A breastfeeding mother's two strongest concerns are: am I making enough milk and Is baby eating enough.
After the initial engorgement phase, once the breasts have regulated a bit (often around 4-6wks, but timeline varies) some women find themselves concerned they no longer have enough milk.
Some women never experience engorgement at all and are concerned about low milk supply.
Some women think they have plenty of milk, but find that a screaming, impossible to satisfy and calm down baby leads them to believe they're not making enough.
So what's going on? Are signs like soft, empty breasts, and fussy babies indicative of low milk supply? While these signs are often evident when someone is experiencing true low supply, in and of themselves, these signs aren't very telling.
Soft empty breasts tell the body to make more milk.
Babies are fussy creatures.
So how, then, can we gauge if we are a.) making enough milk and b.) satisfying our babies?
Adequate weight gain
Adequate diaper output
Baby is content while nursing
First, I'd like to note that an immediate weight loss after birth is very typical. This weight loss can be exaggerated in cases where mothers received a large amount of IV fluids during delivery. These fluids skew baby's birth weight. A 7-10% weight loss is within the realm of normal, and does not necessarily require immediate supplementation, but rather very close monitoring and excellent lactation support.
Babies are expected to gain about 0.5-1oz per day, on average, and approximately a pound a month. Although, less than this can be normal as well. What is important is to see if baby stays on their growth curve. Percentile is not important. It doesn't matter if your baby is in the 1% or 99th.. what matters is they show clear growth patterns and stay on their own growth curve.
Ask your doctor if they are using WHO Growth Charts for Breastfed Babies. Other growth charts compare both breast and formula fed babies, which is not fair as it does not give a clear or accurate picture of expected growth trends.
As a society obsessed with numbers, not being able to see how much goes into baby is pretty overwhelming for some moms. It can be a source of anxiety and concern. There are two methods to quantify input.
One method, you can use with your lactation consultant. During a weighed feed to see how much baby transfers, she will weigh baby, you will feed, then weigh again. Using a sensitive scale you can determine how many ounces baby transferred. Keep in mind, though, this is just a snapshot into the whole picture. This does not indicate how much baby transfers in a 24 hour period and one isolated feeding can not give a full picture. It will, however, give your LC some insight into baby's ability to transfer milk. This kind of assessment is not routine, but can be a way to determine supporting factors for a myriad of concerns.
Please note that a weighted feed at home is invalid, as most home scales are not nearly sensitive or accurate enough to be used for clinical purposes.
Another way to quantify input is to monitor output. What goes in must come out. In the first 6 weeks breastfed babies should poop just about every day. After 6 weeks, it's common for them to poop less frequently. As a newborn, watching poop is a great way to determine if your baby is eating. If poop is transitioning from black meconium to softer, yellow, seedy poop, your baby is getting milk.
In the first week of life we look for approximately 1 diaper per day of life. Then, about 6-8 diapers a day. But don't be surprised if its more! I swear I went through 12 a day during the newborn phase!!
If you do have any supply concerns, it would be wise to discuss your concerns with a lactation specialist to help determine the supply problem is real or perceived. If there is a problem, your lactation consultant can help you develop a plan to both ensure baby is eating enough and increase your supply.
Your pediatrician is an important part of this healthcare team, but please do not be afraid to seek second opinions. Not all pediatricians are well educated on lactation and may not always know the best way to support a mother's milk supply. You always have options and autonomy. Finding a pediatrician who supports breastfeeding mothers with up to date information is very important.
Please remember that the advice in this thread is for the average dyad. Always relay your concerns to your healthcare and lactation support team.
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How about you? Did you ever experience issues with perceived low supply? How did you determine if there was a concern or not? How did you solve that problem? Keep your eyes open for my
upcoming post on managing low milk supply.
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