How Do I Know If My Breastfed Baby Is Getting Enough Milk?
One of the ways breastfeeding is very different from bottle feeding is that it is hard to tell how much milk a baby is taking at a feeding. This leaves many mothers wondering if their baby is getting enough to eat.
Fortunately there are several ways to know if a breastfed baby is getting enough milk, and the simplest is to count poopy diapers. A breastfed baby (3 days old or older) who is getting enough milk will have at least 3 poopy diapers every 24 hours. Poops count as long as they are at least as big as a US quarter. Babies will also usually have at least 5-6 full wet diapers, but poops are a more reliable indicator of whether a baby is getting enough to eat. A one day old baby should poop at least once and a two day old baby should poop at least twice.
Breastfed babies who are getting enough milk will typically gain 4-7 oz or more each week during the first four months, and babies who on average are gaining approximately this much or more, are getting enough milk.
For parents who have reason to believe their baby might not be getting enough milk, another option is to use a scale accurate to 2 grams, or 0.1 oz, and weigh the baby before and after breastfeeding. Any increase in weight will be from milk intake. Sometimes this information is reassuring, and sometimes parents find out that their baby is truly not taking enough milk at feedings. Many lactation consultants have or have access to scales of this accuracy and can provide this service.
How Much Milk Should My Breastfed Baby Be Getting At Each Feeding?
There is no hard and fast rule for how much milk a breastfed baby should get at each feeding. Most babies vary their feedings and eat more at some times than others. (Like adults!)
An approximate guideline for babies who weigh 10 pounds or less is to take the baby’s weight in pounds and multiply it by 2.5 to calculate the amount of milk the baby needs in a 24 hour period.
So for example:
- A 6 pound baby needs about 6 × 2.5 = 15 ounces per 24 hours
- A 7 pound baby needs about 7 × 2.5 = 17.5 ounces per 24 hours
- An 8 pound baby needs about 8 × 2.5 = 20 ounces per 24 hours
- A 9 pound baby needs about 9 × 2.5 = 22.5 ounces per 24 hours
- And a 10 pound baby needs about 10 × 2.5 = 25 ounces per 24 hours
How much milk a baby needs at each feeding depends on how many feedings per day the baby is having. Most breastfeed babies younger than 3 months old need at least 10-12 feedings per day. So if we take the example of a 9 pound baby who is having 10 feedings each day, the baby needs 22.5 ounces each day ÷ 10 feedings = 2.25 ounces per feeding. A baby who is feeding more frequently would need slightly less each feeding, and a baby who is feeding less frequently would need slightly more.
A baby who is behind on growth will need more than this amount to catch up, and families in this situation need to work closely with their pediatrician and a lactation consultant to get their baby’s growth back on track.
Another factor is that the storage capacity of women’s breasts varies widely. Some women can store approximately 1-2 oz in each breast, while others can store over 20 oz! The size of a women’s breasts does not necessarily correlate with storage capacity, so you can’t assume that because you have large breasts, you automatically have a large storage capacity or vice versa. Women with smaller storage capacities typically need to feed their babies more often than other mothers in order to meet their babies’ needs, and most of these moms can make just as much milk over the course of a day...they just have to feed extra frequently.
So Does My Body Have To Keep Making More And More Milk As My Baby Grows??!?
No! This system was designed to work without mothers needing to produce ever increasing amounts of milk. Most moms nursing one baby reach a point when their baby is about 4-6 weeks old where they are producing an average of about 25-35 ounces per day. (Mothers exclusively breastfeeding twins or triplets may be making much much more!) This is the maximum amount she will need to make to meet her baby’s needs.
Many mothers are surprised to learn that as their babies grow, they do not need to produce greater and greater quantities of milk. So what is going on? There are two main reasons this works. The first is, have a look at a World Health Organization growth chart: Babies grow very quickly in the first few months, typically doubling their birth weight by 3-4 months. Their weight gain then gradually slows and most babies don’t triple their birth weight until around a year or later. The small body of the very young baby uses those 25 ounces a day to grow very quickly, while the older baby does not need to continue this fast growth rate, so 25 ounces continues to be sufficient. Older babies are also using their calories differently. Very young babies spend most of their time (and calories) eating, sleeping, pooping and growing, while older babies use calories interacting with people and their environment, learning to move and play and so on.
The second reason mothers’ supplies do not need to increase beyond the 25-35 ounces is that the composition of breastmilk changes to meet the changing needs of the baby. It changes in many ways, including adding more immune factors around 4 months of age, just in time for babies to start putting everything they can get their hands on into their mouths. One very important change that occurs is that the calorie content of breastmilk increases significantly over time. So the older baby is getting the same number of ounces, but more calories!
Sometime between 6 months and a year, babies will start to show signs of readiness to begin eating solid foods. These foods add calories to the baby’s diet, although breastmilk continues to be the main source of nutrition for most babies up to about a year, and a significant source of nutrition and calories for as long as the child is breastfed. As babies and toddlers increase the amount of solid food they take, they gradually decrease the amount of breastmilk they consume.
Often this is not a linear progression and toddlers may seem disinterested in breastfeeding some days, and nurse very frequently other days. This is normal, and most mothers find that their milk supplies can keep pace with their toddlers, at least most of the time!
Mothers’ bodies are designed to nourish their babies and most women can make enough milk. If you are not sure if your baby is getting enough milk, please seek out the breastfeeding support resources in your area.