How do you tell if your baby is getting enough milk? In a world where everything is measured, it can be nerve-wracking when you can’t see how much milk your breasts are making.
Some parenting books recommend routines for breastfed babies. But routines can reduce breastmilk production, as can unnecessary supplements or a dummy. Whatever their weight, a young baby needs to nurse at least 2–3 hourly to establish their mother’s milk supply and get enough milk.
Frequent nursing is normal, partly because breastmilk is a drink as well as a food. Adults rarely go longer than a couple of hours without a drink, snack or meal. Your baby’s tummy is tiny and breastmilk is quickly digested so they needs frequent feeds to help them grow.
Weight gain
Newborns often lose up to 7% of their birth weight in the first few days. Once your milk production increases, usually on day 3–4, expect your baby to begin regaining their lost weight. Most babies regain their birth weight by 10–14 days old. Your baby will grow at their own rate, and a growth chart will indicate how they are doing (see Further Reading). Once breastfeeding is going well and there are no concerns, weighing is advisable no more than once a month in the first six months. If there are concerns, monitor the trend of his weight change over several weeks rather than focusing on one particular week.
Your baby’s weight may increase steadily and so follow a single percentile line on the chart, or rise faster, crossing the percentile lines. A gradual drop from one percentile line to the next (or the equivalent distance) is unlikely to be a problem unless your baby’s weight is low for their age. Heavier newborns often show ‘catch-down’ growth—meaning they gain weight steadily even though they gradually drop against the percentile lines. Dropping against the chart is more of a worry for lower weight babies. Seek help quickly if your baby isn’t gaining weight well.
Look at your baby
You may instinctively know how your baby is doing. Ask yourself: Do they look healthy and seem active and alert? Are they meeting developmental milestones? Do they usually seem content and satisfied after breastfeeds.
Dirty nappies
Dirty nappies are a good indicator of how much milk your baby has taken. The table below shows what is normal.
Age
Dirty nappies per 24 hours
1-2 days
greenish-black tarry meconium
3-5 days
at least 3 greenish transitional poos
5+ days
at least 3-5 yellow, unformed poos, the size of a 2p coin or larger
6 weeks +
possibly less frequent but larger poos
How frequently are you breastfeeding?
The more often you breastfeed, the more milk you will produce. You will make less milk if you breastfeed less often. In the early weeks, a baby needs to nurse about every 2–3 hours, or at least 8–12 times in a 24-hour period, including some feeds at night. Allow your baby to breastfeed for as long and as often as they seem interested. To help them get a balanced meal let them finish feeding from the first breast before offering the second.
Sleepy baby?
A baby who sleeps a lot rather than feeding every 2–3 hours may need to be wakened to nurse, and this is particularly important if they have jaundice or they aren’t gaining enough weight. If this is difficult, or they are lethargic, ask your midwife, health visitor or GP to check that all is well. Our page Sleepy Baby – why and what to do explains more.
For most breastfeeding problems there is a breastfeeding solution. Almost all mothers can produce enough milk to meet their baby’s needs.
Check your baby is latched on well. Make sure they have full body contact with you. Ensure they have a large mouthful of breast and listen and watch for swallowing as they feed. See our article which has lots of information about how to help your baby with positioning and attachment.
Breastfeed often, offering both breasts – at least 8-12 times in 24 hours. Wake your baby if necessary. Watch for rooting (head turning) or fist sucking – crying is a late sign of hunger.
Encourage ‘cluster nursing’ – breastfeed very often at times when your baby is willing to.
Seek skilled help early on if you are finding breastfeeding difficult, uncomfortable or painful. Contact an LLL Leader for help.
Keep your baby close – try laid back breastfeeding, reclining comfortably with your baby while lightly dressed or in skin-to-skin contact close to your breasts. They will have lots of opportunity to breastfeed, even in a light sleep, and this boosts levels of the hormones that increase your milk.
Encourage breastfeeding for comfort as well as food as this boosts milk production. Stop using any dummy—breastfeed instead.
Night feeds are especially important for establishing and increasing milk production. See our page Safe Sleep & The Breastfed Baby.
Get help with household jobs—ignore the jobs around the house and and eat simple, easily prepared meals so you can concentrate on resting and breastfeeding your baby.
The most effective way to increase your milk production is to take your baby to bed with you for a day or two, and focus solely on nursing and caring for him, whilst other people take care of you.
Breast compressions
Breast compressions can encourage a baby to breastfeed actively and take more milk:
Support your breast with one hand—thumb on one side, fingers on the other.
Wait while your baby breastfeeds actively, their jaw moving all the way to their ear. When they stop swallowing, compress your breast firmly to increase milk flow. Hold it squeezed while they continue swallowing, then release your hand.
Rotate your hand around the breast and repeat step 2 on different areas of the breast. Go gently—this should not hurt.
Try switching breasts at least two or three times during each feed—when your baby comes off the first breast on their own or when breast compression no longer keeps them breastfeeding actively. As time goes by you’ll find that you no longer need to do this.
Simple ideas for boosting milk production
Removing small amounts of milk even from soft comfortable breasts increases milk production: Full breasts slow milk production.
Babies nurse for comfort as well as for food: those little ‘in between’ comfort feeds really help your milk production.
Your baby is fussy:Many babies have a regular fussy time (often evenings) however hungry or not they may be. Some babies need lots of stimulation; others need soothing. You’ll soon learn what your baby needs. If they settle at the breast, just let them nurse.
Expect your baby to want to breastfeed very often from time to time: Your breasts will quickly adjust to making more milk if you follow your baby’s needs.
Your baby’s feeds may become shorter perhaps only five minutes at each breast. Most babies become very efficient at breastfeeding once nursing is going well.
Babies’ feeding patterns are very individual: If your baby is gaining weight at an appropriate rate, then following the feeding pattern they choose is the best way to meet their needs. It may be different from other babies.
UK–WHO Growth Charts These charts are based on the growth rates of breastfed babies and can be found in your baby’s Personal Child Health Record (red book). You can download a full range of free charts from: www.rcpch.ac.uk/growthcharts Books The Womanly Art Of Breastfeeding. LLLI, London: Pinter & Martin, 2010
