Is My Breastfed Baby Getting Enough?
It is one of the most common questions asked during my time providing breastfeeding support. These concerns often come from the place of love: mothers love their babies and want their babies to grow and be healthy.
As a breastfeeding mother, it is natural to wonder if your baby is getting enough milk. Understanding more about breastmilk and breastfeeding, plus what signs of adequate milk intake to pay attention to, can help reassure mothers that their baby is getting what they need to thrive and grow.
When breastfeeding happens frequently and responsively to the early cues that the baby shows, without time restriction1, with minimal or managed breastfeeding challenges, and the baby can have calm and effective breastfeeding, mothers can trust their baby’s instinct to self-regulate their own breastmilk intake.
This can happen with the help and involvement of two hormones during breastfeeding.
Breastmilk naturally contains LEPTIN2: a natural appetite-control hormone that stimulates the feeling of satiety/fullness. When a baby breastfeeding effectively directly from the breast, s/he will decide when to stop her/himself and detach from the breast as he had received enough intake of leptin (in the breastmilk), thus less likely to overfeed themselves. On the other hand, an absence or low leptin intake (which may because of various reasons, including given breastmilk substitute powder milk) may result in the baby taking more volume. Simultaneously, the release of another natural hormone CHOLECYSTOKININ3 is happening inside the baby’s stomach as s/he suckle and feed, and send a signal of satiety when the hormone reaches a certain level. A change in cholecystokinin sometimes triggers the baby to cue again after 10-15 minutes of last breastfeeding – this is biologically normal, as babies just need a bit more extra intake to grow.
Understanding what signs to know the baby is getting enough intake is helpful for mothers. What mothers can observe:
1. What comes in must come out. When a baby is well-hydrated, it shows in their output. It is less about the frequency, but more of the appearance his/her urine and stools:
– Urine: Clear-coloured or clear with a slight tinge of yellow, not smelly, and frequent. When a baby does not get enough intake, his/her body will retain the water and regulate urine appearance to become yellow, concentrated, and smelly.
– Stool: Babies that receive only breastmilk in their intake have semi-watery/mushy poos. The appearance and consistency may look firmer if the baby also receives their daily intake from other breastmilk substitutes, including powdered milk and solids, as they are not as easily absorbed by the baby’s tummy compared to breastmilk. The stool frequency may change and less often at around the baby is 6-8 weeks of age, and this is normal as long as the baby’s urine is still clear-coloured, frequent, and not smelly.
2. Your baby is growing. WHO has 3 indicators of growth4: weight, length, and head circumference. The recommendation is to measure these indicators together over 4 weeks/a month (NOT daily or weekly), in conjunction with observation of the baby’s appearance and milestones to assess their growth and development. As a baby grows in spurts, an increase in either one indicator also means your baby is growing. The practical way is to see how they are not fit into their clothes anymore. Growing and developing babies can be seen to have their skin turgor springs back, eyes clear, and interacting with you.
Observing your baby’s behaviour during breastfeeding is also a helpful way to gauge how effective breastfeeding has been (article related will be updated soon).
By breastfeeding your baby often, responsively to their early cues, and not waiting till your baby is upset or crying before offering to breastfeed, you can help your baby optimising their breastmilk intake, as much as your baby needs.
Trust your motherly instinct. You got this 😊
Author:
Cinta Mama – Inggita Shintowati, IBCLC.
MHM. MBBS (S.Ked). MD. Cert IV. Breastfeeding Education (Counselling)
Read article in Bahasa Indonesia (Indonesian) here.
Article above is a general information.
If you need a personalised lactation discussion/consultation, you are welcome to BOOK A SESSION here.
References:
1. Infant Feeding Guidelines: information for health workers | NHMRC
2. Palou, Ma,. Pico, C., Palou, A. (2018). Leptin as a breastmilk component for the prevention of obesity. Nutrition Reviews, 76(12):875-92. https://doi.org/10.1093/nutrit/nuy046
3. Marchini, G. Linden, A. (1992). Cholecystokinin, a satiety signal in newborn infants. J Development Physiology; 17(5):215-9. Cholecystokinin, a satiety signal in newborn infants? – PubMed (nih.gov)
4. WHO 3 wellness indicators. Child growth standards (who.int) WHO 3 baby growth indicator – Search (bing.com)