Is My Baby Getting Enough Breast Milk?

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Answer Sheet
Is My Baby Getting Enough Breast Milk?
A new mothers biggest concern is about how much and how often her baby should breastfeed. Here are some guidelines to help you know
if your baby is getting enough breast milk with each breastfeeding session.
Feeding Cues
Example
Your newborn baby should breastfeed 8 to 12 times within 24
Day 1
1 wet diaper
1 meconium stool (black, tarry)
hours. Tune into your baby’s early feeding cues.
Day 2
2 wet diapers
1 meconium stool (black, tarry)
Nuzzling and open mouth movements
Day 3
3 wet diapers
2-3 transitional stools (greenish)
Day 4
4 wet diapers
3-4 yellow stools
Tense appearance
Day 5-6+
6 wet diapers
3-4 yellow stools
Grunting or other sounds
Babies generally lose a little weight (up to 10% of their birth
Kicking and waving of arms
weight) during the first several days after birth and then begin to
Hand-to-mouth activity
regain weight. Babies generally regain their birth weight within 2
weeks of birth. This is a standard pattern. Have your baby's weight
Crying
checked a couple of times during the first 2 weeks, especially if
Some feedings may be close together, perhaps every hour or so.
you are concerned that your baby is not consuming enough of your
These are called "cluster feedings." Other feedings will be less
breast milk. A check of his weight is the only reliable way to
frequent, every 2 to 3 hours. Feedings do not need to be evenly
determine adequate intake.
spaced and often are not with newborn babies. Wake your baby if
You need to see your baby’s health care provider or a Board
he doesn't awaken to feed within 3 hours of the last feeding during
Certified Lactation Consultant if:
the day. Nighttime feedings can be less frequent but should still
take place.
1. Your baby loses more than 10% of his birth weight, or
If your baby nurses very frequently around the clock, he may not
2. Your baby has not begun to regain weight by his fifth day
be nursing effectively, thereby getting hungry again quickly. Review
after birth, or
the signs of a good latch-on below. Contact a Board Certified
3. Your baby has not regained his birth weight by two weeks, or
Lactation Consultant or other knowledgeable health care provider
for more advice.
4. Your baby is not urinating at least 6 to 8 times per day at five
to six days old, or
Signs of a Good Latch-On
The angle of your baby's lips while at your breast is greater
5. Your baby is not having several stools per day after the
than 140 degrees.
fourth day of breastfeeding.
Most of your areola is in your baby's mouth (1 - 11/2" from the
These signs can indicate inadequate feedings and can become a
base of your nipple, more near your baby's lower lip).
serious concern if not corrected quickly. You may wish to keep a
written record of when your baby urinates, stools and feeds for
Both upper and lower lips are flanged (rolled out).
several days so you can accurately report this to your baby's health
You feel a deep pulling sensation as your baby breastfeeds. It
care provider. Please seek help if your problem does not resolve
should not be a sharp pain or last more than a moment
quickly.
following the latch-on.
Signs of a Good Feeding
Listen for swallowing every 3 to 5 sucks.
Hearing swallowing
Infant Output Guidelines
Your breasts are softer after feedings
Count the number of wet diapers and stools that your baby has
6 to 8 wet diapers per day by Day 5 or Day 6
after your third or fourth day of breastfeeding. Six to eight wet
diapers per day with pale yellow urine indicates an adequate
Feeling a strong, deep, "pulling", suckling at your breasts
intake. Your baby should also have several stools per day. Older
Seeing milk in your baby’s mouth
babies may urinate and stool less. However, the urine should
always be a light yellow color and the stool should be soft.
Leaking from your other breast or feeling a "let-down"
15 to 20 minutes of vigorous suckling on each breast or 20 to
30 minutes on one breast

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Signs That Your Baby is Full
The Dangers of Casual Supplementation
Drowsiness, sleepiness, difficulty arousing baby
Giving an occasional bottle may seem harmless, but during the first
4-6 weeks of breastfeeding, it can create more problems than it
Baby releases from your breast spontaneously
solves. Consider these possible issues and decide if there is a
Relaxed appearance
better option.
Limp arms and hands
Nipple confusion
Does Your Baby Need a Bottle?
Engorgement (short term)
Avoid bottle nipples for about the first 4 to 6 weeks of
Reduced Milk Supply (long term)
breastfeeding. There may be special situations that warrant giving
your baby a supplemental feeding of infant formula, but there
Sore Nipples
aren’t many. If your health care provider recommends a
Shortened duration of breastfeeding
supplemental feeding, it can be given in several ways other than
with a bottle nipple. Small cups, spoons, eye droppers or
Incorrect sucking patterns and ineffective suckling
specialized syringes can be used very successfully with newborns.
Exposure to potential allergens in formula
Most babies who are given unlimited access to the breast do not
need extra feedings.
If giving supplemental feedings become medically necessary, you
Please remember that this is general breastfeeding information only and does
will probably also need to use a hospital grade breast pump such
not replace the advice of your health care provider. If you have a problem that
you are unable to resolve quickly, seek help immediately.
as the Ameda Elite or Ameda Lact-e to establish or maintain your
milk supply. Consult with a Board Certified Lactation Consultant or
other knowledgeable health care provider about your situation.
Written by: Vergie Hughes, RN, MS, IBCLC
Edited by: Anne P. Mark, BSN, RN, IBCLC
References on File.
Choose Purity. Choose Ameda
Ameda Breastfeeding products are manufactured by Ameda A.G.
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