Is My Baby Getting Milk?
This is a foremost concern of most new breastfeeding parents. When we monitor and measure every other aspect of our babies’ lives, especially in the first few weeks, it can be frustrating to be in the dark about how much milk they’re getting.
Pre and post test weights are sometimes used to gain insight into breastfeeding success, but I have often seen these practises lead to feelings of inadequacy and anxiety for the breastfeeding parent. These tests also ignore the fact that breastfeeding is about so much more than simply the amount of breastmilk.
Why the Amount of Milk Doesn’t Really Matter
I eat the same breakfast almost every morning: two packets of oatmeal, a piece of fruit, and an Earl Grey tea. Some days this breakfast takes me straight through until lunch, while on other days I’m gobbling up every snack in sight before noon rolls around. The same is likely true for you. Our hunger needs change from day to day, and also throughout each day. The same is true for babies.
If your baby is still hungry after a feeding, it doesn’t matter if they got 60 g or 160 g during the feed. Since they are the only ones who know if they’ve gotten enough, it is our job to ensure they spend the feeding actually drinking, and to watch their behaviour to know when they are satisfied.
Why Drinking at the Breast Does Matter
When a baby spends more time at the breast nibbling than drinking, there can be a number of unexpected results:
- The baby may fall asleep before they are full, especially if they are younger
- The baby may pull, bite, twist, or hit the breast, especially if they are older
- The baby may lose their deep latch, slipping down to the nipple and causing pain
- The feedings may take a long time
All of these outcomes contribute to inefficient feedings where the baby gets less breastmilk than they otherwise could.
How to Know Your Baby is Drinking at the Breast
We can know when a baby is getting milk at the breast by watching their chin. When they are stimulating the letdown by sucking we see frequent, short sucks, which I sometimes refer to as nibbles. When a baby is nibbling they are asking for milk, but not getting it in large quantities. When they do get a mouthful of milk we see their jaw move down lower, and hang for a pause before it closes again. This is a mouthful and a swallow.
In the video above you can see a baby sucking and drinking at the breast. There are visible drinks at 13, 15, 18, and 21 seconds, and in general every 2-3 seconds thereafter. If you look closely, you can even see a drink at 3 seconds before the baby’s hand is moved out of the way.
Why is it Important to Know Sucks vs Drinks?
By knowing to look out for the pauses in the chin, we can tell when the baby is getting milk, and also when they are not. Knowing when your baby has stopped drinking allows you to manage the breastfeeding session in an informed way, and confidently take measures to increase drinking again. I have found that this method can sometimes be more reliable than listening for swallows, because it works even if you are out and about in a loud location.
This knowledge really hit home for me a few months ago. On an observation day at a hospital I watched a mother breastfeed her jaundiced baby for a pre and post feed test weight. She latched him on and the nurse watched the clock. I could see that the baby was nibbling the whole time, with no obvious drinks. The mother was dismayed when the scale suggested what I already knew: that her son didn’t get much milk during that feeding. I was dismayed that nobody taught her how to know if her baby was drinking, and more importantly, what to do when he wasn’t!
What to do When Your Baby isn’t Drinking
Great! You can tell when your baby is drinking vs nibbling, but now you need to know what to do about it! Read my post on breast compressions here to keep your baby drinking at the breast.