Poor milk supply | breastfedbabies

Breastfeeding mother and babyAlmost all women can produce enough milk to breastfeed. The best way to ensure that your baby is getting enough milk is to make sure that he is well positioned and attached at the breast and to feed your baby as often as he seems hungry or when he needs comforted (responsive feeding).

Unfortunately some breastfeeding mothers stop breastfeeding before they want to because they think they don’t have enough breastmilk.

Things that might lead you to think your baby is not getting enough:

  • your baby is unsettled and seems hungry after a breastfeed
  • your baby wants to feed often with short spaces between feeds
  • your breasts are softer than they were before

These signs do not mean your baby isn’t getting enough milk.

Signs that you and your baby are doing fine:

  • your baby appears content and satisfied after most feeds
  • your baby manages to attach to the breast without a fuss at most feeds
  • your baby is healthy, and gaining weight satisfactorily
  • you feel confident, and your breasts and nipples aren’t sore
  • your baby is having enough wet and dirty nappies 

Nappies what to expect

With the latest disposable nappies it may be hard to tell if they are wet, so to get an idea if there is enough urine, take a fresh nappy and add two to four tablespoons of water. This will give you an idea of how heavy a nappy should be.

On days one and two, your baby will have two or more wet nappies and one or more dirty nappies of meconium (the first dark black poo). Many babies pass ‘urates’, a dark pink/red substance, in the first couple of days. This is not a problem at this stage, but if your baby continues to pass urates beyond the first couple of days you should tell your midwife as this may be a sign that your baby is not getting enough milk.

On days three and four, expect three or more wet nappies and two or more dirty green nappies.

After day five, your baby should have at least six heavy wet nappies daily and by days five and six you will see a soft yellow stool at least one to three or more times every day. Later, it’s normal for bowel movement frequency to change; after 4 weeks or so of age some babies may only have a dirty nappy once a week, and as long as your baby seems happy and comfortable, there’s no need for concern. Breastfed-only babies don’t usually become constipated.

When to ask for help

The two most reliable signs that your baby is not getting enough milk are:

  • your baby is passing small amounts of concentrated urine and has fewer dirty nappies than expected (see above)
  • your baby has slow or poor weight gain

Usual patterns of weight gain in breastfed babies

All babies lose weight in the early days after birth. They are born with supplies of fat and fluids which keep them going for the first few days. They then usually take a few weeks to get back to their birth weight.

After your baby regains his birth weight, he should start to put on between 125g-200g a week for the first four months. Then this slows down after four months to 50g-150g a week and slows again after 6 months to 25g-75g a week.

If your baby’s weight gain seems slow, ask your midwife or health visitor to do a feeding assessment. They can make sure your baby is well positioned and attached, and check if they think he’s feeding often enough.

A breastfeeding counsellor will also be able to support you and to provide important information on how to increase your milk supply. Visit our support groups section for contact numbers.

Increasing your milk supply

  • Make sure your baby is correctly positioned and attached – click here to go to our positioning and attachment section.
  • Let your baby feed as often and as long as he wants.
  • If you think your baby is not feeding enough, offer more breastfeeds.
  • Feed from both breasts at each breastfeed.
  • Stop your baby using a dummy if he has been.
  • Express breastmilk after feeding (if your baby is sleepy and not feeding well).
  • Some babies can be quite sleepy and reluctant to feed, and this may be what has caused a problem with milk supply.

Encouraging a sleepy baby to breastfeed

  • Keep your baby close by you at all times.
  • Place your baby in skin contact with you.
  • Feed your baby with just a nappy on to maximise skin contact.
  • Offer breastfeeds as soon as he wakes up and starts to shows signs of wanting to feed, such as sucking hands and moving his head from side to side – don’t wait until he cries.
  • Tempt him to feed by hand expressing a little breastmilk and offering it.
  • If your baby stops feeding after a short time switch to the other breast and then back again to the first breast.