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Is my baby getting enough milk?
by Melissa Clark Vickers, IBCLC

One of the most common worries new moms have about breastfeeding is how to tell if their babies are getting enough milk. Since we don’t have ounce markers on our breasts, we can’t directly judge how much milk is actually leaving the breast. Fortunately, there are easy ways to tell that your baby is getting what he needs.

Supply and demand
The breast is an amazing milk factory. It bases how much milk to make on how much milk your baby removes. If he takes a lot, your breast makes a lot. If he takes only a little, your breast responds by making less milk. And your breast continues to make milk, even during a feeding. Unlike a bottle, it is never truly empty, so there's no reason to wait a set time period for your breast to "refill." Breastfeeding a newborn

Signs of good breastfeeding

  • Breastfeeding doesn't hurt! When your baby is properly positioned at the breast, it makes it easy for him to get that milk out. A poor position often causes pain while breastfeeding. Sometimes a minor change in positioning makes a major change in comfort – and in the amount of milk your baby can take from the breast. If it hurts, get help.
  • You can hear your baby swallowing while he nurses. Listen for a soft "cah, cah" sound as he nurses. Try placing a finger under his chin to feel him swallow. A typical swallowing pattern starts out with a few quick sucks to get your milk to let down. Then the sucking slows down with a swallow after every suck or two. Your baby may rest for a bit, and then do the quick sucks again, followed by the slow sucking pattern. This means that he has triggered another letdown – and that your body is doing exactly what it is supposed to be doing! Those later letdowns help get the fattier milk out that will help satisfy your baby.
  • Your baby relaxes as he nurses. A hungry baby is usually pretty tense. His hands may be clinched into tight fists. As he feeds, he begins to relax and his hands will open up.
  • You relax as he nurses. One of the best by-products of breastfeeding for moms is the daily dose of a hormone called prolactin. Prolactin helps your body make milk, and has been nicknamed "the mothering hormone." Prolactin relaxes you while you nurse, and helps you cope with the demands of being a new mother. You may notice a wave of relaxation that comes over you during a feeding, complete with yawns and glazed eyes! That's prolactin at work.
  • Your breasts soften during the feeding. Especially in the early weeks, your breasts will feel full and hard at the beginning of a feeding and then feel more like the skin under your arm at the end of the feeding. That milk had to go somewhere! 3 Your baby comes off the breast with a "drunken sailor" look. When your baby has had a good feeding, he'll come off the breast (usually on his own) with a precious look on his face of pure satisfaction – and often with milk running out of his mouth! 3 Your baby is content between feedings. Notice that contentment is at the bottom of the list and not at the top. A baby who is not getting enough to eat will not have enough energy to do more than sleep. A baby who falls asleep at the breast after only a few sucks is probably not getting what he needs. Aim for at least 10 to 12 feedings every 24 hours.
In one end and out the other!
One of the easiest ways to tell whether any milk is going in your baby is to look at what is coming out the other end.

Wet diapers mean your baby is getting enough fluid. Look for six to eight wet diapers per day. If you are using disposables, try pouring 1/4 cup of water in a diaper to see how it feels. You can also put a man's handkerchief inside the diaper to tell when it is wet. The urine should be clear and pale – not dark and strong smelling (signs of dehydration or infection).

Soiled diapers mean he is getting enough calories. After the tar-like meconium passes, you may see two to five or more bowel movements per day. Some babies will have a BM after every meal – often right after you change their diapers! The stool will be mustard-yellow and soft. The smell is not offensive, resembling buttermilk.

  • Your baby is growing! There's no better proof that your baby is getting what he needs than to see how fast he is growing. One study found that babies can grow as much as a half inch in 24 hours! Look for his cheeks to fill out, and his clothes to "shrink." He should be gaining weight, and growing in length and in head circumference.

If you are concerned about whether your baby is getting enough, check with your health care provider and/or a board certified lactation consultant. Most of the time, breastfeeding goes well, and babies grow and develop beautifully on breast milk. If there are problems, most can be resolved quickly. You know your baby better than anybody else does. If you are worried, get help!

About the Author: Melissa Clark Vickers, MEd, IBCLC, is an International Board Certified Lactation Consultant (IBCLC) and freelance writer with extensive experience in breastfeeding education, materials development and individual counseling. She rents and sells electric breastpumps and accessories. Melissa writes, edits and publishes a bimonthly breastfeeding newsletter, Moms & Babies, now in its fifth year. She is an accredited La Leche League Leader with two children: Dan, 14, and Merrilee, 11, both of whom were breastfed.

About the Author: Sharon Waldrop is an iParenting contributing writer.

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