How do I know I'm making enough milk?

In my years of experience counseling hundreds of parents, one concern is evergreen: "I don't think the baby is getting enough milk." In fact, nearly 42% of breastfeeding moms in Virginia quit because they don't think they have enough to satisfy the baby! It makes sense. Newborns notoriously only do three things: eat, sleep, poop. Sleeping and pooping tend to happen without much intervention. Eating, on the other hand is your first responsibility as their parent! Of course that's going to stress you out! Add in all of the "low supply" drama you've seen on social media and the number of people you know who have had to quit? It's bound to feel like a crisis waiting to happen.

But I've come bearing excellent news. It is easy to tell if you're getting enough milk to your baby! And if they're not, many causes of low supply can be managed with technique.

So how can you tell you're making enough milk?

For every day in baby's first week, there should be one poop diaper and one pee diaper for every day since they've been born. The poop should be about the size of a nickle or a quarter and the pee should change the indicator stripe on their diaper. Day one? One of each. Day two? Two of each. Day three? You get it. By day six, things should level off to about 5-6 of each every day, which you can expect for the first month and a half or so (~6 weeks). As their stomach gets larger, their output tends to consolidate.

A baby poop detour

This is a great time to pause and talk about breastmilk poops. Every dirty diaper provides an interesting opportunity to observe the dynamic nature of your milk. As your baby grows and your milk seeds their gut biome, you'll see a rainbow of colors reflecting your shared diet and environment. Mustard yellow is the most common color, often with little sesame seed looking chunks of undigested fat throughout. These little specks are only found in breastmilk diapers! From there, all sorts of yellows, oranges, and browns will appear on any given day. Small changes are very normal.

Sometimes you may see something a little different. A foamy green breastmilk poop could indicate that your letdowns are a little fast and heavy. Baby typically brings in more air when dealing with a heavier flow, which can lead to gas, digestive disruptions, and discomfort. This type of poop can be a good hint on what you're dealing with.

With both of my children, they started to bring home fun infections when they started daycare. One strange symptom we saw a few times was pale (almost white!) or clay colored poop. This can indicate an issue in the liver or kidneys and is definitely worth calling the doctor, especially in a younger baby. They'll talk to you about whether or not they want you to come in.

It's also not unusual to see a little bit of blood in a diaper, especially in the earliest days. Their digestive systems are very new and fragile. However, if you notice more than some specks or it continues over the course of two or more diapers, I would call the pediatrician's nurses to discuss any other symptoms they may want to see baby for.

Other signs to check for milk intake

When a baby has had enough breastmilk, their satisfaction cues combine in a happy state that many parents call "milk drunk"

Diapers are a very easy way to check and track how much baby is eating. But there are lots of other signs you can look for throughout the day to ease your mind:

• Let baby eat until they unlatch and relax in a satisfied way.

• Their face will be gentle and untensed

• Palms will be open

• Not displaying hunger cues

If the baby is finished on one side but doesn't seem finished or still seems hungry, offer the other side! There is no perfect amount of time per breast or per feed.

If you feed on demand until they show you they're full, a typical baby will make sure you're making enough milk.

Not enough milk

Of course, there are times when a baby is not getting enough breastmilk. This can happen for any number of reasons but is also fairly easy to spot. Look for:

• Sunken fontanelles - the soft spot at the top of their head will be noticeably below the rest of their scalp

• When skin is pinched, it will not return to normal quickly

• Lips are very chapped and dry

• Baby is very sleepy and difficult to wake up

Some babies may also develop jaundice if they are not getting enough to drink. You'll notice a yellowing of the skin, often, but not always beginning at the soles of the feet. This can be harder to spot on dark skinned babies, but overall tones will be yellower. The National Health Service in Great Britain published this excellent guide to help assess for jaundice when yellowing might not be the easiest symptom to see.

The Good News

If you have a typical full-term baby and you are:

• Feeding on demand

• Letting them stay on until they're full

• Offering both breasts

They're probably getting enough to eat. It is so normal and so common to stress about your supply and their intake, but once you know these signs, it's much easier to relax.

If you learn these signs and still have concerns, it is best to raise them earlier than later. Your pediatrician can assess their weight and overall health to help you make a decision about how to proceed. There can be many causes to low transfers and getting started on solutions early allows you the most choices.

You can also visit with a lactation counselor or consultant (like Songbird Lactation!) to conduct a weighted feed. This is when baby is weighed on a gram-accurate scale, then fed. Once baby has eaten, they're measured again. The difference in weights is an easy way to understand how much milk is transferring during one session. This information can give a clearer picture of where milk feeding is breaking down. With that, a more tailored plan can be put together.

If you have questions about your supply or your baby's intake, please don't hesitate to give me a call or shoot me a text at 757-276-3241. I often have availability for lactation counseling in the same day or the next day.