This guest blog series is created and written by Robin Kaplan, M.Ed., IBCLC, Owner of the San Diego Breastfeeding Center
How do I know if my baby is getting enough milk?
That is the million-dollar question asked by all breastfeeding parents. While bottles tell us how much our baby has taken in on a minute to minute basis, our breasts don’t come with ounce notches on the sides of them (unfortunately) so we have to take a leap of faith at every feeding that our baby is getting enough milk.
So, if Rule #1 in parenting is ‘Feed the Baby,’ how will a parent know if their breastfed baby has gotten enough milk?
Weight gain
One of the most significant ways a breastfeeding parent will know that their baby is getting enough is by how much weight their baby is gaining over time. Since most babies only see their pediatricians every few months, a baby’s weight gain can be monitored on a more regular basis at a local breastfeeding support group or by an IBCLC (lactation consultant.) When weight gain is steady for several weeks for an exclusively breastfed baby, it is typically not necessary to monitor the baby's weight on a weekly basis. This steady weight gain is a sign that you can trust that you and your baby are in sync with milk supply and getting enough. Here are the expectations for weight gain for a baby in the first year of life.
First 3-5 days: It is important to know that all babies lose weight in the first few days. They are born full of meconium (poop) and don’t need much colostrum (your first milk) for a few days, so normal weight loss is about 7% of their birth weight.
3-5 days old to 4 months old: By day 3-5, your milk should be in and your baby should now be gaining weight. From now until 4 months old, the expected weight gain for your baby is about an ounce per day.
4 months and beyond: Once a baby is 4 months old, their weekly weight gain starts to slow down. Babies are expected to gain about 4-5oz per week from 4-6 months old and then about 2-4oz per week once they hit 6 months old.
Input
Another way to know if your baby is getting enough while breastfeeding is to understand how much milk your baby actually needs. On average, a baby needs about ½ tsp - 2tsp (2-10mls) per feeding on Day 1, about 5-15ml per feeding on day 2, about 15ml-30ml on day 3, and then about 30-60ml (1-2oz) per feeding on day 4. Not a huge amount, right? By 2 weeks, most babies need about 2-3oz per feeding, about 8 times per day, and this may increase slightly by the end of the 1st month. This amount continues to incrementally go up to about 30oz per day by the end of the 2nd or 3rd month and then plateaus here until your baby is a well-established consumer of solid foods (around 10-12 months.)
It can be helpful to know this ‘input’ information when doing a weighted feeding, like at a breastfeeding support group or pediatrician appointment. If your baby is not gaining weight well, then a weighted feeding can help you understand how much your baby is taking in while breastfeeding and if that amount needs to increase.
Output
What goes in, must come out! During those first few months, we expect lots of pees and poops from your baby...which often happen during most breastfeeding sessions. When babies (older than 5 days) are not peeing at least 5 times daily and pooping several times per day, this might be an indication that your baby may need a bit more milk. First, do a weight check, though. If your baby is gaining well and just not pooping, then the output may not be your best indicator of milk intake while breastfeeding.
Behavior after eating
In general, a well-fed baby should be very relaxed after breastfeeding. They will start feedings excited, fists in their faces, rooting around like they’ve never fed before. During the first 2 weeks after birth, babies can be exhausted from their birthing journey, so sometimes their sleepy behavior can be confusing as to whether they took in enough milk or not. For these sleepier kiddos, you will want to keep an eye on their weight gain, just to make sure they are gaining the expected amount. Up until babies are about a month old, they may also fall asleep after a full feeding. If they continue to snooze for an hour or two, they probably took in a good amount of milk while breastfeeding. If they wake up and put their fist in their mouth within a few minutes of unlatching, they probably need a bit more milk to reach satiation.
Babies over a month old don’t always fall asleep after a full feeding. Some may doze a bit at the end of the feeding but, wake up after unlatching. Others might take a decent nap after breastfeeding. If your baby took in a good amount of milk, they will remain in a calm, alert state after unlatching and just seem relatively content. (One side note here…. If your baby is dealing with reflux or uncomfortable gas, they may not be super content after breastfeeding, even when taking in enough milk. An IBCLC can absolutely help with this situation.)
By 3 months old, babies often start to feed for shorter amounts of time (like 15 minutes), which can be confusing to the parent who is used to breastfeeding for 20-40 minutes per feeding session. Again, if your baby seems content and ready to interact with you, they probably took in enough, as a hungry 3 month (or older) kiddo is usually pretty verbal when they want more milk!
If you are still feeling unsure about whether your baby is getting enough while breastfeeding, here are a few additional resources!
Can my baby take in too much milk? Possibly! Click here to learn more about foremilk/hindmilk imbalance.
What if my baby is not getting enough milk while breastfeeding? Take a look at this supplementation article to learn more about how to increase the amount of milk your baby gets while breastfeeding and definitely reach out to a lactation consultant for help!
