Some signs that the baby is getting enough milk include:
- Weight loss less than 10% in the first 3 days
- Gaining weight after day 3
- Adequate urine and stool output
- Regained birth weight by 2 weeks
- Baby has periods of alert, awake and happy times
While your child's practitioner will be the person to help you determine if your child's weight is meeting appropriate goals, there are things you can monitor at home to make sure your child is getting enough milk. Do you notice that your child is awake and alert, noticing things around him? Is she meeting her milestones? Does she have both happy and unhappy times (a typical baby is rarely happy all of the time or sad all of the time)?
Another great indicator is the baby's urine and stool output. This is because if you put food into the baby, it has to come back out. After the first few weeks the baby may become very efficient with his stools and it is normal for a breastfed baby to go several days without stooling. In the first few weeks, however, these guidelines can help you monitor output:
Your baby should have:
- 1 urine and 1 stool on day 1
- 2 each on day 2
- 3 each on day 3
- at least 3 stools and 5 urines each day following
Any stool the size of a quarter or larger can be counted towards the total. The wet diapers should be soaking and families who use cloth diapers should increase minimum wet diapers by one to two diapers a day, since they tend to need changing more frequently. Some babies will just meet these goals and some children will stool with every feeding. Both are completely normal.
The first few days your infant will have stools that are thick, black and tarry. This first stool is called meconium. After the first couple of days your infant's stools should be mustard colored, seedy and loose. The stools will stay this way until you add in complimentary foods at your baby's six-month birthday.
If you notice that your child is not meeting one of the above guidelines, it's important to talk to your child's pediatrician and a qualified lactation professional. The earlier you get help, the more likely it is that the problem will be remedied. A good lactation professional can help you assess your milk supply, assess the baby's feeding and help weed out any problems that you may experience. If you do have an issue, giving supplements via a bottle may only complicate the problem. It's best to let an expert help you determine the cause and the best solution if you run into bumps in the road.
Judging milk intake by the fullness of your breasts or by how much baby sleeps will not give you a good indication of whether baby is getting enough. Breast size is not a good indication of ability to make a milk supply, either. Moms with large breasts can make milk and moms with small breasts can make milk. Frequency of milk removal is the main factor in milk supply, so be sure that you are giving your baby lots of opportunities to nurse. Your infant should nurse at least 8-10 times in 24 hours.
Riordan, J, K Gill-Hopple, and J Angeron. "Indicators of Effective Breastfeeding and Estimates of Breast Milk Intake." Journal of Human Lactation. 21.4 (2005): 406-412. Print.
Adams, D, and S Hewell. "Maternal and Professional Assessment of Breastfeeding." Journal of Human Lactation. 13.4 (1997): 279-283. Print.