It’s common for new mothers to worry that your baby is not getting enough breast milk. This is especially true if you had set ideas of how long and often your baby would feed. Your baby’s feeding pattern will be just as individual as their personality. What is normal for one baby is not for another.
Your milk supply is only considered to be low when you are not producing enough breast milk to meet baby’s nutritional needs. There are general rules you should follow to ensure your baby feeding well. Use these to compare with your situation to judge whether you should seek advice about low milk supply.
If you find yourself with any concerns about the signs of low milk supply then please contact your health care provider or lactation advisor. They will be able to give you face to face assessment based on your individual situation.
1. How often does baby feed?
Breast milk production relies on how often and how well your breasts are being emptied. Your body produces a ‘milk stimulating’ hormone known as prolactin. When your baby suckles and empties your breast frequently, the prolactin is stimulated and makes more milk.
You will notice that when baby needs more milk, such as during a growth spurt, they will feed more often. It’s a simple case of supply and demand, the more baby feeds the more milk you make.
- It’s normal for a newborn to feed 8-12 times in 24 hours
- This helps your body adjust and produce enough to meet baby’s needs
- Frequent feeding in the early weeks vital to building a good milk supply
It is common for newborns to be sleepy and uninterested in feeding, particularly after a long, medicated birth. Be aware of signs of dehydration in a baby so you can alert a health care professional if you are concerned:
- Skin losing its resiliency (when pinched, it stays pinched looking)
- Dry mouth, dry eyes
- Weak cry
- Minimal urine output
2. Is the breast empty?
When your baby is around one month old your milk production will depend more on how well your breasts are drained rather than how often. If you feel your milk supply is low and your breasts don’t feel empty at the end of a feed you may want to consider expressing. Using either hand expression or a breast pump, you can remove the remaining milk and encourage your body to make more.
Remember an empty breast will produce milk faster than a full breast.
3. How often is baby peeing?
One of the best ways for you to quash any concerns of a low milk supply is to monitor how often your baby diapers. Keeping a diary of how often you feed and how many wet or dirty diapers you change in 24 hrs gives a good impression of how much baby is taking in.
These are the volumes you should expect to see in a 24 hour period. If baby does more this is good as it’s a sign they are well hydrated. If you use cloth diapers you should look for 6-8 wet diapers by day 4. This may differ slightly if your milk takes longer to ‘come in’ , so as a rule of thumb if you are still producing colostrum 1-2 wet nappies is ok. When your milk changes to mature milk you should see at least 5-6 wet diapers per day.
At any age any baby urine should be pale or colourless and mild smelling. Contact your health care provider if your baby’s pee is consistently dark or smells offensive.
It is not unusual for baby girls to have a small amount of blood in their diaper after birth. This is simply a pseudo menstruation and caused by moms hormones in baby’s system. You may also notice an orange discharge, particularity in boys’ diapers. These are known as urate crystals and should clear with increased feeds. If the urates persist it may be a sign baby is not receiving enough milk to flush them out.
If you are unsure of how ‘wet’ a diaper should be, pour 2oz (30-60ml) in a dry diaper and feel how heavy and full it is.
At around 6 weeks old the number of wet diapers should decrease again to around 4-5 wet diapers per day (5-6 is using cloth diapers). However, the diapers will feel around 2-4 times heavier as urine output increases to 4oz or more (116ml +).
4. Is the poo changing?
Meconium is the name given to the first poo your baby will do. This can sometimes be a shock to new parents as it is sticky, black and tar like. At around 3 days old your baby’s nappy will change from black to brown/green colour. Then around day 4-5 it will change to a yellow colour, loose and almost ‘seedy’ in consistency.
The change of stool color is normal and is a good sign baby is getting enough milk. As your breast milk is a natural laxative it will help to kick start baby’s digestive system.
This diagram shows volumes you should see in a 24 hour period. All stools should be at least the size of a US Quarter (UK 10p) and should be mild smelling (not offensive). The occasional green or tan coloured stool is normal and is mostly likely the result of moms’ diet. This pattern will normally continue for as long as baby is breastfeeding.
If baby is under 6 weeks and is doing less than 3 stools per day it’s important to ensure he is still gaining weight. Reduced stools may be a sign baby is not feeding for long enough to get the fat, calorie rich milk (hind milk). Check with your paediatrician to ensure weight gain is within normal range for your baby.
5. Is baby gaining weight?
It is normal for all babies, whether breast or formula feed, to lose up to 10% of their birth weight within the first 5 days. Although within the normal range it is best to monitor the milk intake breastfed baby who has lost more than 8% of their birth weight. Baby should regain their birth weight by 10-14 days old. From this age baby should begin to gain weigh at around 5-6oz (140-170g) per week. Check out our article for more information on weight gain for breastfed babies.
You should have regular appointments with your baby doctor to keep track of baby’s weight and ensure they are on the correct growth centile. If you prefer to track baby’s weight at home, you can purchase some electronic baby scales. It is recommended you use these minimally, preferably no more than fortnightly, to prevent unnecessary worry. You can read our reviews of the best baby scales here.
8 Common Concerns About Low Milk Supply
Low milk supply is one of the biggest misconceptions by new mothers. In fact it’s often cited as the reason mothers give up breastfeeding. By familiarizing yourself with normal behaviour and patterns of a breastfed baby you will reduce your worry. If baby is feeding regularly, draining the breast well, peeing, pooping and gaining weight then it is unlikely you have any issue with low milk supply. Here are some situations you may be concerned about and why you don’t need to worry.
1. Baby feeds a lot
It’s normal for a breastfed baby to feed 2-3 hourly. Breast milk digests a lot quickly than formula so baby needs to feed more often. This is normal as it helps to maintain your milk supply, and doesn’t mean baby is still hungry. If baby is still unsettled between feeds or showing signs of dehydration contact a lactation advisor to witness a feed to ensure correct positioning and attachment.
2. Baby suddenly wants to feed ‘all the time’
It is normal for baby to have occasional growth spurts. These usually occur around 2 weeks and 6 weeks old. During this time you will feel like you have spent your whole day with baby attached to you. This is normal and ensures your breast increase your milk supply to met baby’s growing needs. This usually happens for around 3 days and then settles back to a normal routine.
3. Baby doesn’t feed for too long
Breastfeeding is a learning curve for you and baby. As they get older they simply get more efficient at feeding. A decrease in feeding length is usually a sign baby is getting better at extracting the breast milk.
4. Baby is fussy
Up until the age of 12 weeks most breastfed babies will have at least one fussy period of the day. This is often the same time each day and quite common in the evenings. No one really knows what causes this but it is thought to be an evolutionary trait to ensure mom tends to baby. It is common to be concerned that the fussiness is due to lack of milk; however placid babies are much more likely to take in less milk and loss weight.
5. Your breasts leak little (or not at all)
The amount your breasts leak is not related to how much milk you produce. Leaking is much more common in the first few weeks as your milk is over-abundant and not yet regulated to your babies needs. Once your breast milk supply is established and regulated to your babies needs, it’s normal for leaking to slow down or cease.
6. Your breasts are soft
The feeling of heaviness and fullness you experience in the first few weeks will subside one your milk supply establishes. You breast will produce just enough for baby are normally remain soft between feeds unless there has been a long period. In fact at this stage if your breasts become full or hard it’s a sign you need to feed baby or express your milk.
7. You don’t feel a ‘let down’
It’s normal for some moms to never experience a ‘let down’. This is the tingling sensation of your milk being released from your breast tissue. It’s also normal for the sensation to decrease over time if you have previously experienced it. A way for you to recognise when it happens is to watch baby feed. You will first notice they start with short fast sucks and then change to long slow sucks. The point at which they change the pattern is when your ‘let down’ occurs. Check out our 7 tips for helping your let down reflex.
8. You can’t express much
The amount of milk you express is not a reflection of how good your supply is. Expressing milk is a skill which improves with practice. It is common to express very little or no milk the first few times you try. Although modern pumps are getting more advanced as extracting breast milk, a baby will always be much more efficient. Some moms produce very little purely on the fact they are not comfortable with a machine at their breast. Expressed volumes may also depend on the type of expression used or how effective the pump is.