You will be able to determine that your infant is drinking enough breast milk by seeing how many wet and dirty diapers that your baby is having. Your baby will have one dirty diaper for each day of life until day four when they should have three to four stools per day. Babies may also stool every time they nurse or more often. Baby’s stool should be seedy, soft or runny after your milk comes in.
After birth, your baby should have one wet diaper for each day of life. Once mom’s milk comes in, your baby should have six wet diapers every 24 hours. Health care providers will also evaluate your baby’s weight gain to ensure they are getting enough breast milk (see next answer).
A normal infant will lose up to 7% of their birth weight in the first few days. Your pediatrician may become concerned if your baby loses more than 10%. After your breast milk comes in, the average breastfed baby will gain about six ounces per week. Baby should have a weight check at the end of the first week. If the baby is having trouble gaining weight, follow up with a lactation consultant and pediatrician.
Unfortunately, many mother’s concerns that they have an insufficient milk supply will cause them to unnecessarily supplement with formula. Supplementation is a slippery slope to actually causing a supply issue. These misperceptions surrounding milk supply issues cause mothers to stop breastfeeding prior to twelve months. With generations of bottle-feeding mothers before us, the knowledge of how a normal, breastfed infant behaves has been lost.
The breast pump is not a good indicator of your milk supply. Many mothers think that their milk supply is low and it is actually not. If your baby is gaining weight and having enough wet and dirty diapers on breast milk alone, then you do not have a problem with milk supply.
Breast milk supply is based on supply and demand. You must remove more milk from the breast to encourage the development of more breast milk. It is important to do it more frequently. If your baby is not removing enough milk effectively from your breast, then your supply will decrease.
The following are some of the reasons your baby may not be removing milk effectively:
- Your baby’s latch or positioning is not ideal
- A baby who is difficult to wake up
- Nipple shields
- Anatomical problems in baby (cleft palate or lip, lip tie, tongue tie)
- Stopping nursing before baby is done actively nursing
- Breastfeeding less than every 2-3 hours
- Using a pacifier and bottle
- Supplementing with formula, solids, or water.
- Maternal health issues, malnourishment, or dehydration.
If baby has a poor latch or is often sleepy, express milk after or between feedings to maintain a milk supply. You can either hand express or use a breast pump.
- Begin pumping in order to remove milk from the breasts to trigger an increase in supply. Keep pumping about five minutes after the last drops fall. However, even a short pumping session is helpful if you are limited on time.
- Switch sides three or more times per feeding particularly every you’re your baby’s suckling slows down or she falls asleep. Use each side twice per feeding.
- Nurse frequently (every 90 minutes to two hours) and continue through the entire time the baby is actively nursing.
- Try power pumping. Pick one hour and pump for 20 minutes, rest 10 minutes, pump another 10 minutes, rest 10 minutes, pump 10 minutes.
- Galactagogues are supplements that increase breast milk supply. They may be like a Band-Aid to the underlying problem. Some supplements to try are oatmeal, fenugreek, alfalfa, fennel, and blessed thistle.
If your baby is healthy, gaining weight, and having enough wet and dirty diapers, the answer is no. In general, the supplementation with infant formula is a slippery slope. The more that you supplement, the more it affects future breast milk supply.
In some cases, a pediatrician may recommend supplementation. The only time supplementation is medically indicated is when:
- Your baby has a significant weight loss of more than 10% in the newborn infant
- Babies with slow or no weight gain
- Serious illness or health issues in mom or baby
- Physical problems with mom or baby
- Breast refusal
- Separation of mother and baby (work or travel)
- critically dehydrated infants
- Very low birth weight
- Severe dysmaturity of the newborn with possible hypoglycemia
Syndromeassociated with post-maturity and placental insufficiency
- Babies have little subcutaneous fat, skin wrinkling, prominent
- nails, meconium staining of skin and placenta
No, you do not need to adhere to specific guidelines to handle breast milk. Wash your hands with warm water and soap before pumping and handling breast milk. You should also start with clean bottles or new bags and pump parts. Label and date the bottle or bag of breast milk, always using the oldest breast milk bag first. It is important to clean your pump parts after each pumping session with hot water and detergent.
Rinse them thoroughly with hot water. Dry them.
Breast milk can be stored in the general home or work refrigerator. Some women choose to place it in an insulated lunch bag with ice packs and keep it on their desk. Some will let it sit at their desk for a limited amount of time. You can add newly pumped breast milk to the milk that is already in the refrigerator, but you must cool it first.
|Room Temperature||Six hours|
|Insulated bag with ice packs||24 hours|
|Refrigerator (back of fridge)||5 days|
|Home Freezer Compartment||14 days|
|Home Freezer||6 months|