Is my baby getting enough breast milk?

This is a very common question, especially when you first start breast feeding or you are a first-time mum. Although it is impossible to tell you how much a baby is drinking, there are positive signs which can reassure you that all is well.

Poor feeding could be a sign that your baby is unwell. Use the traffic light table below to guide whether you need to seek a medical review.

  • Baby not waking up on their own or you are unable to wake your baby up for feeds

  • Baby alert but breathing too fast to feed

  • Is pale, mottled and feels abnormally cold to touch

  • Has blue lips

  • Has a fit/seizure

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

  • Change in established pattern of feeding - feeding much less frequently or for a much shorter period of time

  • Failing to gain weight adequately, static weight or losing weight (most babies lose some weight in the first two weeks of life)

  • Less wet nappies than before (in the first 48 hours, your baby is likely to have only two or three wet nappies. Wet nappies should become more frequent, with at least six every 24 hours from day five onwards). Tip: It can be hard to tell if disposable nappies are wet. To get an idea, take a nappy and add two to four tablespoons of water - this will give you a better idea of what to look and feel for.

  • Baby seems drowsy (increasingly sleepy) or irritable (unable to settle despite distraction/feeding)

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

  • Baby wakes up for feeds on its own and sleeps for 3-4hrs after a feed. In the early weeks, babies may sleep for less than 3 hours; this is normal.
  • Baby settles following a feed
  • Baby has a good strong suck and feeds in a calm relaxed way
  • At the end of the feed, your breasts feel softer and baby is content and comes off the breast on their own
  • Baby gains weight steadily after the first two weeks (it's normal for babies to lose some of their birth weight in the first two weeks)
  • At the beginning, your baby will produce a black tar-like poo called meconium. After about five or six days, they should pass at least two soft yellow poos. Breastfed babies' poo is runny and doesn't smell.
  • Addition information is available about infant crying and how to cope – click here.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

Is my baby latching on properly?

Breast feeding is a tricky skill that both mum and babies need to learn together. It is very common for women to experience some discomfort at the beginning of a feed whilst your breasts/nipples adapt to feeding regularly.

If you and your baby are comfortable with breast feeding, then you are doing fine. Signs that the baby is latching well to the breast include your baby holding a large mouthful of the breast, taking long sucks with pauses from time to time and coming off the breast feeling content at the end of a feed. Your breast or nipple should not feel sore afterwards.

Occasionally, a baby may be unable to open their mouth wide enough to latch on to the breast properly because they have a tongue tie.

Click here for more information about breast feeding positions and latching on.

 

Thing that can affect your milk supply

Generally speaking, the more your baby feeds - the more breast milk you will produce. However, if you're worried that your baby isn't getting enough milk, talk to your midwife, health visitor or a breast feeding specialist as soon as possible. With their help and advice, you'll be able to identify the problem and find a solution.

Things that could affect your milk supply include:

  • Sore nipples
  • Feeding by the clock
  • Topping up with formula milk
  • Tongue tie
  • Dummies
  • Being apart from your baby
  • Medication

 

How to increase you breast milk?

If you feel you need to boost your milk supply, there are a few ways that you can do this:

  • Try not to give your baby anything other than breast milk. The more you breast feed your baby, the more you'll produce.
  • If you want to give your baby a dummy, try to wait a few weeks - or until you are both comfortable and confident with breastfeeding.
  • Let your baby feed when they want to, for as long as they need to. Don't clock watch.
  • When you're feeding, offer both breasts - remember to switch breasts each feed.
  • Holding your baby close, especially skin-to-skin, will help increase your milk supply.
  • Avoid weaning until your baby is ready - this is usually around six months.

If you are doing all these things already but you're still concerned you have a low milk supply, ask your midwife to refer you to a breast feeding specialist. Feeding specialists are very understanding and will be able to have a look at how your baby's feeding and offer practical advice, help and support.

Expressing and storing breast milk

Expressing milk means extracting milk out of your breasts (using a breast pump or hand expressing) so you can store it and feed it to your baby at a later time.

There are some really good reasons why you might need to feed your baby expressed breast milk:

  • If your baby is premature, they may not be able to feed at the breast but could still get much of the goodness through receiving expressed breast milk.
  • Returning to work or study, someone else can feed them your expressed breast milk.
  • If your breasts feel uncomfortably full (engorged) or your baby can't latch on properly for some reason.

However, if you do feed your baby expressed breast milk, it is important you adhere to strict advice with regards to hygiene and methods involved. Here is the link to all you need know about Expressing Breast Milk and storing it.

 

What you should and shouldn't eat if you're breast feeding:

Click here for some tips on what you should be eating if you're breast feeding.

 

Alcohol and breastfeeding:

While it's safer not to drink any alcohol whilst breast feeding, an occasional alcoholic drink (i.e. 1 or 2 units once or twice a week) is unlikely to harm your baby.

Click here for more information

 

Should I take vitamins during breast feeding?

If you are breast feeding, a balanced diet will provide most vitamins you need. However, you should consider a vitamin D supplement due to the lack of sunshine most of the year in the UK.

Click here for more information.

Breast feeding support:

There is a lot of help and support available for breastfeeding in the community close to where you live. You can talk to your midwife, health visitor or contact any of the breast feeding support services listed below:

Online help:

Local help:

National organisations:

  • National Breast Feeding Helpline 03001000212 (9:30am to 9:30pm daily)
  • Association of Breast Feeding Mothers - Telephone: 03003305453

Where should you seek help?

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance