Some women worry that they aren’t breastfeeding often enough or long enough or that their babies aren’t getting enough milk while breastfeeding. To help you figure out whether your baby is getting adequate nutrition during breastfeeding, ask yourself the following questions.
Is my baby gaining weight? It is normal for all babies to lose weight soon after birth. It is typically regained— and then some— within two weeks. Your baby’s doctor will weigh your baby at each checkup and will let you know if there are any concerns. You should have your first visit with your baby’s health care provider about two days after your baby leaves the hospital. If you’re concerned about your baby’s weight, you may want to schedule more frequent weigh-ins.
How often does my baby breastfeed? Most newborns breastfeed at least eight times every 24 hours— about every one to three hours, depending on time of day. Within two to three months, your baby may begin to go longer between feedings. Many infants will feed more frequently just before taking a two or three hour nap. During growth spurts (the first of which often occurs around 10 to 14 days after birth), as well as at three weeks, six weeks, three months and six months, your baby may take more at each feeding or want to breastfeed more often. Trust your body’s ability to keep up with the increased demand. The more often your baby nurses, the more milk your breasts will produce.
Can I hear my baby swallowing? If you listen carefully, you’ll be able to hear your baby swallowing. This sounds like a soft sigh or a “cah” sound. Also look for a strong, steady, rhythmic motion in your baby’s cheek. There may be a pause while your baby swallows. A small amount of milk may even dribble out of your baby’s mouth. You are likely breastfeeding enough if your baby seems satisfied after a feeding and is alert and active at other times.
How do my breasts feel? When your baby is latched on successfully, you’ll feel a gentle pulling sensation on your breast, rather than a pinching or biting sensation on your nipple. Your breasts may feel firm or full before the feeding and softer or emptier afterward. If breastfeeding hurts, ask for help.
What about my baby’s diapers? For the first few weeks, expect your baby to have six to eight wet diapers a day. A wet diaper will weigh about the same as a dry disposable diaper filled with two to four tablespoons of water. Also expect regular bowel movements—often three or more a day. Some babies will produce stool with each feeding. The stool will be dark and sticky for the first few days, but will eventually become seedy, loose and golden yellow. Older babies may urinate and produce stool less frequently. However, the urine should always be a light yellow color and the stool should be soft.
Example of normal wetting and producing stool
Day 1: 1 wet diaper; 1 meconium stool (black, sticky)
Day 2: 2 wet diapers; 1 meconium stool (black, sticky)
Day 3: 3 wet diapers; 2 to 3 transitional stools (greenish)
Day 4: 4 wet diapers; 3 to 4 yellow stools
Day 5-6+: 6 to 8 wet diapers; 3 to 4 (or more) yellow stools
Your baby may not be getting adequate breast milk if the following situations occur. You need to see your baby’s health care provider or a lactation consultant if:
- your baby loses more than 10 percent of his or her birth weight, or your baby has not begun to regain weight by the fifth day after birth
- your baby has not regained his or her birth weight by two weeks
- your baby is not urinating at least six to eight times per day by the time he or she is five to six days old
- your baby is not having the number of stools per day for their age as indicated in the example above
- your baby is not nursing at least eight times in a 24-hour period by three to four days of age
- you do not feel that your milk has “come in” by day five
- your milk has come in, but you do not hear swallowing or gulping during feeding
- your baby does not seem satisfied after a feeding
- you experience nipple pain throughout the feeding
These signs may indicate inadequate feedings and can be a serious concern if not corrected quickly. You may wish to keep a written record for several days of when your baby urinates, passes stools, and feeds so you can accurately report this to your baby’s health care provider.
Signs of Adequate Breastfeeding
- By the third to fifth day, your breasts should feel full at the beginning of the feeding, and soften after nursing.
- Your nipple should look longer after nursing, but not misshapen.
- You may feel uterine cramping or mild contractions when your baby nurses (this is one way nursing helps get your body back into shape).
- While your baby is feeding on one breast, the opposite breast may leak.
- You should hear your baby swallowing during the feeding.
- Your baby should seem satisfied and content after feedings.