How to know whether I am producing sufficient breast milk?

Question

I have to breast feed my 9 day old for 1 hour. That is frustrating for me, and doesn't satisfy her too. Then I have to feed her about 60 ml formula.

How would I know whether I am producing sufficient breast milk or not? Or the problem is somewhere else?

How to know whether I am producing sufficient breast milk?

You mean "for 1 hour" in a row or during the day?

1 hour in a row. That's the reason of frustration!

And 60ml formula, at once or during the day? just to make sure

60ml formula at once.

In morning (6:00 AM) I feed her breast milk (around 25 minutes), then she sleeps for about 2 hours in a row. Then I feed her 60ml formula (at once) and she sleeps for 4 hours in a row (unless she's wet). Then again I feed her breast milk (1 hour in a row) and try to make her sleep. At this time I often have to give her formula because she keeps on making sucking signs with her lips after I take my breasts out of her mouth and remains active even when I swaddle her when I put her to sleep.

Answer 1

Your body will (except in very rare cases) produce as much milk as your baby needs. There are several ways of messing with this supply and demand system, though, and one of them is by supplementing with formula. You see, once feeding has been established, your breast will produce as much milk as you empty out of it(empty is not really the right word here, as a milk-producing breast can never be truly empty of milk as production is continuous). This means that the more milk you take out, the more you'll produce. But, if you use formula to supplement, the process to produce more milk is never triggered, as you always take the same amount out.

I would try cutting out the formula completely and feed her for shorter periods, but more frequently, say every two hours from when she wakes up in the morning until you put her down for the night (however, unless she has problems with weight gain, though, I would not try to wake her up if she's sleeping just to keep this schedule).

About your one-hour feeding sessions, are you sure that your baby is actually feeding for the entire hour (can you hear her swallowing throughout the feeding session?)? It sounds like she's just using your breast for comfort (which is fine, so long as you're both comfortable with it).

It also seems like your baby is sleeping a lot, and maybe the problem is that she's not really all that tired when you try to put her down after her four hour nap. Try activating her (play little games, sing, or bounce her on your lap for a bit) for about 30-40 minutes before putting her back down again. If your baby is not tired, it's possible that she's just using the hour long feed as a way of entertaining herself.

This all being said, before taking any advice from the Internet, I would suggest seeking the help of a professional lactation consultant to check that your baby has a good latch and that she doesn't have tongue tie (which could stop her from feeding efficiently), just to rule out any technical problems the two of you might have.

Good luck!

Answer 2

You should be nursing 10-12 times per day in order to make sure your body produces enough milk (the more you nurse, the more it produces) and also to prevent engorgement. Aim for feeding about every 2 hours during the day and every 4 hours at night.

You will know if she is taking enough in by how much is coming out the other end. By day 9, a newborn should soil 8-10 diapers a day. After day four, the baby should be done excreting meconium (dark green product of pre-birth ingestion), and stools should be loose and yellow. Stools are usually quite small, and may be seedy or curdy, and there should be several during the day. Urination should be 3-4 tbs 5-6 times a day. If you pour 3 tbsp of water into a clean diaper, you will know how heavy it should feel.

Call your doctor if:

• Baby is having no wet or dirty diapers
• Baby has dark colored urine after day 3 (should be pale yellow to clear)
• Baby has dark colored stools after day 4 (should be mustard yellow, with no meconium)
• Baby has fewer wet/soiled diapers or nurses less frequently than the goals listed here
• Mom has symptoms of mastitis (sore breast with fever, chills, flu-like aching)

The number of feedings and diapers change as baby ages (a 2-6 week old is different than a 9 day old). For more information see the link below.

Source: Kelly Bonyata, BS, IBCLC (Lactation consultant)

Answer 3

It is possible to know how much milk your child is getting: Weigh her on a sufficiently-precise scale, feed her, and then weigh her again. The difference between the two weights is the amount of milk she received. Each 0.063 lbs difference equals 1 oz of milk consumed. (In practice, an accurate measurement can be difficult due to squirminess. You might end up trying to take an average.) She doesn't need to be undressed or diaper-changed... We only care about the weight difference. (It is also interesting to compare this number against the pumped amounts.)

This doesn't necessarily tell you how much she needs, although some references say that babies 1-6 months old drink on average about 25 oz per day.

All that said: The best advice is probably to see an actual lactation consultant soon. They probably have the requisite scales, and their advice is worth it when trying to figure out go-forward plans.

Answer 4

Thanks for the clarifications...

Well, first of all, a newborn, at this age, should be getting more or less 60ml each time, on average. Some babies will take more, some less, it'll depend a lot on her weight when she was born, etc.

Producing milk is something not so consistent among mothers. My wife just produce enough milk after 5 days, some of my friends could not produce enought ever (and had very big babies).

One thing to observe is if the child is developing correctly, and eating enough. This site have some clues about it, the most relevant (I think) is how wet the nappies: does she produces about 8 wet nappies each day? Some heavier, some lighter?

Another think to consider is your alimentation: are you drinking enought water, teas? Liquids are important to produce milk.

And another point: don't expect to produce milk so easily, let's say. Human body is a strange thing, and in general you'll produce more milk as the baby drinks more, and even a crying baby is kind of stimulating to milk prodution (at least our doctor said). Also take care of your nipples, they'll become more sensitive, can even bleedy, as the baby learns to suck harder and grows up.

Finally, making the same movement with the mouth, even when not being feed, is normal, since it's one of the few movements she knows how to do (and keep practicing). And while being feed, she'll be tired too, so some times she'll take longer (and slower) to eat.

When she is hungry, she'll cry...