By Tanya Lieberman, IBCLC
Ever wish your breasts had little ounce markings? If so, you’re not alone. One of the more confusing things about breastfeeding is determining how much milk you’re making. You can’t see how much is going into your baby, so how can you tell if your milk supply is enough for your baby?
On this page we share the best ways to determine if your milk supply is in fact low, and describe the many things that can make you think that your supply is low when it actually isn’t.
Below are some normal experiences that can trick you into believing that your supply is low:
“My baby wants to eat all the time.” It’s normal for babies to eat frequently, generally in the range of 8 to 12 times in 24 hours for many months. This means many hours of feeding a day, and it may feel constant at times. It’s also normal for babies to “cluster feed” at times during the day. If your baby is feeding significantly outside of the 8-12 times range, contact a lactation consultant or other breastfeeding support person.
“My breasts feel softer than they used to.” Toward the end of the first month of breastfeeding many women notice that their breasts have decreased from the size they were when their mature milk came in. This is normal, and does not indicate anything about milk supply.
“I don’t feel that ‘let down’ sensation.” Some women have a “let down” sensation when they make milk, and some don’t. It doesn’t seem to have any bearing on the amount of milk a mother makes, so don’t worry if you don’t feel anything.
“My baby suddenly wants to eat all the time.” Babies go through growth spurts. They do this in order to increase your milk supply to meet an increased need for calories. To do this, they go on a feeding rampage for a few days – eating more often than usual and sometimes acting unsatisfied and fussy after feedings. During a growth spurt it’s common to question your supply. After a growth spurt you’ll find that you have more milk than ever!
“I can’t pump very much.” Pumping output is usually not a good measure of milk supply. Why? Because your body doesn’t always make milk for the pump (it has to be tricked into believing that the pump is your baby!) and when it does the pump doesn’t remove milk as well as your baby does. So don’t gauge your milk supply based on your pumping output. You almost always have more than you pump.
“My baby is fussy when she nurses.” There are many causes of fussiness at the breast. And while hunger is one of them, your baby may be fussy because of gas, pooping, a flow that is too fast or too slow, or a host of other reasons. If you believe that your baby is fussy because he or she isn’t getting enough milk, or if the fussiness is causing you distress, consult a lactation consultant or other breastfeeding support person.
“My baby is suddenly waking up at night a lot.” Night waking can be due to hunger, but it can also be due to teething or “reverse cycling,” (when babies eat less during the day and more at night, often due to a change in routine like a return to work, or distracted behavior during the day).
Here’s how to tell if your milk supply is actually low:
1) Your baby’s weight. The best measure of whether your baby is getting enough milk is his or her weight gain.
If you are concerned about your milk supply, have your baby weighed and re-weighed using a baby scale. Scales will always be a little different, so be sure to compare only weights taken on the same scale. Except in critical situations, weight checks every few days or weekly is generally sufficient.
In the first three months of life babies gain an average of 1 ounce per day. That slows to at least approximately a half an ounce per day between 4 and 6 months.
Occasionally your health care provider may suggest a “test weight,” in which your baby is weighed on a sensitive scale before and after a feeding (with the same clothes on) to determine how much milk the baby received at that feeding. This can give you a snapshot of a feeding, but be cautious in drawing conclusions from the data. The amount of milk babies take in at different feedings can vary widely, so bear this in mind if you do a test weight of your baby.
2) Diaper output. You can get a sense of how much your baby is taking in by what comes out. After the first few days, babies generally have at least three poops that are bigger than a quarter in size each day. This frequency may decline after several weeks. And your baby should have five very wet diapers per day. It can be difficult to measure output in very absorbent diapers, which is why your baby’s weight is considered the ‘bottom line.’
3) Swallowing. You may also take comfort in how much your baby is swallowing when nursing. This is not a definitive measure of your supply and should be confirmed with information about your baby’s growth, but a period of rapid swallowing (one swallow per one or two sucks) during a feeding shows you that your baby is getting milk. To check out your baby’s swallowing, listen for a ‘cah’ sound or a squeak or gulp, and look for a longer and slower movement of the jaw, often with a brief pause at the widest point.
What to do if your milk supply is indeed low:
If your milk supply is low, be sure to get help from a lactation consultant (IBCLC) or other qualified breastfeeding support person. There are many steps you can take to build your milk supply, and these support people will be able to guide you through that process. You can find a lactation consultant by going to www.ilca.org.
The Breastfeeding Mother’s Guide to Making More Milk. Diana West and Lisa Marasco, McGraw Hill, 2009.
La Leche League, International: www.llli.org
Find a lactation consultant: www.ilca.org