One common worry for new mothers who are breastfeeding is that their baby may not be getting enough to eat. This fear can lead mothers to stop breastfeeding entirely or to start supplementing with formula. However, the World Health Organization (WHO) recommends breastfeeding exclusively until the baby is six months old, and continuing to breastfeed with complementary foods until the baby is two years old. Being aware of the signs that your baby isn't getting enough milk can alert you to a potential problem, but it can also ease unfounded fears and allow you to continue breastfeeding longer.
Has Your Milk Come In?
Brand-new mothers may notice that they don't seem to be making very much milk, and this can cause them to worry that they aren't making enough to support their baby's needs. But don't panic! For the first few days of your baby's life, they'll be eating colostrum, which your body started producing while you were pregnant. Colostrum is high in antibodies and immunoglobulins that protect your baby, and they don't need very much of it those first few days.
The milk that most people think of when they think of breastfeeding won't be there until your baby is three or four days old, usually. It could take a day or two longer if you had a difficult delivery, and it may come a day or two sooner if this is not your first baby. You should be able to recognize your milk coming in when it happens. Your breasts will feel heavy, full, and firm, and may be somewhat uncomfortable. Feeding your baby is the best way to relieve this discomfort. You may also notice that your breasts leak when your baby cries, or when you've gone too long without feeding your baby.
Feeding your baby colostrum frequently before your milk comes in can help encourage your milk to come in, so you definitely shouldn't wait for your milk to fully come in to feed your baby. If you haven't seen signs of your milk coming in after four days or so, then it's time to talk to your doctor.
Are You Changing Plenty of Diapers?
One of the surest ways to tell if your baby is getting enough to eat, no matter how old your baby is, is to keep track of how many diapers you need to change every day. What goes in must come out, so if your baby is soiling plenty of diapers, you can be pretty sure that they're getting plenty of nutrition. On the other hand, if your baby's diapers stay dry, that's a good sign that they're not getting enough nutrition and hydration.
So how many diapers should your baby be using? Look for at least six wet diapers and three or four bowel movements a day, until your baby is about a month old. After a month, the wet diapers may decrease to between four and six a day. Breastfed babies tend to continue to have softer and more frequent bowel movements until other foods are introduced.
A lack of wet diapers could indicate that your baby isn't getting enough to eat, and a lack of bowel movements could be a sign of a blockage or some other problem. Either should be reported to your pediatrician. Keep in mind that very absorbent disposable diapers can sometimes make it difficult to tell how often your child is urinating. If you're unsure, you may want to temporarily switch to cloth diapers or less expensive disposables (which tend to be less absorbent.) This will help give you a more immediate and accurate idea of how often your child is urinating.
Is Your Baby Gaining Weight?
If you're still unsure about whether your baby is getting enough to eat, watching their weight should reassure you. However, you should keep in mind that newborns do tend to lose weight in the first few days – they can drop as much as five to ten percent of their birth weight. This is just fluid loss and you shouldn't let it alarm you. Your baby should be back to their birth weight within about two weeks.
As a general rule, your baby should gain between four and seven ounces a week for the first month, between one to two pounds a month for the first six months, and then one pound a month between six months and one year of age. Keep in mind that your breastfed baby may be leaner and gain weight more slowly than a formula-fed baby around the same age. This is normal and not a sign that your baby is less healthy than their formula-fed peers.
Choosing to breastfeed is one of the healthiest decisions you can make for your baby. If you have concerns about whether your baby is getting enough to eat, address them with your pediatrician or a lactation consultant before switching to formula. With feeding schedule adjustments, supplementation, or other adaptations, you may be able to continue to breastfeed and ensure that your baby is thriving. Contact local specialists for more information about newborn care.