Few experiences are as gratifying – for both you and your baby – as breastfeeding. But breasts don’t come measured out in ounces the way baby bottles do, so it can be tricky to know if your newborn is getting enough milk. “On day one, most babies will ingest only a swallow or two a few times a day, but by one week old they need about three ounces of breast milk every few hours,” says board-certified lactation consultant Heather Kelly.
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Three ways to know if your baby is getting enough milk:
1. What goes in must come out
One way to tell how much milk your baby is ingesting is by how many wet and dirty diapers you are changing in a day. “In the first four days of life, the day number should correspond to the number of poopy diapers you change so day one, you want at least one, day two, at least two, and day three at least three, day four at least four, and it caps out around then,” says Kelly.
The appearance of the poop should change, too. When your baby nurses for the first few times ever, he is ingesting colostrum, a thick, white substance that is nutrient-dense and filled with protective antibodies, but low in volume. The colostrum has a laxative effect, helping to move things along in your baby’s GI tract. Your baby’s first poop is comprised of meconium — black, tarry, thick stools that encompass everything your baby has swallowed in utero. “If meconium is starting to move through, it’s a good indicator the baby is swallowing colostrum,” says Kelly.
Days two to three, expect “transitional stools.”The color transforms from black to dark brown, greenish brown, hunter green, and by the end of day four of your baby’s life, stools should be bright mustard yellow and larger than a quarter and your milk should have changed from colostrum into mature milk. “If a new mom calls me and says, ‘I’m on day four, and the baby hasn’t pooped today but yesterday she had a black meconium,’ we know the baby is not getting enough,” says Kelly.
2. Weight gain
Babies who ingest enough milk gain weight. It’s normal for a newborn to lose up to 10 percent of his weight in the first few days after birth, but by day 10 to 14, your baby should be back to birthweight or heavier. The American Academy of Pediatrics recommends that babies be checked by their doctors three to five days after birth and then at one month old. Depending on how well your baby gains weight, the doctor may want to see your baby more frequently.
3. Your baby’s behavior
After a feeding, if your baby is still rooting, fussing, and crying, he probably hasn’t had enough. On the other hand, if your one-week-old baby sleeps through the night beautifully, that’s also a sign that he may not be getting enough milk. Most babies need to nurse about every three hours day and night during the first few days and weeks of life. Typical nursing sessions last between 20 to 50 minutes during which your baby nurses at each breast. Afterwards, your baby should seem content – either sleeping happily or in a quiet alert state, taking in his surroundings. Those are signs of satiety that tell you he is getting enough.
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Laura Flynn McCarthy is a New Hampshire-based writer who specializes in health and parenting topics.