Help Me, Helen! How Do I Know If My Baby’s Getting Enough Milk? When Should I Worry?

Helen Borg is a senior midwife and infant feeding specialist who heads up the drop-in breastfeeding clinic at Mater Dei hospital. As mentioned in the series intro, Helen will cover common issues that can arise when feeding your newborn, giving professional advice and reassurance to help make your journey run smooth.

baby weight gain
How do I know if my baby’s getting enough milk?

The surest sign of whether your baby is getting enough milk is the growth. So, if you have a baby that’s growing well but still seems very demanding when it comes to feeding, then he’s getting enough milk, it’s just that he prefers frequent feeds. Frequent feeding is just a feeding style, it’s nothing to worry about. However, if the weight isn’t picking up as it should, then yes, you will need to intervene.

How you intervene would depend on what you want out of it. If you want to continue to breastfeed, there are ways where you can combine both breast and bottle. It’s about finding the right path for you.

People tend to panic when a baby isn’t feeding well and will do replacement feeding to try and remedy it. So, they will give baby a full bottle feed after a breast feed, and use breastfeeding as a sort of accessory feed. When this happens, I will then see a baby that has been struggling with weight suddenly come to me after two days with a 300g weight gain.

So all weight gain is good… right?breast or bottle

Not quite. It’s important to understand that sudden weight gain is not good either. We all know underfeeding causes malnutrition, but over feeding is also a form of malnutrition, and we don’t want to solve one problem by creating another.

The other thing you have to remember is that when you have had a period of undernutrition, if you then try to correct that with overnutrition, you risk your baby developing weight issues. This is because when the human body hasn’t been getting enough to eat, when it finally does get food, it’s designed to store it. By over nourishing, you’re giving your baby a lot to lay down as fat.

Ideally, we need to find the right balance between the two. I prefer to start with small supplements, and then see the baby a few days later. If that’s not producing the right effect, then I’ll increase it slowly until there’s adequate weight gain. If done correctly, this weight gain won’t happen in one big jump, rather it will be a small, gradual increase at first, and then after a week or so you start getting bigger jumps showing good catch up growth.

How often should I feed my baby?

how often feed babyWhen it comes to breast or bottle feeding, many recommend three or four hours between feeding, however it’s very important to note that most babies will not do this on the dot. They don’t know how to tell time, so you should go on number of feeds to understand if your baby is getting enough milk, and that’s a minimum of six and maximum of eight feeds per 24 hours.

There may be a time of day when they baby wants to drink after two hours, there might a time when he wants to drink after four hours. Nutrition isn’t based on 12 hours, it’s based on 24 hours, and if he gets enough calories in those 24 hours, he will gain weight.

So, if he doesn’t wake up for a feed until after four and a half hours, it’s not a case of panic and take him to hospital, he’s just having a good sleep. Enjoy the peace and quiet!

All research in this area recommends letting your baby take the lead when it comes to feeding, i.e. he’ll feed when he’s hungry. So, feed on demand, but make sure the baby is demanding.

When it comes to spare equipment for new mums, the breastfeeding clinic relies on donations, so if you have any of the following that you no longer need, you can drop them off at the clinic where they will be gratefully received.

-Breast pumps
-Nipple shields

-Milk storage bags or containers
-Breast pads

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