Got (Enough) Milk?
As a Lactation Consultant, I have been asked everything under the sun that has anything to do with breastfeeding, from “can I drink some coffee?” to “can I nurse with a pierced nipple?” to “how does a pump work?” But by far, the most common question I get is, “am I making enough milk for my baby?” Weighing the baby over time is the best way to know if the baby is getting enough milk, but it’s impossible to weigh the baby every feeding or every day. There are some other great ways, besides weighing the baby, to know that breastfeeding is going well.
Here are 5 tips to help you know if your baby is getting enough breast milk:
1. You are feeding your baby very frequently, every time your baby acts hungry. If you are feeding your baby every time your baby acts hungry, 8 to 12 times (or more) every day, even if your baby just finished a meal, you are getting off to a great start. By offering very frequent, on-demand, unlimited feedings at an early age, you are making sure that your baby gets all the milk he or she needs, as well as triggering your body to make lots of milk in the coming weeks and months. Every time your baby latches, your baby is telling your breasts to make more milk. More feeds in the early days results in more milk in the coming months.
But how will you know that your baby has a good latch and is actually getting milk?...
2. You can hear your baby swallowing. All that chugging? That is the sound of your baby getting lots of milk. If you can hear your baby swallow frequently from day 5 on, you can be sure that your baby is drinking. Babies who are getting plenty of milk from breastfeeding will suck once or twice, then swallow, and they will repeat this suck, swallow pattern until…
3. Your baby is content and relaxed after a feeding. Babies are usually tense when they are showing hunger cues. Before the feeding, many babies have their fists clenched up and their arms pulled in tight to their bodies. As the feeding progresses, and you hear frequent swallowing, watch your baby’s arm and hand. The arm and hand will began to loosen and relax, and the fingers will splay open. A hungry baby will pull their arm in if you (gently) pull the hand away from the body. A full, satisfied baby will have a relaxed arm and hand, and when you lift the hand away from the baby’s body, the arm will drop like a wet noodle. The baby’s arm is a good gauge as to how satisfied the baby is after eating.
Your baby needs to have a wide mouth and a deep latch to make sure that he or she is getting enough milk. If your baby has a shallow latch, you could experience sore, painful nipples and engorgement. Another good sign that your baby is getting enough milk is that…
4. Your breasts and nipples are not in pain. Some women feel their breasts fill up every feeding, and some women don’t feel the filling as much. If you generally feel your breasts fill up with milk, and your breasts get softer during a feeding, this is a good sign that your baby is getting lots of milk.
In the early days and weeks of breastfeeding, a little discomfort and tugging on the nipples is common, but toe-curling pain is not normal. If your nipples hurt so much that it takes your breath away, get someone to help you adjust your baby’s latch. Healthy, comfortable nipples are a sign that your baby is latched well.
Besides frequent feeds, lots of swallowing, a content baby, and comfortable nipples, there is one other thing to look for…
5. Pees and poops What comes out of your baby says a lot about what went in your baby. If your baby is having lots of wet diapers and at least a few yellow poops every day, AND you are experiencing ALL of the above, you can be confident that your baby is getting plenty of milk and that your body is making enough.
Bonus Tips! Things that do NOT mean that your baby is starving:
1. Frequent feeding. If it seems like your baby wants to eat all the time, see tip #1 above. This is not a sign that your baby is starving, it is normal for your baby to want to feed very frequently, which ensures that your baby gets fed enough and your body makes enough. More sucking = more milk!
2. Your friend’s baby takes more formula than you pump for your baby. You be you. Moms are valuable teachers for each other, but comparing your baby to another baby isn’t always a good idea. Babies who drink formula require more than babies who take breast milk. Use the tips above to be sure, and when in doubt, it’s always ok to call for a weight check.
If you aren’t seeing all 5 signs that your baby is getting enough milk, or if you have any concerns about it, call your baby’s pediatrician or an IBCLC and get some help.
Nurse on, mama!
How Can I Get This Baby Weight Off Safely?
Safe weight loss is healthy and realistic for breastfeeding women. Breastfeeding uses calories stored up during pregnancy, and a breastfeeding mother will lose 1-2 pounds a month with a normal, healthy diet (eating to hunger) and normal activity. If you want to lose weight faster, you can safely lose 1 pound a week through changes in diet and moderate exercise.
A weight loss of 1 pound a week with a healthy diet (at least 1500 to 1800 high quality calories) and moderate exercise has no effect on the fat content of the breast milk or on the baby’s growth. When you make healthy nutritional choices like eating lean meat, and cutting sugary or salty, high-fat junk food, refined flour, and high calorie drinks, you will experience healthy weight loss. Small changes can make a big difference. For example, cutting out a can of soda per day eliminates 140 calories, or 14 pounds a year!
You may begin a moderate exercise program after getting clearance from your OB or midwife 6 to 8 weeks after delivery. You can safely cut 500 calories from your diet and add a moderate 45 minute exercise routine 4 days a week and lose weight without affecting the quality of your breast milk or the growth of your baby.
I recommend slow, healthy, natural weigh loss through healthy nutrition and moderate exercise. If you have questions, or would like a personalized plan, I can help you! Call or email me if you would like to discuss healthy postpartum weight loss.
Help! My Baby is Feeding All the Time! Is This Normal?
In the early days of your baby’s life, between the hormones, the visitors, the other children and pets, and the exhaustion, it’s easy for moms to feel overwhelmed! Add to this a baby who seems to want to breastfeed all the time, and moms can despair and lack confidence.
On your baby’s first day of life, he will take an average of 1 to 2 teaspoons of colostrum per feeding. Those tiny meals allow your baby to lose some of the extra fluids that are in his body at birth, empty his bowels, and practice lots of feedings without taking in too much.
Your baby might not have many meals in the first 24 hours, but by the second day of life, he will be eating 8 to 12 times or more per day! Most babies cluster feed in the evening and nighttime hours during the first few days of life. Cluster feeding simply means your baby wants to have several meals back to back. It’s important to understand that when your baby cluster feeds, this is perfectly normal and expected, and it does not mean that something is wrong or that your baby is starving.
If everything is fine, why is my baby sucking so much?
Each time your baby latches, even though he isn’t getting a large meal, he is doing a very important job: telling your body to make lots of milk for him. As he sucks at the breast, your breast is changed and milk production is triggered. The more he latches in the first few days, the more milk you will be making in the first weeks and months.
More sucking now = more milk later!
Your colostrum is all your baby needs, and it’s really important to not despair and give your baby formula during those few nights of cluster feeding! Continuing to offer him your breast when he is acting hungry, even if he just had a meal, will:
1. Give baby everything he needs and wants
2. Trigger your breasts to make lots of milk
3. Help prevent engorgement
4. Help calm you and increase your confidence.
Anytime you are not sure if things are going well, make sure to consult your pediatrician or an IBCLC. I can visit you in the comfort of your home to assess a feeding and make a customized feeding plan for you. I will weigh your baby with my hospital-grade baby scale before and after he eats, so we will see how much he's getting. I am available to come to your house to help you usually within 24 hours of your request! Contact me here.
Having a baby in the NICU can be extremely stressful and traumatic for families. Moms who want to breastfeed experience additional stress because they are separated from their babies most of the day.
Pumping milk for your NICU baby is worth the effort!
If you have any questions about pumping milk for your NICU baby, I can help you. I have experience in the NICU both as an RN and as an IBCLC.
In-home consultations are usually available within 24 hours of your request. If you have any concerns, don’t hesitate to call and get help!
Can I breastfeed if I have had a breast reduction?
There are many reasons women have breast surgery, and cosmetic concerns are by far the most common. However, there are some risk factors, such as obesity, diabetes, hypothyroidism, or PCOS, which need to be considered when a woman has had breast reduction surgery and later wants to breastfeed. Make sure you discuss your health history with your lactation consultant so that she can help you make a feeding plan that will best meet the needs of you and your baby.
The likelihood of you being able to exclusively breastfeed depends on the surgical technique used, the amount of glandular tissue removed, and the resultant integrity of blood supply and nerve pathways.
The pedicle technique leaves the nipple and areola attached to the breast gland on a stalk of tissue. A wedge is removed from the undersides of the breast; for the most part, the breast tissue, blood supply, and some nerves remain intact, and breastfeeding will have varying degrees of success.
The free nipple technique removes the nipple areola entirely. The blood supply to the nipple areola is severed and nerve damage occurs.
The amount of breast tissue removed does not appear to affect breastfeeding. The most important factors that do affect breastfeeding are the integrity of the nerves and of the milk ducts. Incisions around the areola are more likely to cause nerve damage and severed milk ducts than incisions in the fold under the breast or in the armpit.
If your breast surgery involved removing some of the milk making glands, this will likely affect the volume of milk you can produce. Milk ducts are more likely to be cut when surgical incisions are made around the areola or into the body of the breast, rather than incisions made in the fold under the breast or in armpit. Milk ducts do regrow, and the rate of regrowth is faster during pregnancy and breastfeeding. This means that you can possibly produce more milk with subsequent pregnancies.
Nerves can regenerate over time, at about 1 mm per month. The more time has passed since your surgery, the more sensitive your breasts and nipples are likely to become, which increases your likelihood of producing enough breast milk. The amount of sensation in your breast will be an important indicator of the amount of nerve damage sustained. If you can feel both touch and temperature on your areola and nipple, you are more likely to experience normal milk ejection during breastfeeding.
Tips for breastfeeding after breast reduction surgery:
One of the most common concerns I hear from moms is, "I don't know if I have enough milk." There are a few easy ways to know, so that you don't have to guess if your exclusively breastfed infant is getting enough to eat.
First of all, if you are feeding your baby on demand (not scheduling feeds, but feeding whenever he is hungry), and your baby is eating 8 times (or more) per day, that is a good sign.
Secondly, by the time your baby is 5 days old, if he is having at least 5 wet diapers a day and at least 1 yellow poopie diaper per day, this indicates adequate milk intake.
A third sign that your baby is getting enough is that breastfeeding is comfortable to you and your breasts are not hurting. This is a sign that your baby has a good, effective latch.
It is important that you can hear your baby swallowing when he is feeding. Your baby should be visibly more relaxed at the breast after he feeds than he was before the meal.
The most obvious way to monitor if your baby is getting enough is to check his weight. Obviously this is only helpful on days that your baby gets a weight check, and is not helpful on a day to day basis. Make sure you keep your baby's appointments with his doctor so that any possible problems can be identified early.
If you are experiencing all of these things, that is a very good sign that breast-feeding is going well and that your baby is getting enough milk:
These are NOT signs that you aren't making enough milk for your baby:
These are signs that your baby might not be getting enough:
If you have any concerns, call your baby's doctor or an IBCLC right away.
Greensboro Lactation Consultants can perform a "weighed feeding", meaning your baby will be weighed before and after a feeding. This will help us determine how much milk your baby is taking. I can be reached by phone here and by email here. In-home consultations are available usually within 24 hours of your request, so if you're worried about it, don't wait!
Your new baby has a very tiny little stomach. Very small amounts of colostrum in the early days is plenty for him to grow healthy and strong. Your colostrum is perfect for him, and it’s unlikely that he will need anything else!
Let’s take a look at the amount of colostrum that your baby needs in the first 4 days.
On baby’s first day of life, he needs about 2 to 10 ml per feeding, which is about the size of a cherry! In his first day of life, he will take about one ounce total.
On your baby’s second day of life, he needs about 5-15 ml per feeding – that’s about a teaspoon to about half an ounce per feeding, or about the size of a walnut. He will eat 8 to 12 times (or more) on day 2.
From month one to month 6, your baby needs 3 to 5 ounces per feeding, or a total of 25-35 ounces per day. Breastfed babies do not need as much milk as formula fed babies do, and they do not require more and more as they get older.
If you have any concerns about how much milk you are producing, or if you are unsure that your baby is getting enough, please talk about your concerns with a certified lactation consultant.
I am available for in-home consultations usually within 24 hours of your request. Call or email me if you have any concerns.
Beth Sanders, BSN, RN, IBCLC