Is My Baby Getting Enough
Do any of you as new parents worry that your breastfed baby is not ‘getting enough’? Has the culture of our time made you numbers and data preoccupied, and you have been told you need to see a quantity enter your baby to know he or she has gotten enough to grow?
I am here to help dispel that myth and teach you how you can dial into your individual baby to ensure that your baby is consuming enough calories to thrive. These are called ‘Signs of Milk Transfer.’ Here we go. First, it is important to get a realistic idea of how much babies actually take per feed. It is probably much less than you would have imagined. The media has portrayed these large bottles filled to the top. This shifts our idea of what is biologically appropriate for a developing baby and a tiny stomach. There are bottom line incentives that benefit many companies to have us thinking that our babies are taking in copious amounts of fluid per feed. Let’s get down to the facts. Before reading on, take a guess at how big your newborn’s tummy is and how much would fit in that tummy comfortably. See if you were close.
Your baby was born with a stomach about the size of a marble! Are you surprised?! I know I was. Do you want to guess approximately how much goes into that one day old tummy per feed? A teaspoon! Yes, about 5ml of colostrum is a feed for your newborn baby. Does that help rest your mind about quantity expectations? I hope so. On day of life three your baby’s stomach is approximately the size of a ping pong ball and will take about 1 oz (30ml) of food per feed. On day of life ten your baby’s stomach has grown to about the size of an egg and takes about 2 oz (60ml) of food. Often times, babies will ingest about 2-5 ounces per feed for their entire time breastfeeding. Are you surprised it is not these large quantities you see in huge bottles? Babies are designed with a fast metabolism to eat frequent, small meals as opposed to large (Thanksgiving type meals) only a few times in 24 hours. Babies will often eat 12 times (and sometimes more) in a 24hr period. Therefore, it is in your baby’s (and your milk supply’s) best interest to feed often (any time he/she is displaying cues; see blog on cues) and throw the feeding schedules where they belong…in the trash.
Now let’s talk about how to know your baby is getting enough. First, what goes in must come out. Therefore, your baby’s output is an indicator that your baby is or is not getting adequate intake. On day of life one we are looking for one pee and one poop. When I say ‘day’ I am referring to a 24 hour period. The first poops are black and tarry and called meconium. On day of life 2 we are looking for two pees and two poops. On day of life three we are looking for three pees and three poops. From that point on we are looking for three or more poops and five or more pees. Another thing to keep in mind is often times there is pee with a poop, but it could be hard to tell. Many babies will poop with each feed and that is perfectly normal, while others will poop three times in 24 hours. They are both on the normal curve. Also, some days your baby may poop much more than on other days. As your baby gets older than 4 months old he/she may poop less frequently.
Another sign of milk transfer is your baby’s weight. All babies lose weight after birth. If you had any fluids during the delivery they will be excreted, plus amniotic fluid. Babies are born full (not hungry) and they will drop weight after birth. Most professionals are looking to make sure your baby does not drop below 10% of his/her birth weight before getting concerned. In addition, many babies will typically not regain to their birth weight until day of life fourteen. Professionals, including most lactation consultants, will be weighing your baby to make sure things are trending in the right direction and your baby is thriving and not showing signs of lethargy or too much jaundice. Weight gain after the initial drop is a good indicator that breastfeeding is going well and your baby is getting enough.
Our next sign that your baby is getting enough is that your breasts feel lighter after a feed. If you started the feed with heavy breasts and end with lighter breasts, the milk went somewhere. Into your baby! Keep in mind, as time passes, your baby will become a proficient feeder and your breasts dial into the exact amount your baby needs, your breasts will likely no longer feel this heaviness, so they may not feel much different before and after a feed. However, this could be a good indicator in the first few weeks of life, while your milk is still regulating to your baby. Another tip is that the first milk you produce is called colostrum. This milk is very high in immune properties (among other wonderful qualities) and helps to seal up the gut of your newborn. This first milk is thick and the consistency of maple syrup. Therefore, your breasts will often not feel heavy until your milk increases in volume and begins to transition into more mature milk starting around days 2-4 post-partum.
The next sign your baby is getting enough is you will see gliding sucks and hear swallowing. Again, this does not typically happen with colostrum, so be patient for this one as your milk increases in volume. The first swallows of thick colostrum sound more like a ‘click’ and often you cannot even hear it. Once your milk has increased in volume, you should be able to hear more pronounced swallows, which would be a more familiar sound to you.
As you can see, there are many ways to know your baby is getting enough nutrition. Looking for these signs should give you comfort that things are going well, or alert you to getting support if something is not going as it should. If your baby is not waking to feed, seems lethargic, is highly unsettled (not calmed by feeds), or looks suntanned (yellow skin) then please reach out to your medical professional and a lactation consultant to get additional support. If you would like more information on making sure your baby is getting enough or any other breastfeeding topic or question, please reach out to me. I would be happy to help support you and your baby to achieve your breastfeeding goals. Learn about my breastfeeding classes.