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

by | Jun 5, 2020

Breastfeeding can be tricky – and you might be worried about whether your baby is getting enough breastmilk in. Doula Donna Bland addresses this concern.

One of the most frequently asked questions I get from new parents is how to tell whether their breastfed baby is getting enough milk. To truly understand the answer, I always start with educating parents on the basics of a baby’s digestive anatomy.

A full-term baby is born with a stomach about the size of a marble or a blueberry. This means that babies don’t have the ability to drink large amounts of milk, regardless of whether it’s breastmilk or formula.

By day three, your baby’s stomach has increased to the size of a walnut. After 10 days, the stomach is now the size of an apricot, and by a month old, the stomach is around the size of a large chicken egg.

After the delivery of your baby and its placenta, breastmilk called colostrum is made available for your newborn. This milk is often referred to as “liquid gold”, because although low in quantity, it is extremely high in nutritional value. In the first few days when colostrum is present, a baby only needs about a teaspoon (5-7ml) of breastmilk.

In the past, mothers were advised to feed every three to four hours, but with the help of evidence-based research, we have come to better understand how newborns should be breastfed in order to thrive.

An interesting fact is that one teaspoon of colostrum is equivalent to six teaspoons of mature milk. Due to the low quantity of colostrum in the early days of breastfeeding, we encourage moms to feed frequently, even if baby only drinks for a short time. This encourages stimulation of the breasts, which is the best way to increase milk supply. The more regularly your baby is at the breast, the more milk you will produce.

Within your baby’s first week of life, breastmilk changes from colostrum to a transitional milk, preparing for the mature milk that is usually available after about two weeks. These two stages produce higher quantities of breastmilk, but the consistency, colour and properties within them are different to the colostrum that your baby first drank. This does not mean however, that they are inferior in quality. Each stage of breastmilk adjusts to your baby’s needs.

Interestingly, when a baby is actively suckling at its mother’s breast, a message is sent the brain for the body to produce a cocktail of hormones in order to make more breastmilk available to the baby. After a minute or two, a milk ejection reflex or “let down” happens. This is a surge of breastmilk made readily available for baby’s consumption.

Research has shown that a mom can have as many as seven milk ejection reflexes in one feed, depending on the length of the feed and how actively her baby is drinking. It has also been documented that the average milk ejection reflex produces around 35ml of breastmilk. So, if a baby is at the breast, and the mother has three milk ejection reflexes in that time, for example, her baby may drink as much as 105ml of breastmilk.

Another important aspect to bear in mind as a result of these milk ejection reflexes, is that 80% of the breastmilk your baby receives is produced during a feed.

The best advice I can give is:

  • Spend time skin-to-skin with your baby.
  • Breastfeed your baby regularly (try not to go beyond three-hour intervals in the early days).
  • Make sure your baby is latching well.
  • Listen for swallowing sounds.
  • Look out for wet nappies (the norm is five or more wet nappies a day).
  • Look after yourself. Make sure you are getting enough rest, eating a nutritious diet and keeping yourself well hydrated.
  • Have your baby weighed every couple of weeks.
  • Trust your instincts.
  • And if you’re still unsure or need some assistance, find a lactation consultant who can assist you on this wonderful journey.