How To Tell If Your Baby Is Getting Enough Breast Milk

Why is breastfeeding important?

Breast milk provides the best nutrition for your baby. Breast milk has substances in it that are healthy for your baby. Breastfeeding helps protect your baby from infection. It also may decrease your baby's risk for allergies and other medical conditions, such as asthma and diabetes. Breastfeeding can decrease your risk for diseases, such as breast and ovarian cancer and diabetes.

When will my breast milk come in?

Your breasts have tissue in them that are filled with cells that make milk. You will lactate (create milk) for as long as milk is removed from your breast by breastfeeding or pumping. After giving birth, you will breastfeed your baby colostrum until your milk supply comes in. Colostrum is a thick type of milk that has many nutrients in it. It normally takes about 2 to 4 days before milk starts replacing the colostrum.

How do I know if my baby is getting enough breast milk?

• Your baby has many wet or soiled diapers each day. Once your milk has come in, your baby should have 6 to 8 wet diapers a day. By four days old, your baby should have 3 to 4 soiled diapers each day. By five days old, your baby should have 4 to 5 yellowish bowel movements (BMs) each day.
  
  
• Your baby is gaining weight. Your baby's caregiver will check his weight at each visit to see if he is gaining weight as he should. If the caregiver has concerns about your baby's weight, he may arrange for your baby to be weighed at home. Your baby may lose weight in the first three days after birth. By 4 to 5 days old, your baby should start gaining weight.
  
  
• Your breasts feel different before and after breastfeeding. Your breasts should feel full before breastfeeding your baby and softer after. This means that your baby is emptying your breasts during breastfeeding.
  
  
• Your baby wants to breastfeed eight or more times a day. Your baby may let you know when he is ready to breastfeed. He may be wide awake and moving his arms and legs more. He may turn his head toward your breast and move his mouth more. He may put his hand up to his mouth and suck his fingers or his fist.
  
  
• Your baby is latched on correctly. You know your baby is latched on correctly when:
  
  
  • You hear your baby swallow. You should be able to hear him suck and swallow in a regular pattern.
    
    
  • Breastfeeding is not painful for you. You should have little or no discomfort in your nipple or breast.
    
    
  • Your baby is calm and relaxed during and after breastfeeding. Your baby should seem calm after breastfeeding. He may fall asleep, or his face, arms, and hands may look relaxed.

How can I care for myself while I am breastfeeding?

• Keep a diary: Write down each time you breastfeed your baby and when you pump your breasts. Make a note of how much milk you pump out each time. You also can write down when your baby has wet or soiled diapers. A diary can help you and your caregiver learn if you are making enough milk to feed your baby.
  
  
• Eat a healthy diet: Eating enough healthy food can help your body make enough breast milk. Your caregiver also may have you take vitamins, such as vitamin D. Talk with your caregiver before taking any vitamins or supplements. Ask your caregiver for more information on breastfeeding and your diet.
  
  
• Talk to your caregiver before taking any medicines: This includes all prescription and nonprescription (over-the-counter) medicines. Some medicines may decrease the amount of breast milk you make. Other medicines may enter your breast milk and affect your baby.
  
  
• Do not smoke: If you smoke, it is never too late to quit. Smoking can decrease how much breast milk you make. Smoking harms your body in many ways. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. Talk with your caregiver if you smoke and need help to quit.
  
  
• Limit or avoid alcohol: If you choose to drink alcohol, breastfeed your baby before you drink it. Do not breastfeed your baby for at least 2 to 2 ½ hours after having one drink. One drink of alcohol is 12 ounces of beer or four ounces of wine. One ounce of liquor, such as whiskey, is one drink of alcohol. Talk to your caregiver if you drink alcohol and are breastfeeding.
  
  
• Go to all follow-up visits with your caregiver: Ask your caregiver when to return for follow-up visits. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

When should I call my caregiver?

Call your caregiver if:

• Your baby is four or more days old and has less than six wet diapers each day.
  
  
• Your baby is four or more days old and has less than three BMs each day.
  
  
• Your baby is not gaining weight or looks as if he is losing weight.
  
  
• Your breasts do not feel full or swollen, or you are not leaking breast milk within five days of giving birth.
  
  
• Your baby is feeding less than eight times each day.
  
  
• Your baby breastfeeds for less than 10 minutes or for more than 50 minutes.
  
  
• Your baby is fussy or acts hungry after you breastfeed.
  
  
• You do not hear your baby swallowing while you are breastfeeding.
  
  
• You have nipple pain while feeding or between feedings. Your nipples may look red, dry, and cracked. They may have scabs on them.
  
  
• Your baby becomes jaundiced (skin and whites of the eyes are turning yellow).

Where can I go for support and more information?

Breastfeeding can be hard. Learn as much as you can about breastfeeding. Your caregiver also may have you see a caregiver, called a lactation consultant, to help you with breastfeeding. You also can contact the following:

• Academy of Breastfeeding Medicine
  140 Huguenot
  New Rochelle , NY 10801
  Phone: 1- 914 - 740-2115
  Phone: 1- 800 - 990-4226
  Web Address: www.bfmed.org
  

Care Agreement

You have the right to help plan how you are going to feed your baby. To help with this plan, you must learn as much as you can about breastfeeding. Ask your caregiver questions about breastfeeding. You can talk with him about the best way to feed your baby.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.