One of the biggest worries a nursing mother may have is low milk supply. Consider the following scenarios:
Nursing is going well but suddenly the baby seems unsatisfied and wants to nurse all the time. The mother’s breasts feel less full, particularly in the evening. Is the mother’s supply low?
In the early days a nursing mother’s breasts may feel full or even engorged. If a mother has oversupply issues, this feeling of fullness may be constant and she may experience more than one episode of engorgement. If that feeling of fullness is suddenly gone, is the mother’s milk supply low?
In the first scenario, the baby is likely going through a growth spurt. Growth spurts typically occur around three weeks, six weeks and three months of age. During these times of rapid growth, the baby wants to nurse more often than usual. A mother may worry that the baby is not getting satisfied at the breast, but that more frequent nursing is simply the baby’s way of increasing the mother’s milk supply. The more the baby “demands” the more the mother will “supply.” It’s not a sign that the baby is not getting enough milk or needs supplementation. The mother’s breasts may feel less full but they are continually producing milk and the rate of milk production actually increases when the breasts are less full and slows as the breasts fill.
What about the mother who always felt full but suddenly does not? This mother’s milk supply may be regulating. That means that instead of tending to over-produce, the principle of supply and demand is starting to regulate the production of milk. It can take 6-12 weeks or more after the birth for the milk supply to regulate. While it can be very disconcerting for a mother when her breasts feel less full suddenly, it can actually be a blessing. Oversupply can lead to plugged ducts and mastitis. It can also give the baby problems with a foremilk/hindmilk imbalance. So it’s a good thing if the milk supply regulates and the mother can rest assured that the wheels of supply and demand are functioning.
My baby seemed so unsatisfied that I gave him a bottle and he sucked it right down!
If a mother is worried that her baby is not getting enough milk and she offers a bottle of artificial baby milk, the baby may well take it whether the baby needs it or not. The flow from a baby bottle is much faster. Gravity does all the work and the baby does not have to suck hard to get the fluid out. Thus a baby may take in more than the baby needs (and may consequently spit up more). If the baby then goes longer in between feedings (and thus appears more “satisfied”) that may be because it’s harder for the baby to digest artificial milk. Breast milk is the perfect baby food and is easy for the baby’s undeveloped digestive system to process.
So what are signs that the baby is getting enough breast milk and supplementation is not necessary? The best indicators are: adequate wet and poopy diapers, weight gain and lack of lethargy. For a baby six weeks and younger, it’s a good sign if the baby has at least five wet disposable diapers or six wet cloth diapers per day (one to two is normal in the first few days before the mother’s milk comes in). Look for three to four bowel movements the size of a quarter (once the baby passes the meconium and starts having yellowish breast milk poop). Older babies may start to have fewer bowel movements–even as little as one per week is normal as long as the baby continues to gain weight normally.
If the baby does not have enough wet and poopy diapers, weight gain is a concern, or the baby seems lethargic, consult a doctor. If the doctor suggest supplementation, try to troubleshoot any breastfeeding concerns, discuss ways to increase milk supply and consider supplementing with expressed breast milk.