Is my baby getting enough breast milk?
This is a very common question, especially when you first start breast feeding or you are a first-time mum. Although it is impossible to tell you how much a baby is drinking, there are positive signs which can reassure you that all is well. Poor feeding could be a sign that your baby is unwell.
- Baby not waking up on their own or you are unable to wake your baby up for feeds
- Baby alert but breathing too fast to feed
- Is pale, mottled and feels abnormally cold to touch
- Has pauses in their breathing lasting more than 10 seconds, is grunting or has blue lips
- Is stiff or rigid or makes repeated, jerky movements of arms or legs that doesn't stop when you hold them (a fit or seizure)
- Is extremely agitated (crying inconsolably despite distraction), confused, floppy or very lethargic (difficult to wake)
- Has a rash that does not disappear with pressure (the ‘Glass Test’)
- Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
- Change in established pattern of feeding - feeding much less frequently or for a much shorter period of time
- Failing to gain weight adequately, static weight or losing weight (most babies lose some weight in the first two weeks of life)
- Less wet nappies than before (in the first 48 hours, your baby is likely to have only two or three wet nappies. Wet nappies should become more frequent, with at least six every 24 hours from day five onwards). Tip: It can be hard to tell if disposable nappies are wet. To get an idea, take a nappy and add two to four tablespoons of water - this will give you a better idea of what to look and feel for.
- Baby seems drowsy (increasingly sleepy) or irritable (unable to settle despite distraction/feeding)
You need to contact a doctor or nurse today.
Please call your GP surgery (or call NHS 111 if your GP surgery is closed).
We recognise that during the current COVID-19 crisis, at peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest ED.
- Baby wakes up for feeds on its own and sleeps for 3-4hrs after a feed. In the early weeks, babies may sleep for less than 3 hours; this is normal.
- Baby settles following a feed
- Baby has a good strong suck and feeds in a calm relaxed way
- At the end of the feed, your breasts feel softer and baby is content and comes off the breast on their own
- Baby gains weight steadily after the first two weeks (it's normal for babies to lose some of their birth weight in the first two weeks)
- At the beginning, your baby will produce a black tar-like poo called meconium. After about five or six days, they should pass at least two soft yellow poos. Breastfed babies' poo is runny and doesn't smell.
- Additional advice is also available to young families for coping with crying of well babies – click here.
Continue providing your child’s care at home. If you are still concerned about your child contact your Health Visitor or GP. Call NHS 111 – dial 111 when your GP surgery is closed.
Is my baby latching on properly?
Breast feeding is a tricky skill that both mum and babies need to learn together. It is very common for women to experience some discomfort at the beginning of a feed whilst your breasts/nipples adapt to feeding regularly.
If you and your baby are comfortable with breast feeding, then you are doing fine. Signs that the baby is latching well to the breast include your baby holding a large mouthful of the breast, taking long sucks with pauses from time to time and coming off the breast feeling content at the end of a feed. Your breast or nipple should not feel sore afterwards.
Occasionally, a baby may be unable to open their mouth wide enough to latch on to the breast properly because they have a tongue tie. Click here for more information - NHS Tongue-Tie Advice.
Thing that can affect your milk supply
Generally speaking, the more your baby feeds - the more breast milk you will produce. However, if you're worried that your baby isn't getting enough milk, talk to your midwife, health visitor or a breast feeding specialist as soon as possible. With their help and advice, you'll be able to identify the problem and find a solution.
- Sore nipples
- Feeding by the clock
- Topping up with formula milk
- Tongue tie
- Being apart from your baby
How to increase you breast milk?
If you feel you need to boost your milk supply, there are a few ways that you can do this:
- Try not to give your baby anything other than breast milk. The more you breast feed your baby, the more you'll produce.
- If you want to give your baby a dummy, try to wait a few weeks - or until you are both comfortable and confident with breastfeeding.
- Let your baby feed when they want to, for as long as they need to. Don't clock watch.
- When you're feeding, offer both breasts - remember to switch breasts each feed.
- Holding your baby close, especially skin-to-skin, will help increase your milk supply.
- Avoid weaning until your baby is ready - this is usually around six months.
If you are doing all these things already but you're still concerned you have a low milk supply, ask your midwife to refer you to a breast feeding specialist. Feeding specialists are very understanding and will be able to have a look at how your baby's feeding and offer practical advice, help and support.
Expressing and storing breast milk
Expressing milk means extracting milk out of your breasts (using a breast pump or hand expressing) so you can store it and feed it to your baby at a later time.
There are some really good reasons why you might need to feed your baby expressed breast milk:
- If your baby is premature, they may not be able to feed at the breast but could still get much of the goodness through receiving expressed breast milk.
- Returning to work or study, someone else can feed them your expressed breast milk.
- If your breasts feel uncomfortably full (engorged) or your baby can't latch on properly for some reason.
However, if you do feed your baby expressed breast milk, it is important you adhere to strict advice with regards to hygiene and methods involved. Here is the link to all you need know about Expressing Breast Milk and storing it.
What you should and shouldn't eat if you're breast feeding:
And more importantly, here is some information on food that you should be avoiding where possible.
Alcohol and breastfeeding:
While it's safer not to drink any alcohol whilst breast feeding, an occasional alcoholic drink (i.e. 1 or 2 units once or twice a week) is unlikely to harm your baby.
Should I take vitamins during breast feeding?
If you are breast feeding, a balanced diet will provide most vitamins you need. However, you should consider a vitamin D supplement due to the lack of sunshine most of the year in the UK.
Breast feeding support:
There is a lot of help and support available for breastfeeding in the community close to where you live. You can talk to your midwife, health visitor or contact any of the breast feeding support services listed below:
- Breast Feeding Friend from Start4Life on Amazon Alexa
- Breast Feeding Friend Chatbot on Facebook Messenger
- The Breastfeeding Network
- La Lech League offers mother-to-mother breast feeding support
- One to one support from midwives, health visitors and locally trained volunteer mothers. There are usually drop-in clinics held by health visitors for new mums and local breast feeding support groups (click here for more information on local services)
- Baby Café is a network of breastfeeding drop-ins. you can find your nearest drop-in on the website by entering your post code.
- National Breast Feeding Helpline 03001000212 (9:30am to 9:30pm daily)
- Association of Breast Feeding Mothers - Telephone: 03003305453
This guidance has been reviewed and adapted by healthcare professionals across Frimley with consent from the Hampshire development groups.