Is my baby getting enough breast milk?
Let me start by saying that baby’s crying is never a reliable sign of whether the baby needs more food. Babies cry for a number of reasons early after birth among which are: transitioning to a new way of life outside the womb, learning to breathe, being cold, being hot, having a wet or dirty diaper, being stressed due to the feeling of coming poo-poo or pee-pee, having gases, feeling lonely and missing mom (remember in the womb the baby spent all the time being 1 with his mom and now he needs to be frequently held and carried in her arms to feel secure), having belly aches or headaches, being stressed due to new smells in the house or seeing new people coming to visit and many more. Some babies cry more than others, every baby is unique, but crying itself, its duration and frequency, cannot serve as a reliable sign for needing to start giving formula at any point. Breast milk always stays the best and most advanced nutrition for the baby and even when breast milk is not enough for the baby there are many ways to increase lactation without having to start supplementing with powdered artificial milk.
Here is the list of things that parents need to check in order to know if their baby is getting enough breast milk:
1) Diaper output (if nothing goes in, nothing goes out!). After the first 2 weeks of life the baby should have at least 5-6 heavy wet diapers in 24 hours, and about 3 liquid stools of mustard (yellow to brown) color.
2) Weight gain. It’s natural that babies would lose up to 7% of weight in the first week after birth. However, at 2 weeks the baby is expected to be back on his birth weight. After it the weight gain should be about 15 grams a day or 450 grams a month. (Yes, breastfed babies can gain weight at slower speed compared to formula fed ones and still be in great shape and develop even better than their peers on artificial feeding.)
3) Growth in length. Baby should become “taller” by at least 2 cm a month (more is welcome of course! Growth in height is usually even more important than his weight gain in estimating the overall development ).
4) Calm awake times. There should be some awake and peaceful times during the day and night when baby is not sleeping and not interested in breastfeeding.
5) Frequent breastfeeding. Baby should be breastfeeding at least 10-12 times in 24 hr in the first week of life and 6-8 times after the first 2 weeks.
6) Active and efficient suckling at the breast. Baby should start each breastfeeding with active suckling and then slowly relaxing (and even falling asleep) after some time. Swallowing should be heard at the times when baby is suckling actively.
7) Change in breast firmness. Breasts should feel softer after the baby nursed from them (or one of them).
8) Breastfeeding does not hurt. Baby should be breastfeeding with a wide open mouth taking a large portion of areola (dark circle around the nipple) into his mouth. Breastfeeding should feel comfortable and pleasant. If there is pain, it could be a sign of not efficient milk removal which would lead to sore nipples, unhappy baby and decreased milk supply. Breastfeeding is not supposed to hurt and if it does you need to search for help from an experienced breastfeeding helper!
9) Baby is fed on demand. Baby should be fed on early hunger cues before he starts crying, not on rigid timed schedule (when breastfeeding a mother cannot be sure how much milk the baby took at each time, so she cannot make a decision on how long the baby will have to stay before he is hungry again).
10) Baby decides how long he wants to stay on each side. The first front milk always has more water content while the back milk that comes at the end of each breastfeeding is more rich in fat and calories, so the mother should allow the baby to decide whether he wants to drink and switch breasts often during one feeding, or whether he wants to eat and needs to stay breastfeeding on one side for a long time, sometimes up to one hour!
So as you see, dear mothers, there are so many ways you can ensure that your baby is getting enough food! It’s easy to start doubting ourselves and our ability to produce enough food for our newborns (especially if everyone around keeps on telling us every day that the baby must be starving if we don’t give him formula). But our breast milk is the way intended by nature to feed our babies! So believe in yourselves and if you only start worrying or doubting about anything don’t hesitate to contact me and ask as many questions as you need! We will evaluate the situation and if necessary will can always increase lactation and overcome all the difficulties you might have! Breastfeeding is a miracle!
By Nadiya Dragan El-Chiti,
Experienced Nursing Mother
Trained and Certified by World Vision in “Exclusive Breastfeeding”