   Yes  |  No
6. Is the baby eating at least 8 times in 24 hours?
   Yes  |  No
7. Does the baby seem satisfied after a feeding?
   Yes  |  No
8. After the initial weight drop, has your baby started gaining 3/4 - 1 ounce per day?
   Yes  |  No                                                               
9. If tyou had some nipple soreness, is gone?                                                                                    Yes  |  No

Practices that hinder milk supply include "scheduling".  Making an infant wait for feedings, lowers milk supply and slows weight gain.  Infants may need to eat at 1-3 hours apart during the day, especially between day 10 and three weeks when the first grown spurt occurs.  The only scheduling that should occur is if the infant has not asked to be fed at the 3 hour mark from the beginning of the last feeding, it is time to nurse.  A mininum of eight times a day is normal for a newborn.  The longest stretch you could hope for is one 5 hour stretch.  It is common for newborns to feed up to 12 times per day during a grown spurt.  This practice ensure a healthy milk supply for a growing baby as milk supply follows a demand and supply principle.

Other practices that can hinder milk supply are the use of a nipple shield.  While they have a time and place to assist in latch.  They are not a cure for sore nipples and should not be used unless necessary and discontinued as soon as possible.  When using a nipple shield, a cut out ultra thin silicone nipple shield is best.  Place the cut out at the baby's chin so that the skin to skin can elevate your hormone response which increases milk supply.

Another practice than can reduce milk supply is unresolved engorment.  When the milk first comes in 3-5 days postpartum, softening the breasts with warm moist heat from a compress or disposable diaper doused with hot water and warmed in the microwave is essential before nursing or pumping so that milk is more effectively extracted.  Milk that is not extracted actually reduces milk supply as your body is being signaled that you do not need the milk.  That is why the practice of waiting for an insurance pump is not the best idea.  If your insurance company will not allow you to get a pump until after the birth, go with a private pay DME.  That way, you can order the breast pump on the day of the baby's birth and it will be at your doorstep between 3-5 days when you need it most.  You then have to file for reimbursement with your insurance company, but it beats waiting around for a company to bill your insurance and you may not have your pump when you need it most. 

Here is to a Healthy Milk Supply, Mamas!
Tanya

Breast Milk Intake Chart: Infant Weight - How Much Breast Milk

One of the top questions we get, is how much do I leave for my baby in a bottle when I am away at work?  After all, your breasts don't come with ounce markers because your baby feeds on demand.  But for moms who are working or away from their baby short term, it is important to know how to determine how much milk is appropriate to leave.  For infants up to six months old, the quickest way to determine this is to take your baby's current weight rounding up to the nearest half pound and multiply by 2.5.  For example, a baby who is 10 lbs will need 25 ounces per day.  Then divide by the number of feedings per day, normally 8 for an infant under six months of age.  Therefore 25 ounces divided by 8 feedings is 3.12 ounces per bottle which we will round up to the nearest quarter ounce.  In other words, leave 31/4 ounces for a 10 lb baby for every 3 hours that you will be away.  Also leaving an extra frozen bottle is a good idea for emergencies.  Here is a link to a breast milk intake chart for those of you who are like me and have a mental block when it comes to math.

If you are trying to determine breast milk intake in those early days for your peace of mind or if your baby doctor is indicating that your baby is slow to gain weight, an affordable accurate baby scale with memory is a great tool.

Remember, diapers are a great indicator that your baby is getting enough.  Infants from day 6 through 6 weeks should have 6-8 wet diapers per day and 3-4 dirty diapers larger than a silver dollar.  Also note that older babies who are on solid food do not use this chart.  At that age, they take an average of 24-32 oz per day in addition to three solid meals per day.  When feeding solid foods, breastfeed first as breastmilk is still the main source of nutrition.  

If you still have concerns, having an affordable accurate digital baby scale is a plus.  Choose a digital baby scale that is accurate within 5 grams and has memory for before and after feeds to give you an idea of your baby's breast milk intake.

Best wishes!

Tanya