How do I know if my baby is getting enough breast milk?

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A nursing mom frequently asks this question in the early weeks of breastfeeding. How do I know if my baby is getting enough breast milk?

In bottle feeding, we can easily see how much milk baby is taking. In contrast, measuring breast milk intake is not that straight forward.

Some well-meaning relatives may say, if baby cries after feeding, that means he wants more. If a baby is at the breast all the time, that means you are not producing enough milk. If baby finishes bottle after breastfeeding, that means he does not get adequate breast milk. And the list goes on.

But are those signs really true? Fortunately NO. Yes, your baby may still get enough breast milk even though he behaves like that.

As a nursing mom, you need to know, how to tell EXACTLY if your baby is getting enough. And not only that! You should be able to explain to your family and relatives -who thought your baby is starving- that they may be wrong.

 Is my baby getting enough?

There are two ways to check if your baby is taking adequate breast milk, diaper count and weight gain. Very simple, right. Let’s discuss each of them in more detail.

>>Just starting to breastfeed? Click here to get a handy checklist to prepare you for breastfeeding<<

 How many diaper counts your baby should have

I strongly recommend every mother to keep track on your baby’s progress, especially during the first few weeks after birth.  I did mine in a baby log book given by the hospital where I gave birth. If you don’t have any baby log book yet, at the end of this post , I’ll share where to download it for FREE.

Here are some guidelines to monitor your newborn baby’s diaper output.

• At the first two days, baby will have about 2-3 wet diapers and pass meconium (dark green colored stools).
• As milk starts to come in around day 2-3 (it can take longer than that, mine comes at day 5), the number of wet diapers will increase to 3-5 per day. The stool will gradually transform into greenish, then mustard yellow. It is also common to see something like ‘mustard seeds’ in the stool.
• If milk has not come in yet, you may notice some pink crystals in the diaper, indicating baby gets low milk intake. If this happens at day 2 or 3, don’t worry yet. But if this occurs consistently, even at day 4-5, get help as soon as possible.
• As the milk supply establishes, baby will have 6-8 wet diapers and 3-5 stools a day. The stool frequency can be up to 12 times a day (some babies are like this), as long as the stool is not too runny, he will be fine.

Wet diaper indicator: How wet is wet enough?

• Have a sample of soaked diaper. Take a clean diaper; pour 2 table spoons of water or 3 table spoons (if your baby weighs more than 3.6kg) onto it. This is how a soaked diaper would feel. Now, put that sample diaper in a ziplock bag. Whenever you change your baby’s diaper, compare the diaper wetness with the diaper sample.
• Use cloth diapers. With cloth diapers, it is easier to check if diaper is really wet. I personally use this method, but if you don’t want, I truly understand the reason. Do what you find most comfortable for yourself.
• Use a disposable diaper with wetness indicator. Some diaper brands, like Huggies, has diaper type with has wetness indicator, that change color when the diaper is wet enough. The indicator may vary across brands, such as line strips or star-shape pattern.

What is the normal weight gain to indicate enough milk intake?

If milk comes in rather slow, baby may lose more weight, but will catch up as soon as milk is available, and typically this group will get back to her birth weight at the end of second week.

It is normal for a baby to lose weight up to 10% of her birth weight. If milk comes in early (around day 2-3), baby will usually gain weight faster and will be back to her birth weight at the end of the first week. When milk comes rather slow, usually he will be back to birth weight after 2 weeks.

Image source

Monitoring baby weight gain

• Between 0-3 months old: baby should gain approximately 1oz (30 gr) daily or at least 6 oz (180 gr) weekly
• Between 4-6 months old: baby should gain at least 0.6oz (18 gr) daily
• Between 7-9 months old: baby should gain at least 0.4 oz (12 gr) daily
• Between 10-12 months old: baby should gain at least 0.3 oz (9 gr) daily

Important!

When you track your baby’s weight gain, you want the scale reading to be as accurate as possible. For that, pay attention to the following:

• While the indicators here are specified in daily, in normal case, weighing the baby once a week should suffice for monitoring purpose.

• Weight reading to be taken at the same scale. For most accurate result, the weight should be measured using exactly the same scale. Simply because each scale measures differently. If you use your hospital scale at week 0 and your own scale at week 1, you may get some mismatch in readings. For best result, you may want to rent a high-quality baby scale to have consistent readings
• Remove baby clothing before weighing. We don’t want baby’s clothing to affect the scale reading, so it is best to remove all clothing and accessories, such as booties, mittens, hat, including the diaper.
• Consistent weighing time. If you weigh weekly, make sure you do it at exact same day, e.g Monday to Monday. For even better accuracy, do it at same timing (say always do it in the morning).

Weighing every few days or weekly is usually enough for most of the cases, but in critical cases, weighing should be performed daily.

Feeding test weight

If you want to measure how much breast milk exactly a baby takes for every feeding, you can do feeding test weight.

This is usually done when a baby receives a mixture between breast milk and supplementation, so that diaper output and normal weighing can not be used as a reference. The amount of milk taken is simply the weight after subtract the weight before. And then, you can convert the weight to volumetric unit to get the amount of milk in ounces or ml.

Please notice that the amount of milk that your baby is taking in a single feeding varies throughout the day, so multiple weighing (ideally throughout every feeding in 24-hour period) should be performed to get more accurate result.

Now that you have tracked baby weight gain and diaper output, you can roughly gauge if your baby has taken enough milk. If your monitoring result indicate that she doesn’t get enough milk, seek professional help as soon as possible.

In the part 2 of this article we will rule out common misconceptions on breastfed baby behavior.

Oh, before you go, here is the FREE baby log book printable that I was talking about. Enjoy!

Do you want to read further about:

• how to get a head start of your milk production
• how to know if your baby is getting enough milk
• how to maximize your milk supply
• which food and herbs can boost up your supply
• how to supplement your baby without sacrificing your milk supply
• how to build up supply prior of going back to work

All of these topics are covered in this comprehensive guide for making more milk.