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Home › Expert Q&A › General Concerns › Common Questions › How can I tell if my 1-month-old is nursing efficiently?

Expert Q&A

 

By Karen Zeretzke
IBCLC, Lactation Consultant

My baby is 1 month old, and I'm still unable to tell if she's nursing efficiently. She has a habit of nursing vigorously for the first five to 10 minutes with audible swallowing sounds. But then she would begin to suck very shallow, and I can no longer hear the swallowing sound. How can I tell if she's still ""drinking"" after the initial let-down and audible swallowing? She appears ""satisfied"" after most nursing sessions but since I can't tell if she's eating enough, I supplement with 3 to 6 ounces of formula (or expressed breast milk) in a 24-hour period. She's gaining weight well, but when can I stop supplementing and start trusting myself? I automatically start questioning my own milk supply whenever she starts fussing and shows signs of hunger (rooting, turning cheek toward my breast, sucking hand) even right after a nursing. Any advice you can provide will be very helpful."

It can be frustrating to feel you can't tell if your daughter is getting enough milk! Breasts make milk as the need is perceived and work on supply and demand. Milk that is removed is refilled; milk that stays in the breast indicates to your body that there is more milk than is needed and production will decline. The ongoing research by Dr. Peter Hartmann in Australia is showing how very true this is.

So if you are looking to increase your milk supply and decrease the formula supplements, you need to either allow your daughter to nurse more frequently and for longer periods, or if she won't, use a double hospital-grade breast pump to trick your body into thinking there isn't enough milk. Babies are by far the best way to stimulate your breasts; even the very best pumps are a distant second.

Milk supplies upgrade (or downgrade) on a three- to five-day schedule; if you begin extra nursing today, you should see more milk in three to five days. If that amount isn't enough, keep up the extra nursing/pumping until you reach your goal.

One of the best ways to tell (if you aren't giving her anything else) is the old ""what goes in on one end comes out on the other"" theory. If your daughter is having five to six wet disposable (or six to eight wet cotton) diapers and two to three bowel movements daily up until about 6 weeks of age, when the bowel movements will decrease sharply because there is no longer any colostrums, which is a very laxative substance in your milk.

Watching for hunger cues is a good way to decide when to offer to nurse. Crying is the last hunger cue! Earlier ones are lip and tongue movements, restlessness, hands moving up toward the face and head turning from side to side.

As you are asking your body to produce more milk, be sure to pamper yourself to make the job easier: Sleep enough, eat well and drink to thirst.

You may also consider attending La Leche League meetings in your area for more support. You may call 1-800-LA LECHE (1-800-525-3243) to find out what is available or look on the Web at www.lalecheleague.org.

Karen Zeretzke, MEd, IBCLC, RLC"

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