How to tell if you have an adequate supply

Is baby gaining weight?

  • If your baby is gaining weight with breastfeeding alone then your supply is likely to be fine

How many wet nappies is baby having?

  • Babies should have 5 heavily wet nappies per day
  • The urine should be clear/ pale
  • The urine shouldn’t have a strong smell or odour

How many dirty nappies

  • Days 1-3 baby passes meconium
  • Days 3-5 stools transition to pasty mustard colour. It is a good sign that an exclusively breastfed baby is getting enough if on days 3-4 your baby’s poo has started to transition from meconium to a mustard colour.
  • If by days 4-5 the baby’s poo remains black or brown in colour this may be a sign the baby is not getting enough milk
  • Baby may have 1-4 bowel movements from birth to 4-5 weeks of age. It is not uncommon for an exclusively breastfed baby’s stool pattern to change to once per week or (like my baby) every 10 days- this does not mean the baby is constipated.

Signs that do not necessarily mean you have a low supply

Baby is breastfeeding frequently

  • It takes a baby an average of 90 minutes to digest a full belly of breast milk compared to 3 hours for formula. This is because the nutrient rich breastmilk is specific to your baby’s individual needs and is easily absorbed where as the generic formula is harder for the baby to break down.
  • Babies also have a strong urge to suck and feel most secure when in direct contact with Mum. This often leads to frequent breastfeeding which is completely normal and helps the baby feel protected and reassured
  • ‘My baby wants to feed for longer and more frequently. Is he getting enough?’ This one of the most common questions I am asked as a lactation consultant. Babies go through growth spurts (the first usually being around 6 weeks of age) and starts nursing more frequently in order to increase your supply. It is important not to offer any supplement feeds as this may have a detrimental impact on supply

Your baby is fussy in the late afternoon/ early evenings

  • This is the time when most women’s milk supply is at it’s lowest. You may notice your baby tends to cluster feed during this time. Remember breasts are like rivers not lakes so allowing the baby to breastfeed frequently during this time will ensure baby is stimulating your supply and able to get enough milk.
  • Your baby may be tanking up on breast milk ready to settle down for a long period of sleep. It is usually after a cluster-feeding period that the baby will have its longest period of sleep.
  • This is also considering the ‘witching hour’ where most babies often become fussy due to over stimulation or from becoming over tired. During this time it’s important to help settle your baby and make them feel secure through direct contact with Mum and allowing unrestricted breastfeeding.
  • Some babies are fussy all the time and there may be a reason for the (reflux or colic) or there might not be a reason. It is important to get your baby checked by your doctor if you are concerned there may be an underlying reason. Often babies grow out of being fussy by 12-16 weeks old

Your baby isn’t breastfeeding for as long

  • As babies get older they are able to drain the breast quicker and more efficiently

My breasts don’t leak milk or have stopped leaking

  • Some women do not leak much and some leak constantly
  • Leaking does not indicate you have an adequate supply

My breasts feel softer

  • This is normal. You will likely experience some engorgement when your milk first comes in and this will usually subside after a few days, leaving your breasts feel softer and less full.

I don’t get any milk when I pump

  • A baby with correct position and attachment will drain the breast better than a pump
  • Some women will only experience stimulation by the baby and are unable to get a let down when using a breast pump
  • Breast pump quality differs greatly between different manufacturers so it may be the breast pump is not the right fit or poor quality to stimulate.

What to do if you have a low supply

  • Consult a Lactation Consultant for assessment
  • Encourage unrestricted breastfeeding
  • Encourage as much skin-to-skin time as possible
  • Consider expressing using a good quality breast pump (Medela or Spektra)
    • Aim to express 8 times in 24 hour period for at least 48 hours (always after a breastfeed)
    • Ensure pump flanges fit your breast (nipple should not be rubbing on the flange)
    • Preferably pump using a double pump (stimulating both breasts at the same time)
    • Pump for 15 minutes each time
    • If milk supply is still low after expressing for 48 hours continue frequent expressing and also consider herbal remedies and/or Domperidone
  • If milk supply is still low after expressing for 48 hours continue frequent expressing and also consider herbal remedies and/or Domperidone
  • Herbal remedies
    • Fenugreek + blessed thistle
  • Domperidone
    • Seek advice from your doctor or medical professional to ensure this medication is appropriate
    • Usual dose 10mg 3x per day. However please take only as your doctor has advised.
    • ○Has been linked to cardiac issues when taken in large quantities

Resources

Australian Breastfeeding Association

https://www.breastfeeding.asn.au/bf-info/common-concerns%E2%80%93mum/supply

Breastfeeding Inc- Protocol to Manage Breastmilk Intake

https://www.breastfeedinginc.ca/informations/protocol-to-manage-breastmilk-intake/

KellyMom parenting and breastfeeding

https://kellymom.com/hot-topics/low-supply/

The Royal Women’s Hospital

https://www.thewomens.org.au/health-information/breastfeeding/breastfeeding-problems/low-milk-supply/