How do I know if my baby is getting enough breastmilk?

It is very unusual that a new mother is unable to physiologically make enough milk for her newborn. Many women successfully breastfeed twins – breastfeeding works on supply and demand, so the more milk your baby needs, the more you make.

Worrying about how much milk your baby is getting doesn't help you relax and feel comfortable learning to breastfeed.

If, after reading through this section, you are still unsure, try asking your midwife, peer supporter or breastfeeding counsellor for help, or ring NCT Breastfeeding Line on 0300 330 0771

How do I know  that my baby is feeding well? 

• Your baby has a large mouthful of breast.
• Your baby’s chin is firmly touching your breast.
• It doesn’t hurt you to feed (although the first few sucks may feel strong).
• If you can see the dark skin around your nipple, you should see more dark skin above your baby’s top lip than below her bottom lip.
• Your baby’s cheeks stay rounded during sucking.
• Your baby rhythmically takes long sucks and swallows (it’s normal for her to pause from time to time).
• Your baby finishes the feed and comes off the breast on her own.

How do I know my baby is getting enough milk?

• In the first 48 hours, your baby is likely to have only two or three wet nappies. Wet nappies should then start to become more frequent, with at least six every 24 hours from day five onwards. Urine should be pale and not dark brown.
• After the initial meconium, your baby should be passing creamy yellow stools every day (more about what you should see in your baby's nappy.)
• Most babies lose weight initially. She should be weighed by a health professional some time around day three to five. From then on, she should start to gain weight. Most babies regain their birth weight in the first two weeks.
• Your breasts and nipples should not be sore. If they are, do ask for help.
• Your baby will be content and satisfied after most feeds and will come off the breast on her own.

If you are concerned about any of these points, speak to your midwife or health visitor

She’s feeding all the time!
This could be because:

• She’s not attached properly so not receiving enough of the creamier milk that comes with the let-down reflex (your nipples may also be very sore).
• She’s trying to build up your milk supply – and babies sometimes have increases in appetite, which leads to more milk being made.
• She needs the comfort and closeness that being at the breast gives her.

She’s not feeding enough!
Sometimes a newborn baby is very drowsy and seems uninterested in feeding. This can happen particularly after a mother is given drugs like Pethidine in labour. If you are worried that your baby is unusually sleepy or ill, ask your carer for help or ring NCT Breastfeeding Line 0300 330 0771

• There’s no need to wait for your newborn or young baby to cry before you offer her a feed. Signs that she may be waking and ready to feed include:
  - flickering eyelids
  - little noises
  - mouth movements
  - turning her head /searching for a breast (rooting)
  - sucking on her hand or clothes
• Hold her close to your breast and touch his lips with your nipple. Some mothers like to squeeze out a few drops of milk to tempt the baby.
• You might like to have a bath with your baby to encourage her to latch on and feed. It works best if you lie back in warm water with your baby on your chest, her lower body in the water. You may need someone else there who can keep your baby warm by gently pouring water over her.
• Some mothers have been able to identify a 'hungry' cry (a sound like 'neh') in a newborn.

How to make more milk

• Feeding your baby more frequently helps build up your supply.
• Check the position and latch – you may have more than enough milk, but if your baby is not properly attached and is not getting the milk, your body will start to produce less.
• You may need to ask for help from a health professional or breastfeeding counsellor. The best helpers will enable you to learn to do this for yourself.
• If you give formula milk instead of breastfeeding, or as a ‘top-up’, your body will produce less milk – so it’s better to breastfeed more often. You can offer 3 or 4 ‘sides’ at a feed if your baby is still hungry after two breasts. It is recommended that breastfed babies don't have anything else to eat or drink for the first six months (this is called exclusive breastfeeding).
• Your own diet, fluid intake and amount of rest have very little to do with your ability to make milk. But eating regularly and drinking to thirst will help you to feel more able to cope with caring for a baby.

See also:

• Why breastfeeding matters
• Possible problems
• Feeding positions
• Supporting breastfeeding
• Straight after birth
• How much, how often
• Breastfeeding - Home

More resources:
The Department of Health 'Feeding your baby' guide, available in hard copy or download from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_107706.pdf

NHS guidance on breastfeeding is available at www.breastfeeding.nhs.uk

Association of Breastfeeding Mothers: http://abm.me.uk/

Bump to Breastfeeding DVD: your midwife should be able to provide a copy for you to borrow, or go to www.bestbeginnings.org.uk