Question: Do I have enough milk for my baby, how will I know that my baby is getting enough?
Renee Kam (lactation consultant): Many mums worry about whether their baby is getting enough milk. The good news is that most mums can make plenty of milk for their baby or babies. There are three reliable signs that your baby is getting enough milk: weight gain, poos and wees.
A baby who is getting enough milk will gain enough weight and your child and family health nurse will tell you how much is enough. After a small early weight loss in the early days babies put on an average of 150 to 200 grams a week for the first few months.
From then on babies tend to put on a smaller average weekly weight gain.
Now with poos: An exclusively breastfed new born baby usually has three or more soft or runny poos each day for several weeks. Each poo is usually at least the size of a 50 cent piece. After the first six weeks or so healthy breastfed babies do varying amount of poo. Some keep doing lots of poos each day but others only do one poo every few days or so. As long as the poo is soft and there's plenty of it and your baby is thriving and content it's all okay.
In terms of wees: A baby should have at least five heavy wet disposal nappies a day or six to eight wet cloth nappies a day. The wees should be pale in colour.
Some mothers say they think their baby acts like they aren't getting enough milk or they can't express much milk or their breasts don’t feel full or their baby drinks more milk from a bottle after a breastfeed. They might worry that they haven't got enough milk.
But weight gain, regular poos and wees are the only reliable signs that your baby is getting enough milk.
Talk to your midwife, child and family health nurse or lactation consultant if you’re worried.
Question: I seem to have too much milk. Is this normal?
Renee: It's normal for you to feel a change in your breasts between two and six days after birth. This is when your milk comes in and your milk changes from thick yellow colostrum to a thinner pale milk often with a bluish tinge. Your breasts might get larger, heavier and possibly tender or more sensitive. This fullness usually sorts itself out within the first few weeks as the amount of milk you're making gets in sync with the amount of milk your baby is drinking.
If you keep making too much milk after the early weeks you might have an over-supply of milk. You might have rapidly filling breasts between feeds and breast milk might leak from your nipples between feeds too. If you have an over-supply you have a higher risk of a blocked duct or mastitis.
You might also have a fast let down reflex. If you have a fast let down you might notice that your baby often gags or gulps at the start of the feed and might come off the breast coughing.
A baby whose mother has an over-supply often has more wet and dirty nappies than usual, a lot of unsettled behaviour and large weight gains. Baby might also spit up quite a bit of milk after feeds.
If you think you might have an over-supply call the Australian Breastfeeding Association Helpline on 1800 686 268 or talk to a lactation consultant.
Question: Do I need to express breastmilk?
Renee: If your baby is feeding well and you and your baby can be together for all feeds there's no need for you to express unless you want to. For example if you're going out without your baby you could express before you go so you can leave some express breastmilk for your baby’s carer to give your baby while you're away.
For further information about breastfeeding call the Australian Breastfeeding Association Helpline on 1800 686 268. Talk to a lactation consultant and/or your child and family health nurse. Visit the Raising Children Network website at http://raisingchildren.net.au or the ABA website http://www.breastfeeding.asn.au.