Globally, about 40% of mothers breastfeed their babies and health authorities around the world continue to encourage women to do so due to the nutritional benefit of breast milk. But breastfeeding can raise some concerns for mothers, especially first time mothers. The main such concern is whether baby is getting enough milk. Unlike with bottle feeding, whether it is baby formula or expressed breast milk, there is no way to verify the exact quantity of milk being breastfed.
Nagging questions are always on the mind of mothers who opt to breastfeed. Is the breast milk too much or too little? Is baby getting enough nutrition? Am I starving baby? Will the lack of breast milk affect baby’s growth and development or stunt him/her for life? These are common questions and concerns on the minds of mothers but there are a few simple ways to know if your breast milk is adequate for baby. However, if in doubt it is always advisable to speak to the baby’s pediatrician. Professional advice is always comforting. Remember that it is possible you have a low milk supply or baby is not drinking as much as he/she should, and the signs may not be immediately obvious.
Baby’s Weight Gain
Baby’s body weight is probably the single best indicator of whether breastfeeding is adequate. Remember that baby may lose around 10% of his/her birth weight in the first few days of life and this is not usually due to feeding or a lack thereof. Gradually baby will gain this weight, usually within the first 2 to 3 weeks of life. If baby is gaining weight at a steady pace then you can rest assured that your breast milk production is adequate. Even if you cannot weigh baby on a scale, you will notice the change in weight when carrying baby and even the change in the way baby’s clothing fits as compared to when he/she was born.
Alert And Active Baby
Baby will sleep most of the time, especially in the first 2 weeks of life. He/she will also not be as alert and active within the early weeks. But gradually baby becomes a bit more responsive. Even though baby cannot see a distance or coordinate head movements, you will notice baby responding to you by touch and sound. Baby will also be more ‘awake’ then he/she was in the first 2 weeks. Even crying and fussing to be carried or comforted are good signs that baby is thriving. A malnourished child would be extremely lethargic and non-responsive when awake. So monitor baby’s level of alertness and activity after about 2 weeks or so.
Baby’s Stool And Urine
Another good indication that your breast milk is sufficient is by assessing baby’s urine output and bowel movements. Remember that if baby is not getting enough nourishment then his/her body will retain as much liquid as possible and there would not be much waste material for the stool. Do not get too concerned about baby’s yellowish bowel movements, which can sometimes even be green. It is not about the color of the stool as much as it is about the frequency of bowel movements and quantity of stool passed. Sometimes it is easier to judge by the number of times you need to change baby’s diapers. On average, a baby will use about 6 diapers a day and sometimes as much as 10.
Baby Wants To Feed Often
A newborn baby will want to feed around 12 times a day, sometimes a bit more or less. It can be as frequent as 90 minutes between feeds or extend to as much as 3 hours between a feed. And as baby grows, he/she will sleep longer hours at night and therefore feed less. This is normal. If baby was not getting enough milk, he/she will not be as demanding about being fed. And breast feeding will not pacify a crying baby when all other aspects (like a clean diaper, comfortable clothes, being rocked) has been taken care of. So baby’s frequent feeding is a good indicator that there is breast milk being produced. Do not worry about the quantity. Your breasts will produce more or less milk accordingly.
Swallowing During Feeds
If you listen carefully, you should be able to hear baby swallowing when you feed him/her. This is a good sign that he/she is getting milk in the mouth and therefore has to swallow it. Even if you cannot hear it, you should be able to see baby swallow. Remember that if there was no milk then baby would just suck on the nipple in a similar ways as sucking on a pacifier, without frequent swallowing. Although swallowing during feeds is not a reliable indicator of whether baby is getting enough breast milk, when considered along with other factors like baby’s stool and weight gain, it will help put your mind at ease about the adequacy of the breast milk.
Feeling Of The Breasts
Another indicator of whether baby is getting enough milk is by assessing the feeling of the breasts after a feed. When baby has not fed for a while, you breasts should feel ‘heavy’. But after a large feed the breasts will feel lighter or ’empty’ and you may be able to see a slight difference in the appearance of the breasts. Also helpful is the sensation on your breast when baby is feeding. It should be a pulling type of sensation but not painful unless you have a breast infection (mastitis). Baby will pause every now and then to breathe though. If baby was not getting any milk from the breast, he/she may suck but not pull on the breast during feeds.
When To Worry
Speak to baby’s pediatrician if you are uncertain about whether the milk is sufficient. But here are some points that warrants medical attention if you are concerned about feeding.
- Baby is crying excessively and cannot be consoled for long periods of time.
- Baby is not sucking on your breast but trying to suck everywhere else.
- Baby become lethargic, listless and non-responsive after being alert and active.
- Baby’s stool becomes pale in color or no stool is being passed.
- Baby is not urinating at all or it is very little and abnormally concentrated.
- Baby’s mouth is extremely dry, the eyes become sunken and the skin abnormally dry.
Although not all of these points are directly related to breastfeeding problems, it may be a helpful indicator of when baby needs to be seen by a pediatrician.