Breastfeeding parents commonly fear not feeding the baby enough, a perfectly understandable concern in a culture governed by bottle feeding. We can’t measure how much milk leaves the breast and enters the baby’s stomach, so how can new parents rest assured their newborn receives adequate milk?
Happily, a number of ways to verify intake while nursing do exist! Check them out.
Also known as output. If it’s coming out, then it’s going in! In the very first days of life, the color and consistency of the baby’s poo should change gradually, from a black, tarry substance on day 1 to a curdy, mustard-yellow liquid on day 4. In a perfect world, the baby will have one bowel movement for every day of life–one on day 1, two on day 2, etc. until day 4. However, just like us, babies don’t always poop on a perfect schedule, or in a uniform quantity. Day 2 might be one huge blowout, and day 3, three little movements.
On the whole, you want to see output increasing, and color changing to yellow. Urine should be clear and odorless, and increasing to about 5 – 6 wet diapers a day by day 4.
Once the baby has transitioned to the mustard poo of mature breastmilk, regular daily output is a sign that the dyad is indeed transferring adequate sustenance from the breast. Output is one of the most reliable indicators lactation professionals rely on to determine if a breastfeeding couplet is on the right track.
In the first days postpartum, the mother produces colostrum, or newborn milk. Because the consistency is quite viscous and volume low, this may not be as helpful before the transition to more watery, mature milk. Once this happens, however, most moms can easily gauge when it’s time to feed by the fullness of their breasts! Likewise, you can observe the change in firmness (or lack thereof) to estimate how well baby eats. If a good amount of milk ends up in the baby’s belly, the breast will feel distinctly softer.
Get in the habit of watching your baby’s throat during a feed. Typically, when there is a letdown of milk (milk ejection reflex) the baby’s jaw will begin dropping farther and more slowly as he swallows mouthfuls of milk. Open your ears, as well–many baby’s make a soft “kah” sound as they swallow. You will also be able to see the return to “non-nutritive” sucking between letdowns, which is a smaller, more rapid movement. This sucking is what triggers the release of oxytocin, which in turn signals the mammary glands to eject milk. Each feed should be a mix of both types.
Once you’re familiar with this, you can see how much of the feed consists of swallowing versus comfort nursing. A baby who swallows vigorously and often is moving milk.
Relaxed and Content
Many babies start at the breast with their little hands and arms squeezed tight, and as their bellies fill the slowly unwind and those hands fall open. Take a look at your baby after eating. Is she fussy? Or does she look quiet and happy, with her muscles relaxed and soft? Full tummies = happy babies.Baby initiates and ends feeds
Babies have two jobs: eating and eliminating. If they aren’t waking on their own to eat (routinely sleeping more than 4-5 hours) then we want to verify that they are not too tired to rouse themselves. Likewise, if a baby routinely falls asleep on the breast–particularly when there hasn’t been much swallowing–we want to look at all the other factors and rule out a baby who is too tired to finish a feed.
If all other indicators are normal (lots of wet and poopy diapers, baby looks more relaxed after eating, the breast feels much softer) then we’re not going to panic. The breast is comfy! It’s a happy place, and some babies will fall asleep after eating. However, a super sleepy baby can indicate a lack of energy due to insufficient calories.
All together now
To reiterate this last point, you want to tune in to all of these signs and consider them as part of the whole. If any of them is consistently off the mark and you want help evaluating the big picture, come visit one of our free groups, five days a week in El Paso. Pain during breastfeeding suggests something amiss and will often accompany other red flags. Whether it does or not, definitely consult with a pro if it hurts.
Weight gain will be the definitive answer on adequate eating, although this shouldn’t be done every day unless you’d like to end up a neurotic mess. Weight checks are best left to pediatricians, and are a critical, if less frequent, piece of the picture.
If you encountered any of these signs with your babies, we'd love to hear about it below so other mamas can learn.
Rachel Curtis, CLC