Milk Supply and Weight Gain
While each mother and baby are unique, there are some general guidelines regarding milk supply and weight gain. The information below is meant to provide basic information for breastfeeding moms. We encourage you to seek help from a board-certified lactation consultant (IBCLC) if your baby’s weight gain does not meet these guidelines.
Weight Gain in the Early Days
Most mothers need early and frequent milk removal to make milk. Skin to skin contact during the first hour after birth, and offering the breast with feeding cues, or at least every 2 to 3 hours, helps a mother to establish a good milk supply.
If a baby is not latching after birth, a mother may use a quality breast pump every 2-3 hours. Some mothers find it more helpful to hand express in the early days. A video demonstrating this can be found at: http://newborns.stanford.edu/Breastfeeding/MAXProduction.html
Babies often lose up to 10% of their birth weight in the first 4 days. By day 4, a baby should stop losing weight and start to gain weight. Babies feed better when they are gaining weight. What is normal behavior for a baby who is gaining weight?
- Waking every 2-4 hours, or at least 8-10 times a day, with feeding cues.
- Feeding 10-30 minutes from one or both breasts per feed.
- Acting content after feeding.
- Having at least 3 yellow stools and 6 wets in 24 hours.
- Gaining at least 7-10 ounces a week in the first 3 months (average of 1+ ounce per day).
By day 14, a baby should regain their birth weight.
Once a baby is back to birth weight, and gaining well, a baby may start sleeping longer at night and feeding a bit less frequently. However, it is normal for a baby to wake at least every 3-4 hours at night until they are older and removing more milk at a feeding.
A general rule of thumb is that removing milk more often (less than every 3 hours) will increase your milk supply and removing milk less often (more than every 3 to 4 hours) will decrease your supply. This is due to hormones that help regulate milk supply.
Size of Feedings and Overall Milk Intake
A newborn’s stomach is small. At 24 hours of age, a baby will consume about 5 to 10 cc of colostrum (the early milk) at each feeding. As milk supply increases, a baby’s stomach capacity gradually increases. Around day 3, stomach capacity is ~30 cc (1 ounce), and by 1 month, it may be up to 3 to 5 ounces.
In the early days, practice latching on both sides at each feed. Once your baby is gaining well, with plenty of wets and stools, try to soften well/drain one breast before offering the second breast. Mothers who store a lot of milk in their breasts (more than 3 ounces per side) may only feed their baby from one breast per feed. Other mothers may feed their baby from both breasts each feed. Follow your baby’s lead.
More important than the size of a feed is overall milk intake. It may vary from day to day, but most babies average in the range of 19 to 30 ounces a day by the time they are one month old or about 10 pounds. Each baby should consistently follow his or her growth curve on the WHO growth chart. It is okay to be at the 5th percentile or the 90th percentile, as long as a baby is consistently gaining and staying on their curve.
Remember, every bit of milk that your baby gets is beneficial. The benefits are dose related. Exclusive breast milk and breast feeding for six months is very good for your baby. But any breast milk and any breast feeding is beneficial for your baby.
As Your Baby gets Older ...
As babies get older, they become more efficient at the breast. A baby over 2 months of age may finish a feed in 3 to 5 minutes. Your baby may also nurse less often – every 3 to 5 hours rather than every 2 to 3 hours. Your breasts may not feel as full and you may be less aware of let-down. This can all be normal.
At 3 months of age, normal gain slows down a bit to ~4 to 7 ounces a week. At six months of age, normal gain is ~2.5 to 4 ounces a week. IF you have concerns about whether your baby is gaining, chart your baby’s weight on the WHO growth chart (see above).
All mothers make and store different amounts of milk in their breasts. If you are a mother who stores small amounts of milk in each breast, you can still breastfeed your baby. However, you may need to remove milk frequently, even as your baby gets older.
Frequent milk removal is still the key to supply. If you are back at work and pumping, or your baby is sleeping longer at night, you might see a slight decrease in your supply. Your baby may let you know by fidgeting at the breast, or wanting to feed more often. You may need to remove milk more often when home with your baby, or feed baby in the middle of the night.
All hormonal methods of birth control CAN decrease your milk production. (See our information on Hormonal Methods of Birth Control.) You may want to consider a barrier method of birth control, or avoid hormonal birth control that is injected or implanted.
(See our information on Supporting Your Milk Supply if you feel your milk supply is not adequate for your baby.)