Signs of Milk Sufficiency

First 3-4 days:

Baby may want to “cluster nurse”-- nurse almost every hour for several times, then sleep 4-6 hours to recover from birth (baby is also tired). Try to wake baby after 3 hours if s/he isn’t stirring (for first week)
May cry for many reasons other than “hunger”, don’t give formula just because baby cries, ask nurse to help decide if there is any other reason for crying or any reason baby might need formula (low blood sugar, prematurity, jaundice, etc.)
You may or may not feel milk “letdown”, colostrum is very small in amount (teaspoons) but very rich in exactly what newborn needs
May feel uterus contracting and increased cramping/bleeding while nursing, also thirst
By 24 hours of age, baby should pee and poop once at least, then increase to number of wet diapers per day = age in days plus one extra, till day 5, and poop at least once per day
By day 3 or 4 you should see some changes in the breasts as milk replaces the colostrum- and in the stools- more yellow and less sticky
Expect weight loss for up to 3-4 days, by one week of age MAY lose up to 7% of birth weight- this is normal

Later signs of adequate milk supply/intake (for breast or bottle feeding)—

Poops at least once per day OR has soft, larger stools less frequently
Wets at least 6 X per day after first week
Baby quits losing weight by one week of age, gets back up to birth weight by 2 weeks of age
Then starts to gain 4-8 ounces per week until birth weight is doubled around 6 months of age (on average)
Baby gradually outgrows clothes and diapers
Baby looks more contented after feedings, relaxed and falls asleep or “falls off” the breast or bottle when full
Baby sleeps some between feedings
Don’t expect sleep through the night for at least 6 weeks
Babies cry for many reasons other than hunger, you will learn to distinguish the cries

For breastfeeding after first 3-4 days-

Baby nurses more steadily now, you may hear swallowing and gulping
You can see milk around the lips or in spit up
Breasts feel somewhat fuller before feeding, then soft after
Expect “days of frequency” when baby wants to nurse more frequently, in preparation for a growth spurt when s/he will need more milk (can be around 2 weeks, 6 weeks, 2-3 months, 6 months) VERY IMPORTANT TO NURSE MORE OFTEN FOR 1-2 DAYS THEN!!
SOMETIMES you feel milk let down (not always), milk may flow from the other breast while nursing

EARLY FEEDING CUES- don’t wait till baby crying if you can catch them earlier!

Baby is more alert, not yet fussing and crying
Smacking lips, sucking fingers, “fidgeting”
Rooting around and “looking for” the breast
Eyes fluttering (may still be closed)
Cooing or sighing noises
Bringing hands toward face/mouth

NOTE: Baby may NOT give these cues if it is preterm (born before 37 weeks) or small (less than 5 ½ pounds), or sick. These babies should be roused from sleep and put to breast every few hours till adequate weight gain is assured and the milk is flowing well. If they do not nurse adequately, a hospital grade breast pump may be needed. Call for help!