What do you mean the breastfeeding breast doesn’t come with a gauge? How will I know how much milk my baby is getting? In our modern, data-driven society, “trusting” the art of breastfeeding can be extremely frustrating. We have grown up as the rubric generation – getting points for every little project or poster. Now we are expected to just trust our baby’s growth, well-being, and satiety, with no numbers or assessment?
While this is often how breastfeeding feels, especially at the beginning, it is important to know the signs of success and when to call for help. Though breasts don't grow a gauge to measure milk consumed during pregnancy, there are definitely signs that indicate adequate milk transfer. Plus, as providers (IBCLCs, pediatricians, OB-GYNS, etc.), we have established a few tools and metrics to assess milk transfer and ultimately exclusive breastfeeding success.
6 Signs Baby is Getting Milk When Feeding at the Breast:
Your breasts seem less full. For some women, this is dramatic – from engorged to relaxed. For others, they cannot feel as much of a difference between feeds.
Your baby seems satisfied. Your baby is no longer crying or showing hunger cues for 2+ hours. Your baby sleeps comfortably.
You see milk in your baby's mouth. This can be especially encouraging at the beginning, seeing milk on the tongue or dribbling out in a sleepy smile.
Regular swallowing is noted during a feed. Once a letdown occurs, your baby should suck and swallow in a regular pattern. It will slow as they fill up and less swallowing will occur. If they are full and falling asleep, they may have more of a quivering or quick sucking pattern. This is often for comfort.
Your baby is growing! This is a huge priority for your pediatric provider. They will monitor your baby’s growth and growth curve or pattern. In between appointments, you can monitor diaper and clothing fit to check for growth at home. As babies get bigger, they will need the next size up and start to develop some new rolls.
Regular wet and poopy diapers. After the first week or so, breastfed babies should have at least 6 wet diapers a day. Poops should be regular, and typically with breastfed babies they are loose, yellow, and seedy. With newborns, we expect at least 4 teaspoons of stool daily, but after that, there are different stooling patterns depending on the baby's age, so discuss this further with your peds provider if you have questions.
What is a weighted feed? Should I be doing weighted feeds?
A weighted feed is a tool used to see how much milk a baby is actually taking in at the breast. They are typically done by a healthcare provider/IBCLC in a medical setting or during a formal assessment or consultation. Weighted feeds are useful tools, but do not need to be done for every baby or at every feed. If your baby is showing signs of satiety and growing well, you most likely do not need a weighted feed. The weighted feed is used when there are concerns that breastfeeding is not working, or for reassurance. The scale used for weights during a weighted feed should be accurate to 1 gram and not your typical bathroom scale. Though they can be purchased online, they are often expensive and can be rented if deemed necessary. Here is an example of one for purchase. Some families that are struggling with milk transfer at the breast, slow weight gain in their baby, or have other medical concerns will opt to get one. The IBCLCs and medical providers doing weight feeds should have a device similar to this that will accurately check transfer to 1 gram (1 gram is equal to 1 milliliter so it translates well for fluid intake assessment).
How to do a weighted feed:
Step 1: Weigh the baby before the feed and record the weight. Make sure the baby has a clean or non-poopy diaper and that they are wearing the clothes they will keep on the whole time. It is also fine to strip them down to just a diaper and feed skin to skin to avoid any weight confusion.
Step 2: Feed the baby! This can be a complete/full feed or feeding for a set time, say 10-15 mins. The goal is to assess the baby’s intake.
Step 3: Weigh the baby again and record the weight. Use the same clothes, diaper, etc. from the previous weight to stay consistent.
Step 4: Calculate the difference in weights. The weight gained in the second feed is roughly how much the baby consumed. Remember that 1 gram is equal to 1 milliliter and that 30 ml is 1 ounce.
Step 5: Discuss consumption vs expectations for age and size. Is the baby eating appropriately for age in the given timeframe? Then you can strategize with the provider about what needs to be changed or feel some reassurance that breastfeeding is working!
With weighted feeds and monitoring for all the signs of successful transfer, it should still be noted that nothing should replace regular appointments and assessments by your pediatric provider. They will be able to monitor your baby's growth on the standardized growth curve, in addition to checking for normal development milestones and keeping the baby up to date on their vaccines. In the meantime and between visits though, trust the signs and trust yourself. Babies have been breastfeeding since the beginning of time. They have been growing and thriving even without a gauge. You got this modern mama, go out there and make breastfeeding work for you!
***Items listed in this article use affiliate links to route to the products available for purchase. Modern Guide to Breastfeeding has no direct sponsorship or advertising relationship with these brands, but rather we include these links as examples of different items we have seen to be useful for breastfeeding families. While helpful for some, we do not endorse their necessity for breastfeeding success or necessarily favor any of these products over more cost-effective alternatives. Any revenue generated from purchases via these links will support Modern Guide to Breastfeeding’s mission of providing evidence-based breastfeeding education.
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