How Do I Know if My Baby is Hungry?

When figuring out if your baby is getting enough breast milk, you will want to start by making sure you are recognizing his/her feeding cues. Babies are born with an ingrained rooting reflex when they are hungry. The following are signs that your baby is looking to be fed:

• Making mouthing movements
• Bringing hands to mouth and sucking on fist
• Moving head from side to side
• Smacking lips
• Crying as the final hunger cue

Initiating a feeding will be much easier if you notice your baby’s feeding cues and can get him latched on before she starts crying. Watching for your baby’s hunger cues rather than the clock will ensure your baby gets enough breast milk and will help you maintain your milk supply. This is called feeding on demand.

What if My Baby Won’t Wake Up To Feed?

Sometimes in the first weeks, babies are very sleepy. This is a very common problem. As parents, you may need to help your baby wake up for feeds to make sure they get enough breast milk. You can do this by:

• Giving a diaper change
• Stripping baby down to his/her diaper and placing baby skin to skin with you
• Sometimes applying a cool washcloth to your baby’s feet
• Expressing some breast milk and placing it on your baby’s lips
• Compressing the breast to push milk into your baby’s mouth to wake up a sleepy baby already on the breast, to continue the feeding as long as possible

How Do I Know if Baby is Getting Enough Breast Milk?

Breastfeeding provides multiple benefits to your baby and family including helping mom bond with baby, immunity benefits, and cost savings. However, many moms worry whether their baby is getting enough to eat in the first few weeks of life because they cannot see how much the baby is taking as you would with a bottle. As new parents, you can rest assured that baby is getting enough if baby:

• Begins to gain her birth weight back during the first two weeks of life and continues to gain weight according to their growth curve
• Is having enough pale and odorless wet diapers according to baby’s age (one per day of age, then six or more at day five)
• Has transitional bowel movements by three days of age
• Settles for at least a short period of time between feeds (does not cry when taken off the breast, and does not constantly fall asleep shortly after being put on the breast)
• Your breasts feel softer after feeds (which doesn’t always happen)

Common Misconceptions That Mom is Not Producing Enough:

Some moms feel like they are not producing enough milk based on some inaccurate information, and may feel the need to switch to formula. The following are NOT signs that you are not producing enough milk:

• Feeling like your breasts are soft before feeds – before feeds, some milk is stored in the mammary glands but some is also produced during feeds. How full your breasts are is not a good sign of how much milk your baby will receive. Once a mom’s milk supply is established a couple of weeks postpartum, it is normal to not feel engorgement or fullness of the breasts
• You are unable to pump large amounts of milk – babies are much more efficient at removing milk from the breast than breast pumps. The amount taken during a pumping session is not a good indication of how much milk you are producing
• Baby is wanting to feed hourly – it is normal for babies to feed 8-12 times in 24 hours, which means, depending on how long their nursing sessions are, your baby could be showing hunger cues every hour after a feeding finishes. This is especially true when your baby is cluster feeding
• You are unable to express colostrum or breast milk from your nipple – some moms can express milk easily from their breasts, while others cannot. This is not a good indication of whether baby will be able to get enough milk

How Do I Know if Baby is Finished a Feeding?

Babies normally will display a few signs that they are full. They may:

• Fall asleep at the breast or appear very relaxed with minimal sucking. This is only a good sign if your baby shows signs of having a good feed prior to becoming sleepy, including strong and steady jaw thrusts and audible swallowing. Babies should be fed on demand and each baby is different in their length of feeds, but generally, a newborn should have strong jaw thrusts and audible swallowing for at least a couple of minutes per feed in order to get both the foremilk (watery, given first) and hindmilk (fatty, given later in feed)
• Take themselves off of the breast and appear content, no longer displaying signs of hunger
• Refuse to take the second breast or be re-latched to the first when they come off

When Should We Get Help?

•  Your baby won’t wake up for feeds at least 8 times in 24 hours
• Your Baby is not wetting enough diapers or there is “brick dust” in the urine. A reddish tinge in your baby’s diaper is usually not blood, but rather the presence of uric acid crystals, which can be due to dehydration. Brick dust can be quite common in the first couple of days of life as babies can lose up to 10% of their weight, but it can also be a sign that your baby has lost too much weight. Take a picture or keep the diaper so you can show your health provider
• Baby has more yellowing of their skin and whites of their eyes than when they were last seen by her health provider. This could indicate jaundice and should be seen immediately
• You are concerned that your baby may not be gaining weight
• You are concerned with how your baby is acting (ie. limp arms and legs, not having periods of alertness, or she is excessively irritable)
• Your nipples are cracked and bleeding, or there are signs of possible infection (pain, swelling, redness, oozing)
• You don’t feel that your baby is latching on to the breast properly, or if it hurts to breastfeed

Breastfeeding Basics

For additional information, you can view my other posts about breastfeeding tips and tricks, and breastfeeding complications and solutions.

If your baby is alert and active, breastfeeding should be done on demand. If your baby is sleepy or there are health concerns you may need to wake them for feedings and monitor them more closely.

Newborn babies should be breastfed 8-12 x/day. If you are concerned about your baby’s feeding, you can time their feedings from the beginning of one to the beginning of the next. For example, if you fed baby at 08:00 AM for 45 minutes, and baby wants to feed again at 10:00 AM, your baby is feeding every two hours, not every hour and 15 minutes. The frequency and time taken for feeds should reduce as your baby becomes more efficient. In the beginning, you really will feel like your baby feeds all the time!

keep a log of the frequency of feeds, alert periods, and wet/dirty diapers. It will prove to be very helpful when you are learning to breastfeed and are sleep deprived, especially when the nurse asks how many wet diapers your baby has had in the past 24 hours and you don’t even know what time it is!

During the first week, your baby should have at least one wet diaper for each day of age. After day five, your baby should have six or more wet diapers per day. How many wet diapers your baby has is a good indication of how much milk they are getting.

Baby’s stools should change from dark and tarry meconium to light brown transitional stools, and then to the yellow, seedy stools often seen in breastfed infants (sometimes they can also. Meconium should start becoming lighter by day three. This is a good indication that your baby is getting enough to eat.

After birth, babies can lose up to 10% of their weight without any concern.

Most babies gain their birth weight back by two weeks of age.

When a baby is breastfeeding, you can tell she is swallowing by listening for puffs of air. It is normal for a baby to stop sucking for short periods of time before she swallows. These inactive periods are necessary and do not mean that baby is done nursing or that they should be taken off the breast.

There should be no clicking noises. Clicking noises suggest there is not a tight seal to your baby’s latch, which can cause your baby to become dehydrated or excessively gassy.

Save your nipple when taking your baby off your breast by putting a pinky finger in baby’s mouth to remove suction.

Your baby should be allowed to finish their feeding on one breast before starting on the next. Make sure to burp your baby between switching breasts and after feeds. Breastfed babies are not as gassy as formula fed but still need to be burped. Try burping for a couple of minutes before proceeding. Sleeping babies tend to be harder to burp than when they are awake.

Use a lanolin cream in between feeds to help prevent your nipple pain, cracks, and bleeding. It is safe for your baby to ingest and you can get it at any store that sells baby supplies.

Babies often cluster feed in the evenings (hourly), before a long sleep period, and during growth spurts. Growth spurts happen at roughly 3 weeks, 6 weeks, 3 months, and 6 months. This can vary from baby to baby. It is best not to fight with your baby during these periods (you won’t win!) but rather to just hunker down on the couch and feed your baby until their tummy’s content.

Resources

Book in with me for an online breastfeeding session.

International Breastfeeding Center (2008). Is My Baby Getting Enough? http://www.nbci.ca/index.php?option=com_content&id=23:is-my-baby-getting-enough-milk&Itemid=17

La Leche League International (2006). How Can I Tell That My Baby is Getting Enough Milk? http://www.llli.org/faq/enough.html

Kelly Mom (1996-2016). Is Baby Getting Enough Milk? http://kellymom.com/bf/got-milk/supply-worries/enough-milk/