As someone who works with new moms a lot, I have to say that the number one question I get is: “How do I know my baby is getting enough breastmilk?” It would be a lot more convenient if breasts came with ounce markers, wouldn’t it?! Since it’s not always quantifiable in such a way, there are a few other ways to know that baby is getting enough.
If your baby is back up to birthweight by 2 weeks of age, or at the very least gaining half an ounce to an ounce per day (4-8 ounces per week in the early weeks), this is all good news. Keep in mind that different scales might be slightly calibrated differently, so it’s important to use the same scale. Also, weight can vary up to several ounces, depending on different conditions, such as: did baby just eat? Did you just change a wet or dirty diaper? Are they wearing any clothes? A dry diaper or no diaper at all? It’s better to watch trends over time, rather than just individual numbers.
All those wet and dirty diapers
This is a little easier to measure than weight, considering most household bathroom scales don’t measure to half an ounce! The general rule is, if it’s going out, it’s coming in. In the first few days, babies should be producing one wet and one dirty diaper for each day of life. For example, we would expect one wet diaper and one poopy diaper on day one, two wet and two poopy diapers on day two, and so on. After mom’s milk “comes in”(usually between days 3-5) we generally expect about 5-6 wet and 3-4 poopy diapers per day. This can sometimes be confusing, since it’s measured every 24 hours, so if your baby was born, say, at 3pm, each day would be measured from 3pm on one day to 3pm the next. After mom’s milk is in, we also expect the color of the poop to change from the thick, tarry brown meconium to green and then seedy yellow. At the end of about one month, some babies begin to poop less frequently and this isn’t a cause for alarm.
Good, Frequent Feedings – All. The. Time!
Ok, I’ll be the bad guy here. In the early days, it’s going to feel like you’re always nursing. It’s a skill that becomes much more efficient with time, but it takes a while to get in sync with baby, and sometimes babies are sleepy at the breast. Keeping baby awake at the breast during a feeding, and feeding often- at least 8-12 times per day- are key to baby getting the intake they need. Looking for jaw movement and listening for swallowing once more milk volume is in (after day 3-5) are both signs of good milk transfer. You can also watch the baby- at the beginning of a feeding, they are likely to be tense, and have their eyebrows furrowed and fists clenched. By the end of a feeding, their hands and face should be totally relaxed. The only exception to this rule is a very sleepy baby. If they fall asleep at the breast after less than 5 minutes, they probably are too sleepy to really have gotten much milk, but might appear relaxed. However, at the end of a few months, it’s possible that 5-10 minutes might constitute a full, efficient feeding session!
Take a step back and look at your baby
If any of these measures are a little off, it’s helpful to look at the big picture. Does baby seem content? Are they having lots of quiet alert time? If you’re concerned about your baby getting enough, it might be worth it to contact a lactation consultant. If your baby is having less than 4 poopy diapers per 24 hours by day 4 (or if they are still dark brown by day 4), if there are any red stains in the diaper after day 3, or if your baby is not breastfeeding at least 8 times every 24 hours it would be a good idea to contact a lactation consultant.