Because the breasts aren’t transparent or marked off in ounces, some mothers find it difficult to trust their babies are getting enough when breastfeeding. Because we come from a culture that was predominantly bottle-feeding for many years, we expect to be able to measure what our babies are eating so that we know we’re giving them just the right amount of food for growth.
Some basics ‘rules’ you can trust for knowing your breastfed baby is getting enough when nursing are:
- Your baby is feeding often: For newborns, this might be every 1-2 hours around the clock. Even older babies sometimes nurse every couple of hours. As long as you are following your baby’s hunger cues and not holding him off because it’s not the right time yet to feed again, his frequency of nursing is just right for him. Don’t be alarmed if your baby wants to cluster feeding (several hours of very closely spaced feedings), or if his frequency picks up during growth spurts (when he needs to nurse more often to boost your supply).
- Your baby is having plenty of wet and dirty diapers: Once your milk comes in, expect 6-8 really wet cloth diapers each day. Your baby’s urine should be pale to clear. By the end of the first week of life, baby should be having at least 3 yellow, seedy bowel movements each day. If your baby is having more than that, it’s fine. But if your baby is having fewer wet and dirty diapers, he may need to eat more often. After about 4-6 weeks, some babies have fewer bowel movements without a problem.
- Your baby is growing appropriately: Most babies lose a little bit of weight in the few days after birth but regain their birthweight by 10 to 14 days. Some babies take a little longer. Expect your baby to gain about ½ ounce per day thereafter.
- Your baby is meeting developmental milestones: Is your baby more awake and alert, interacting with you, your partner, any siblings? As the days go by, you will notice your baby learning new things and falling into more of a pattern of eating, sleeping and waking.
What if you’re pumping and giving your baby breastmilk by bottle? How will you know how much is needed? At first, your baby doesn’t need much – studies show that in the first month of life, babies have a 20ml (about 2/3 ounce) stomach capacity, and that it takes about one hour for baby to digest this milk. Other researchers have said that at about 10 days, baby’s stomach is about the size of a golf ball, which can be calculated to about 2 ounces of fluid.
Then, from age one month to age six months, the amount of breastmilk babies consume stays pretty constant at about 25 ounces of breastmilk per day (some take a little more, some a little less; so the range is 19 to 30 ounces). If you need to leave bottles for your baby, divide that 25 ounces by the number of feedings per day and you’ll get the number of ounces you need per feeding. For example, if your baby is feeding 10 times per day, that’s 2½ ounces per feeding.
One of the most common reasons that mother’s wean well before they intended is that their baby seemed like he wasn’t getting enough. If you are nursing your baby on cue, are allowing him to determine how long on each side, and aren’t scheduling his feedings, then chances are that he’s getting just enough for him. Your breasts should feel a little fuller before a feeding and softer after a feeding. It takes about 4 to 6 weeks for your milk supply to become established. After that time, your body may be making just enough milk for your baby’s feedings, and not wasting energy making more. So while you may think your supply has diminished because your breasts no longer feel engorged, it’s more likely the case that your supply has perfectly evened out to meet your baby’s needs.
The most important rule is to follow your instincts. If your baby seems fussy and unsettled, it could be that he’s not getting enough to eat. But it could also be lots of other things. Working with a lactation consultant or trained breastfeeding counselor will help you to determine the best course of action to be sure you and your baby have a healthy breastfeeding relationship.