You're at the end of your rope. Your new baby has been nursing for what seems like the entire day, and when she's not at the breast, she's crying. You wonder if maybe you aren't producing enough to satisfy her. How can you tell when your baby is getting enough?

   The amount of milk a mother's breast produce is dependent upon the effectiveness and frequency of sucking her baby does at her breast. The more often and effectively her baby sucks, the more milk is produced. This is accomplished when the hormones, prolactin and oxytocin, are released by her pituitary gland. Prolactin is the milk-producing hormone, while oxytocin causes the "let-down" or milk ejection reflex.

   Many mothers worry that they do not have enough milk. You can be confident that your baby is getting enough milk if the following conditions are present:

• Your baby has 2-5 bowel movements and 6-8 very wet diapers per day (for the first six to eight weeks). In older babies, the number of wet diapers should remain the same but the number of bowel movements may decrease.
   
• Your baby is nursing frequently - at least 8-12 times in a 24 hour period, or approximately every 2-3 hours. While some babies nurse less frequently and others more often, there is not a problem unless your baby is not gaining well.
   
• Your baby is gaining an average of at least one pound (453 grams) per month, or 4-7 ounces per week. This is an average; some weeks your baby will gain more, others less. Remember that some babies take 2-3 weeks to regain their birth weight. If you have questions concerning your baby's weight, discuss them with your baby's doctor.
   
• Your baby appears healthy. He should have good color and muscle tone, and appear to be "filling out" and growing in length.

   If you remain concerned about your milk supply, perhaps your baby is displaying one of the following behavior patterns, and sounding a "false alarm":

• Your baby seems hungry soon after being fed. As breast milk is more easily digested than formula, breastfed babies need to be fed more often than formula fed babies.
   
• Your baby nurses "all the time." Perhaps your baby has a strong need to suck or be held. Your baby's frequent nursing will guarantee a good milk supply.
   
• Your baby is fussy. Many babies have a fussy period at the same time each day, while others fuss all day. If nursing doesn't help, try rocking or walking him, using a sling or front carrier around the house, or perhaps swaddling him.
   
• Your breasts seem softer. This happens as your milk production adjusts to meet your baby's demands.
   
• Your baby suddenly nurses more frequently and/or for increased lengths of time. This could be due to your sleepy newborn "waking up" or, if the increase occurs at 2 weeks, 6 weeks or 3 months of age, it could be the result of a growth spurt. Your baby is simply increasing your supply through his increased sucking.
   
• Your breasts no longer leak. Once your supply is established, leaking between feedings may no longer be a problem. Leaking is not related to supply.
   
• Your let-down sensation doesn't feel as strong as it once did, or you've never felt it all. Some mothers never feel a let-down, but by observing their baby's pattern of swallowing and sucking they recognize when it is occurring.
   
• Your baby suddenly decreases his nursing time. Now that your baby is an experienced nurser, he may be able to extract the milk more quickly.

   You and your baby may experience several or all of these occurrences during the course of breastfeeding. If you continue to have questions concerning your milk supply, be sure to get in touch with a La Leche League Leader or other breastfeeding specialist. In many cases, improved breastfeeding techniques will quickly resolve the situation. Your happy, healthy breastfed baby will prove ample reward for your efforts.

   For further information, see The Womanly Art of Breastfeeding, published by La Leche League International. Establishing Your Milk Supply (reprint no. 81) and/or Increasing Your Milk (reprint no. 85), both from La Leche League International; or contact A Birth Center at (954) 456-4888.

Reprinted with permission from Woman to Woman the newsletter of the Reading Birth & Woman's Center

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