How to tell if your baby is getting enough breastmilk

“I just wish there was a full/empty gauge on my boobs so I could see how much bub is getting”. If I had a dollar for every time I’ve heard this from a mum, I’d be a millionaire. It would be so reassuring! We’ve become so fixated on measuring things that it’s really hard to not have an exact measure of how much milk our babies are getting when they breastfeed. What if I told you there are ways you can tell if your baby is getting enough breastmilk? There absolutely are! And most of them are things you can easily check at home. In this post I’m going to cover easy signs that you can look for that show your baby is getting enough breastmilk without having to express your milk and bottle feed.

Nappy output

My favourite saying when I’m working with mums is “if it comes out, it had to have gone in in the first place!”. And this is so true! If your baby is having a good amount of wet and dirty nappies each day, that is one of the true signs that that show they’re getting enough milk.

Wet nappies:

Your baby should be having at least:

Day 1 after birth: 1 wet nappy over 24 hours

Day 2: 2 wet nappies over 24 hours 

Day 3: 3 wet nappies over 24 hours

Day 4: 4 wet nappies over 24 hours

Day 5 and onwards: at least 5 heavy wet nappies in 24 hours.

You should be able to feel the weight of the wee in the nappy. The nappies with the blue indicator lines can be a bit misleading and change at the smallest wee, meaning you change the nappy sooner and it seems like baby has good urine output when they may not. It’s totally ok to change your baby’s nappy as soon as you see any tiny indicator that they have done a wee, but it’s important to take that into consideration when counting wet nappies, as a nappy like that is unlikely to be a full heavy wet nappy.

The wee should be clear or straw colour and without a strong smell. If your baby’s wee is yellow or orange and/or has a strong smell, they may not be getting enough milk. If this is your situation, you can find out what you should do next in this blog post about boosting low milk supply.

Dirty/poo nappies

Poos will increase in number and size and change in colour over the first few days as your baby starts to get more colostrum and then when your milk comes in on around day 3 (for most mums – it can sometimes take longer).

In the first few days you can expect:

Day 1: Sticky green/black poos. This is called meconium.

Day 2: Softer green/black poos. Poos should be starting to get less sticky.

Day 3: Greenish brown coloured poos, usually dark in colour and still becoming less sticky.

Day 4: At least 3 in 24 hours, lighter green/brown poos or changing to a mustard yellow colour that’s runnier in texture. It’s normal if there are flecks or seed-looking pieces through it.

Day 5 – 6-8 weeks of age: At least 3 mustard yellow poos, runny or soft in texture. It’s still normal if there are flecks or seed-looking pieces through it.

6-8 weeks of age until introduction of solids at around 6 months: The colour and texture should stay the same, mustard yellow poos, runny or soft in texture but your baby may poo less often. Some babies continue to poo 3 or more times a day and others do less. Ideally, they should still be pooing at least once a day when we think about how our digestive systems work. If your baby is not doing a poo every day, it’s important to check their weight to make sure their growth is on track.

6 months + : Once solid foods and fluids are introduced, your baby’s poo will change in colour, smell and texture depending on what they’re eating. Often the poos are more formed (has some shape, like an adult poo), darker in colour and have a more unpleasant smell. It should not hurt your baby or cause them to bleed from their bottoms when they poo. If this is your situation, try reducing the amount of solids your baby is having and offering them more breastmilk feeds. It’s also important to see your GP if this is happening.

Weight gain

The first 3 months of your baby’s life outside your tummy are the fastest they will ever grow. Your baby’s growth (in weight, length, and head circumference) should be following a curve shape on the World Health Organization growth charts (like the one in your baby’s health record book).

It’s normal for your baby to lose some weight in the first few days after birth, but they should soon start regaining that weight and be back to their birth weight by 2 weeks of age. If your baby isn’t gaining weight in the first week and isn’t back to their birth weight by 2 weeks of age, they may not be getting enough breastmilk. It’s really important to get help from an International Board Certified Lactation Consultant (IBCLC) if this is your situation. You can book a home visit or online video consult with me here.

From 2 weeks to 3 months of age, your baby should be gaining at least 150g-200g each week. More is ok when your baby is breastfed with no top ups or bottles. You can’t overfeed a breastfed baby when they’re only feeding at the breast. If you are giving top ups or bottle feeds as well as breastfeeding, it is possible to overfeed your baby and they may be getting more milk than they need if their weight gain is over 200g per week. Get in touch with an IBCLC to help you work out a plan that suits you and your baby.

From 3 months to 6 months of age, your baby’s growth starts to slow a little. During this time, they should be gaining at least 100g-150g per week.

From 6 – 12 months, your baby should be gaining 70-90g per week.

Growth in length and head circumference

Your baby should be growing in length and head circumference. Their length should increase 1.5 times in 12 months and head circumference increases by about 11 cm in 12 months.

Generally happy

Your baby should be generally content for most of the time. All babies have periods in the day where they get cranky or unsettled, but this should not be lasting all day, every day. If you’re worried about your baby’s behaviour, check in with an IBCLC and your child health nurse or GP to rule out any feeding or medical issues.

Meeting developmental milestones

Your baby should be meeting their developmental milestones. Remember though, babies often vary a little in when they start doing new things, but if there is a big delay, that can be a concern. This Gr8 Start booklet is a fantastic resource that shows what milestones your baby should be reaching and when. If you’re worried your baby isn’t meeting their milestones, you might like to check in with your local child health nurse to chat about your concerns.

Signs that can trick you

There are a few common baby behaviours and situations that often make mums worry that their babies aren’t getting enough milk when they actually are. The signs I talked about above, are the true and evidence-based signs that show whether your baby is getting enough milk. The next few behaviours and signs I’m going to talk about below are not true signs and can make you worry when your supply and your baby’s intake are actually fine.

Very frequent feeding

Breastfed babies feed between 8-12 times per day, the average is 11. Breastmilk is very easily digested so it moves through your baby’s digestive system quickly and they’re soon ready for another feed. Babies also breastfeed for many reasons other than just hunger. They get closeness, comfort, safety, pain relief and infection fighting antibodies all from breastmilk and the act of breastfeeding.

If your baby’s feeding a lot and they’re showing all the true signs talked about above, your baby is getting enough breastmilk from you! Their behaviour does not mean they’re not getting enough.

If they’re not meeting the signs above and feeding very frequently, this can be a sign that they’re not getting enough breastmilk. It’s important that you get in touch with an IBCLC to help you work out why that is and come up with a plan to get things back on track.

Fussy periods/Cluster feeding/Unsettled in the evenings

Just like frequent feeding above, it’s very normal for breastfed babies to have periods in the day where they seem cranky and unsettled even though they’ve just been fed, changed, and cuddled. This often happens in the late afternoon/evening times. Some people call this the witching hour! It’s ok to follow your baby’s lead here and feed them as often as they’re asking for it, even if they have fed not long before. If your baby is showing this behaviour and they’re also showing all the true and evidence-based signs mentioned above, your baby’s fussiness and frequent feeds are not because of low supply or milk intake.

Waking overnight

It’s very normal for babies wake overnight to breastfeed. Young babies can often be getting 20% of their milk intake at nighttime, so night feeds are important for their growth. Night feeds are also very important for your milk supply. The milk making hormones are at their highest between midnight and 4am, so getting feeds in at these times can help boost and maintain your supply.

Your milk supply works on a supply and demand basis. The more milk removed = more milk made, so your baby feeding every few hours, even through the night is also helping to boost and maintain your milk supply.

Research shows us that it’s very normal for babies to continue waking through the night after their first birthday (about 1/3 of babies). That doesn’t make it easy, and it is definitely exhausting, but it doesn’t mean that you’re doing something wrong or there’s something wrong with your baby if they still wake through the night, and it definitely doesn’t mean that they’re not getting enough milk from you. This is just normal baby sleep patterns. The Australian Breastfeeding Association has some great info on coping with broken sleep that you might find helpful: https://www.breastfeeding.asn.au/resources/broken-sleep

Only getting small amounts of milk when you express

The amount of milk you get out when you express does not necessarily show how much milk you’re making. Lots of mums panic when they can only get 10 or 20mLs of breastmilk out when they’re expressing, but often it’s just that the breast pump can’t get the milk out as effectively as a baby who’s latching well.

Lots of mums find that breast pumps just don’t trigger their let down (the reflex that gets the milk flowing when your baby sucks) as well as their cute and cuddly babies. So, the milk is there in the breasts, the pump just can’t get it out.

There are a few things you can do to help get more milk when you express:

• Encourage your letdown to get the milk flowing by stimulating your nipples with your fingers, gently massaging the breast, using a warm pack on your breast or hand expressing for a few minutes to get the let downs started.
• Make sure your pump flange is the right size for your nipples. Breast pumps usually come with 24mm flanges as standard, but these are usually too big for most mums. Milky Business has a great measuring tool you can download to make sure your size is right.
• Hands on expressing technique can often get more milk out. There’s a great video on this HERE.

We’ve talked a lot about the TRUE signs that show your baby is getting enough milk, including their nappy output, their growth in weight length and head circumference, their behaviour, and developmental milestones. So now you know how to filter out the true signs VS the common signs and behaviours that can trick you into thinking your baby isn’t getting enough when they actually are. If you’re ever concerned about how much milk your baby’s getting, there is help out there. Please, PLEASE get in touch with an IBCLC to support you ASAP. Whether it be for reassurance, or helping you develop a plan to increase your supply, the sooner you act on this the more likely you are to have a better outcome. You can book a home visit or online video call with here.

Please help me spread the word on this! Share this post with another pregnant or breastfeeding mumma to build their confidence in their breastfeeding journey.