How To Tell If Your Baby Is Getting Enough Breastmilk

WHAT YOU SHOULD KNOW:

• Breastfeeding offers many good effects for both you and your baby. It helps strengthen the bond between you and your baby. Breastfeeding helps stop bleeding from your uterus (womb) right after giving birth. Breastfeeding also helps you lose the extra weight and fat you put on during pregnancy. Breastfeeding without giving any formula to your baby can delay the return of your menstrual cycles. It can help control or decrease the amount of sugar in your blood and reduce your risk for diabetes (too high blood sugar). It helps protect you against breast, ovarian and uterine cancers. Breastfeeding can also make your bones stronger and help prevent osteoporosis later in life.
  
  
• Breast milk requires no preparation, and is always clean, fresh, and at the right temperature. Human breast milk has the best combination of nutrients for your baby. Nutrients include all the protein, fat, sugar, vitamins, and minerals your baby needs for his body and brain to grow. Breastfeeding helps protect your baby from infections. It may also decrease your baby's risk of getting allergies and certain diseases. These diseases include sudden infant death syndrome (SIDS), asthma, diabetes (high blood sugar), lymphoma (lymph node cancer), and leukemia (blood cancer). Signs that your baby is getting enough breast milk include changes in your breasts before and after feeding. There are also signs your baby makes that you can look for to make sure he is getting enough breast milk.

AFTER YOU LEAVE:

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Breastfeeding signs that your baby is getting enough breast milk:

• Breastfeeding is not painful for you: When your baby is well latched-on during breastfeeding, you should have little or no discomfort in your nipple or breast. To latch-on means that your baby has taken all of your nipple and part of your areola (dark circle around your nipple) far into his mouth. Correct latch-on is important for your baby to get enough breast milk.
  
  
• You hear your baby suck and swallow: Your baby should be able to suckle milk right away after he latches-on. Suckling should change from quick short sucks to slow deep sucks. You should be able to hear your baby swallowing and see his jaw move downward with each suck. He should remain relaxed until he finishes.
  
  
• Your breasts feel different before and after breastfeeding: Your breasts should feel full before breastfeeding your baby and softer after. You may feel some nipple discomfort but it should be mild and only last for about a week. Two weeks after giving birth, you should start having a milk let-down reflex. The milk let-down reflex is the process that starts milk flowing through your milk ducts. You may have tingling or a feel of pins and needles in your breasts when this happens. Milk may also drip or spray from your other breast while breastfeeding.

Signs your baby shows that he is getting enough breast milk:

• Your baby breastfeeds often and is drinking enough milk at each feeding: Breastfed babies usually want to feed every 2 to 4 hours. Your baby will usually breastfeed between 8 and 12 times each day. He should act content after every feeding.
  
  
  • Your jaundiced baby: Your baby may get newborn jaundice or breast milk jaundice. Newborn jaundice usually starts when he is 3 or 4 days old. Breast milk jaundice usually starts at around seven days of age. Jaundice is a condition where his skin becomes yellow or yellow-orange in color. If your baby has jaundice, getting enough milk is very important. Being well fed will help him get rid of the jaundice. He should be breastfeeding 11 or more times in a day. Getting rid of jaundice can make your baby's stools a greenish color instead of yellow. Ask your caregiver for more information about jaundice in newborns.
    
    
  
  
• Your baby urinates and has stools often: Your baby's urine should look clear. His stools should be yellow and yogurt-like with seedy curds. His pattern of passing urine and stool will change over time:
  
  
  • First two days of age: Your baby may urinate only two times a day.
    
    
  • From 3 to 5 days old: Your baby should be passing stools 3 to 4 stools a day. He should also urinate 3 to 5 times a day.
    
    
  • From 5 to 7 days old: Your baby should have 3 to 6 stools a day. He should urinate 4 to 6 times a day.
    
    
  • One month: Your baby may have fewer stools each day. Babies that only drink breast milk may go several days without having a bowel movement.
  
  
• Your baby's weight increases as he grows older: Your baby's caregiver will check his weight at each visit to see if he is gaining weight as he should. If he has concerns about your baby's weight, he may arrange for your baby to be weighed at home. It is normal for breastfed babies to be leaner (look thinner) and have less fat on their bodies compared to formula-fed babies. Breastfed babies generally follow this pattern of weight gain:
  
  
  • The first few days of your baby's life: Your baby may lose up to 10 percent of his birth weight. This is normal and happens to all babies after being born. This means that if your baby weighed seven pounds at birth, he may lose up to 11 ounces to then weigh six pounds and five ounces.
    
    
    • Your milk comes in 2 to 4 days after delivery: Your milk will come in within the first several of days after your baby is born. This means that your body is changing from making colostrum (KO-lah-strum) to making regular milk to feed your baby. Colostrum is the yellow, creamy fluid your breasts make before they start making milk. When this happens, your baby should start to gain weight.
      
      
    
    
  • From 10 to 14 days old: Your baby should weigh more than what he weighed when he was born.
    
    
  • Two months old: Your baby should gain about one ounce each day.
    
    
  • From 4 to 6 months old: Your baby's weight should be two times as much as he weighed when he was born. For example, if he weighed seven pounds at birth, he should now weigh 14 pounds.
    
    
  • One year old: Your baby's weight should be three times as much as he weighed when he was born. For example, if he weighed seven pounds at birth, he should now weigh 21 pounds.

Breastfeeding schedule:

• Breastfeed your baby whenever he shows signs that he wants to be fed. Signs may include looking more awake, being more active, mouthing, or rooting. Mouthing is when your baby puts his hands in his mouth or acts like he is sucking. Rooting is when your baby opens his mouth and turns his head to where his cheek is touched. Fussing and crying are later signs of hunger.
  
  
• Breastfeed your baby regularly, even at night. Breastfeed your baby 8 to 12 times a day, or every 2 to 3 hours. You may have a longer gap of 4 to 5 hours when breastfeeding at night. This long gap should not happen more than once each night. It may take your baby 10 to 15 minutes to finish breastfeeding on each breast. Over time, your baby will learn how to breastfeed faster. Offer your baby your other breast after he finishes the milk in one breast. Your baby may stop feeding and act like he has had enough milk after feeding from only one breast. When this happens, burp your baby or change his diaper to keep him awake and active. You may also pump and empty your breasts after feeding your baby.
  
  
• Record feeding and diaper information. Your baby's caregiver may ask you to write down information about when your baby breastfeeds. Other things you may be asked to write down are how long your baby suckled on each breast, and when he passed urine or stool. You may want to do this, without being asked to do it, if you have concerns about how well your baby is breastfeeding.

Diet:

• Avoid eating foods that have caused allergies in other family members. These foods may include peanuts, eggs, fish, and wheat. Ask your baby's caregiver for more information about food allergy.
  
  
• Drink enough liquids. Drink 1.8 Liters of liquid each day (close to 8 eight-ounce cups). Good liquids to drink are milk, water, and juices.
  
  
• Decrease the amount of caffeine you drink. Caffeine is found in drinks such as coffee, tea, and soda.
  
  
• Decrease the amount of alcohol you drink. Alcohol is found in beer, wine, liquor, such as vodka and whiskey, and other adult drinks. Do not drink more than one glass of wine, or 2 bottles or cans of beer in a day. Do not drink alcohol at least two hours before you breastfeed. Drinking alcohol close to a feed can change the taste of milk and be passed on to your baby. Ask your caregiver for more information about alcohol use while you are breastfeeding.
  
  
• Eat a variety of healthy foods from all the food groups every day. Choose foods that will give your body the extra nutrition it needs as you breastfeed. Dairy products, such as milk, yogurt, and cheese, and brown and white bread, provide calcium. Red meat and fortified breakfast cereals provide iron. Eat a variety of fruits and vegetables, including dark green and orange vegetables, and legumes (dry beans). Eat the right amount of calories as advised by your caregiver. Ask your caregiver for information about breastfeeding and your diet. Ask your caregiver if you need to take vitamins, minerals, or other food supplements. Ask him also if you need to be on a special diet.
  
  
• Limit the amount of fish you eat to limit mercury in your diet. Mercury is found in large bottom-dwelling fish, such as shark, swordfish, mackerel, and tilefish. You can eat up to 12 oz of other kinds of fish every week. That includes a maximum of 6 oz of albacore (white) tuna per week. Always check for advisories about eating locally-caught fish.

Rest:

• You must get enough rest and sleep when you are breastfeeding. Rest and sleep will help your body produce more breast milk. You need to get 8 to 10 hours of restful sleep, even if it has breaks in between during the day and night. Try to sleep or rest when your baby is sleeping. Being tired or feeling stressed will decrease the amount of breast milk you make.
  
  
• Your main task is to care for yourself and your baby. Do not use this time to catch up on housekeeping. Ask family and friends to help you with chores and emotional support. Do not be afraid to let them know what you need and accept their help when offered.
  
  
• Limit visitors and distractions during the first weeks of your baby's life. Tell people who want to visit you and the baby to wait until you are comfortable with breastfeeding. You need uninterrupted time with your baby to practice how to breastfeed him. If you have other children, arrange for someone else to care for them and keep them busy will you are breastfeeding.

Factors that can decrease breast milk supply:

• Being pregnant again.
  
  
• Being tired or having stress, such as mental and emotional stress.
  
  
• Drinking too much alcohol.
  
  
• Smoking.
  
  
• Taking antihistamine medicine.
  
  
• Using contraceptives (birth control methods) that contain estrogen, such as birth control pills, patch, or vaginal ring.
  
  
• Wearing a tight bra or a sling, or sleeping on your stomach. These put pressure on your breasts which can block milk ducts.

For more information: Ask for information about breastfeeding and make sure caregivers know that breastfeeding is important to you. Join a breastfeeding support group. Ask your caregiver for the name of a Lactation Consultant. This person is specially trained to help women breastfeed their babies. Contact the following for more information:

• La Leche League International
  1400 N. Meacham Rd
  Schaumburg, IL 60173-4808
  Phone: 1-847-519-7730
  Web Address: http://www.lalecheleague.org
  

• The National Women's Health Information Center
  Phone: 1-800-994-9662
  Web Address: http://www.4woman.gov
  

• Women, Infants and Children Program
  Food and Nutrition Services
  WIC Program
  Supplemental Food Programs Division
  Alexandria, VA 22302
  Phone: 1-703-305-2196
  Web Address: http://www.fns.usda.gov/wic
  

CONTACT A CAREGIVER IF:

• You or your baby has a fever.
  
  
• Your baby is very sleepy or very irritable, or acts hungry after most feedings.
  
  
• Your baby refuses to breastfeed for more than 8 hours.
  
  
• You feel you are not making enough breast milk for your baby.
  
  
• You have nipple pain that becomes worse after breastfeeding, or feel a lump or a hard area in your breast.
  
  
• Your breasts become hard, painful, or swollen, or you cannot get your milk to flow.
  
  
• Your breasts do not feel full before feedings and softer after breastfeeding.

SEEK CARE IMMEDIATELY IF:

• Your baby will not breastfeed or feeds poorly, and he acts sleepy and has floppy muscle tone.
  
  
• Your baby has not had a wet diaper in the past 6 to 8 hours.
  
  
• Your baby's hands and feet are cold to the touch, he is breathing fast, and does not interact with you.
  
  
• Your baby's soft spot on the top of his head is sunken in or his eyes appear sunken.
  
  
• Your baby cries but has no tears, is irritable, and has a dry mouth and lips.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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.

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