Am I Making Enough? Common Concerns About Breastfeeding

December 11, 2017

As postpartum doulas and lactation professionals, we are often fielding questions about what is or isn't normal when it comes to breastfeeding in those early weeks! The three most common questions we get are:

  • How do I know if the baby is getting enough to eat?
  • Am I producing enough milk?
  • How will I know my milk is coming in?

These questions are incredibly normal! Almost all new moms wonder, and hopefully we can help to put you at ease.

Two Signs that Baby Is Getting What Is Needed

It's normal to wonder how your baby can thrive on colostrum, that early milk your body produces that seems to come in small quantities. Remember, though, that at birth, your baby's stomach is only about the size of a marble. It slowly grows to about the size of an egg in the first two weeks, which coincides with your milk coming in! Here are two easy ways that you can tell your baby is getting what he or she needs in those first few days, weeks, and months:

1. Weight gain. All babies do lose a little bit of weight at birth, and up to about a 7-10% loss in the first few days is considered normal. After that, we expect babies to make a steady rebound of at least 5 oz per week. The newborn should also be back to birth weight by 2 weeks of age or sooner. These are all things the pediatrician would be keeping tabs on at your baby's regular visits.

2. Diaper output. A dehydrated or malnourished baby isn't going to poop and pee as much as, so the number of wet and dirty diapers in a day is an easy way to tell if a baby is getting in what they need to grow and thrive! We expect babies to have at least one wet and one dirty diaper for each day of life up to day 4, when newborns even out to about 3-4 dirty diapers (the size of a quarter or larger), and 5-6 wet diapers in a 24 hour period.

If your baby seems fussy, even after feeding, try to keep the whole picture in mind too! Most babies do have fussy periods, and being at the breast is very comforting and soothing to them. They will also go through growth spurts where they will demand to feed more frequently. This isn't because they are starving- they are simply ordering off the menu to signal your body to produce more milk and meet the demand of their big growth spurt!

Why You Pump Might Not Be the Best Indicator

In those first few days especially, be aware that what you pump might not be the most reliable indicator of how much milk you are making or baby is receiving. Pumps do not remove milk from your breast the same way that babies do, and your pump is not going to be as efficient at getting milk out as your baby will be!

This is especially true in the first few days when you are producing colostrum. Colostrum is pretty thick, more like a paste than a liquid. It is difficult for your pump to remove as much colostrum as it can remove more mature milk.

What to Expect as Your Milk Comes In

Most women do experience some changes in their breasts during pregnancy. Most women begin to produce colostrum, that early milk, around 32 weeks. After birth, you will probably feel your breasts fill around day 3-5 as your milk begins to transition from colostrum, the early milk, to more mature milk. You may notice some leaking and engorgement or none at all.

As your supply regulates, your breasts will no longer “feel” full or leak anymore, though. Typically this happens within the first month or two. This is normal, and doesn’t mean that your supply suddenly dropped necessarily.

Remember too that milk production is a supply and demand system. The more you take out, the more your breasts produce. Draining the breast by feeding or pumping often is the best way to ensure an adequate milk supply for the long haul, and is one of the reasons lactation consultants will tell you to be sure to feed or pump at least 8 times in every 24 hour period, and not go any longer than 2-3 hours between feedings (although once established, one 4-5 hour stretch for sleep is typically ok).