How do I know if my newborn is getting enough Breastmilk

[aimeeeleanor]

My newborn (4weeks4days old) is worrying me. I’m trying to exclusively breastfeed but have supplemented a few times with formula & expressed breastmilk from a bottle

He seems to be satisfied (ish) feeding from me on a morning & middle of the night feeds when I’m sure my milk is more abundant & will nap after an hour or so’s feeding & changing. However from early/mid afternoon he just constantly cluster feeds. On & off me, never seeming full. I try to make sure he is actively feeding by tickling his feet etc & he does seem to be but will then start to doze at the boob after a certain amount of time

Depending how tired I am, we then sometimes try giving him a bottle of formula around 100ml (or mixed breastmilk & formula depending if I have managed to pump) on an evening before bedtime which he gulps down, despite having being on me constantly all afternoon & evening

So my question is - Is it normal to cluster feed & then still gulp down a bottle after being on me for literally hours? Should I just be bottle feeding at this point, am I starving him until he gets his evening bottle

He has a tonne of wet & dirty nappies all day & night long, usually every couple of hours or so (unless he’s napping of course). His weight gain has been slow, only regaining his birth weight at 3 weeks. At his last weigh in at 4 weeks he had only gained 100g in 5 days, I’ve been told babies should gain 30-35g per day

He also had a tongue tie but that was sorted at 2 weeks old & he is feeding (or at least my nipples feel) that he’s latching much better since

Why is this so bloody hard :( I can see why so many Mums give up on breastfeeding. The stress & pressure is almost unbearable

I should add he has been doing this since birth practically, so doesn’t seem to be a growth spurt. He has always cluster fed on an afternoon

You have to trust he is getting enough. The cluster feeding is like a pre order of more milk. It stimulates production so stopping it, and bottle feeding stops the pre order. In time this could affect supply.

it is totally normal for babies of this age and older to cluster feed (potentially all day!!) as well as using you to help fall asleep so it is ok for them to sleep but if this is a specific feed the tickling feet to wake them up can help as can taking off layers (probably not wearing many in this weather anyway!!)

but keep offering and feed on demand not on a schedule you have decided upon and in time a feeding schedule will develop. The key I think is not to worry. Take care of your health, feed regularly and it will all take care of itself.

bare in mind thier stomach is tiny, they need to fill it often!

Lovely!!

I cannot write a proper message now because I am expressing now and it’s not a hands free pump! But I think you can be reassured that this is normal. If you’re on Instagram, follow a lady called Kathryn Stagg INCLC-she is like a guru!

I’ll try to write something better soon!x

Nappies! If there are plenty of wet nappies then things are going well. Tiny babies will often take a bottle when offered, even when they don't need it, because they are hardwired to suck when something goes in their mouth. With breast they can control it better and the supply ebbs and flows, but bottle will just come out. My breastfed DD would most likely have take. a bottle if I offered it at 4 weeks but then probably spent the next two hours posseting plenty of it back up or doing a massive poonami.

Fussiness in evenings is totally normal and not just a BF baby thing. It will pass. DD2 is 8 weeks now and already evenings are less fraught. I found putting her in a sling helped as she was getting overtired through fussing and it helped her go to sleep.

If your baby has lots of wet nappies, is bright and alert, is gaining weight fine, then you are doing a grand job!

My second baby was a lot like this. She just chomped and chomped all evening. It’s not uncommon, so don’t feel you’re failing. As PP said, babies do this to stimulate future supply, so you’ll likely have bucketfuls of milk soon. It’s also possible you have a slightly slow let down reflex so baby has to suck a lot to get the milk needed. If this is the case things will improve naturally as baby grows and gets stronger. But my main advice for now is try to relax, make sure you have plenty of cold drinks and snacks on hand for cluster feeding times, stick on a box set of grab a good book, and put your feet up. Think of the constant feeding as a great excuse to relax and enjoy some tv or whatever while you still can.

Just to add a wet nappy is a HEAVY wet nappy- compared against a dry nappy, it should be quite noticeably heavier at each nappy change which I'd do midway through a feed to wake baby up again. I'd class a full feed as both boobs, is he taking that? If he takes both sides and sleeps well between feeds (at least 3 hrs if not having a growth spurt) and has heavy wet nappies as well as the dirty ones, and is gaining weight well consistently, he's getting enough. Has he been checked to see that the tongue tie hasn't reattached?

If he's giving lots of wet and dirty nappies, he's getting enough. Don't stress about only gaining a little weight in a few days - he's not a robot and weight can fluxuate a bit. Just keep an eye on it over time and ensure that he is gaining overall.

As to the cluster feeding, that is normal. Mine cluster fed for 3 months. He gained weight but was never properly chubby like other babies - he never had any fat rolls. Now a happy 1 year old who still loves to eat!

Cluster feeding is normal for breastfed babies. They’re not just feeding for food but for comfort too. All three of mine cluster fed and I’m currently feeding a 5 week old who cluster feeds in the late afternoon/ evening. It’s been the same pattern with all 3. My youngest is gaining weight quicker than he should be so no supply issues.

I think people just have expectations of babies to behave like formula fed babies in terms of eating habits, on a schedule every 3-4 hours etc. This is not the reality with breastfed babies, cluster feeding helps increase supply and is important. Breastfed babies will also have smaller more regular feeds. It’s hard work sometimes, psychologically more than physically I think, but there’s nothing wrong. Until breastfeeding is the norm then people will think cluster feeding is a problem because their baby isn’t behaving or feeding like a formula fed baby is. I always get comments from people about how much my baby feeds as it seems like he’s on and off a lot, but at this age it’s normal.

If the baby has wet and dirty nappies and is gaining weight then you’re doing well.

He is getting enough to survive on by the sounds of it but obviously he will gain more weight if you feed more bottles. It's your choice. Whatever you want to do. I personally preferred knowing they were more contented with a top up feed each time and I think you do become a bit of a dummy to them aswell with the boob. Congratulations and good luck with your baby !

You have to trust it. Cluster feeding is basically putting in the order for the next day. You should be able to feel the difference between sucking and feeding, there is no need for him to be on you for houra if he is just sucking.

Weight gain, and wet and dirty nappies are all good signs. You need to make sure if you are giving a bottle of formula you are pumping at the same time.

Honestly, i have said this to frienda as well, if you 'need to knowhow much' he is drinking then you may struggle with BF as you don't know. Its not the same as formula. You should be able to feel the difference in your breast beforw and after a good feed as well

You tell by the nappies.

Cluster feeding serves a purpose, your baby is telling the breasts to make more milk as they're growing fast. It's not all about just being full. Baby is doing their job.

What goes in must come out: plenty of wet/dirty nappies means it went in.

Cluster feeding tells your body to keep making lovely milk, he doesn't have another way to do that.

I'd say you're describing a well-fed baby.

I had a baby who wasn't gaining enough weight.i thought everything was fine as she was having wet and dirty nappies BUT I didn't realise they have to be heavy. I have formula in the short term while I worked with a lactation consultant to increase my supply. She started gaining lots of weight immediately. She is now a 6 month old chunk and I have been EBF ever since.

100g isn't bad over a few days but it should be over the full week and they vary in weight gain day by day.

@De88 Agreed re heavy wet nappy and gaining weight but you can have both of those things and a baby that doesn’t sleep for 3 hours. Some babies wake for other reasons than hunger - don’t assume OP that it’s evidence that your baby isn’t getting enough, but I agree with the rest.

That is so normal! The first 3 months they basically spend on the boob, building your supply. Mine fed probably 20 times a day. It's not like giving them a bottle and the they're done, totally different thing. Just keep bf on demand and you can do it! After 3/4 months old it will be much easier. I know that probably seems far away now but it isn't!

Just be aware that you will damage your supply if you supplement with formula.

A kit if people do this but The problem is if the baby is sucking and full from a bottle they won't feed as much which means they're not stimulating you and your supply will reduce, you'll need to give more bottles so it's a vicious circle.
Cluster feeding is normal. Nappies (yes ones with some weight in them) and weight gain are the only things you should be looking at - when they've had a tongue tie clipped it can take them a little while to catch up so as long as weight gain is steady I would just be letting the baby feed as much as you can to increase supply and "put in its order". It sounds like you have a good supply but remember tongue tie was preventing that being fully established so you're both working to catch up - it's not a problem and it will happen quickly but you need to feed feed feed and when she's on the bottle she's not feeding. If you do feel you have to give some formula, may I suggest a cup rather than a bottle to prevent latch confusion - especially as they're already relearning their latch after the snip.
You're doing a great job - you just have to trust your own body and keep going.

"A lot of people" that should say.
Also, babies breastfeed for other reasons than just nutrition - comfort, skin to skin, even building immune system. If they ask for it, they need it so you can give it to her,

Out put - nappies and weight gain.
Babies don’t cluster feed because they aren’t getting enough. They cluster feed to tell your body that tomorrow they will need more milk. The cluster feeding is making your body produce the milk he will need in the future.

A ton of wet and dirty nappies plus putting on weight is the only measure you need for breastfeeding.

Cluster feeding is how baby increases your milk supply.

Sounds like it's going well.

Normal. And as pp have said, he’s not just feeding to be full, or to stimulate your supply – it’s a nice comfortable place for him to be. If he’s happy and you’re happy (I always was, sitting on the sofa doing nothing but “oh, I’m feeding the baby so please can you bring me some cake? And a tea? And the remote control? And some more cake?”), go with the flow. Breastfeeding becomes much less stressful once you just go with the flow and accept there won’t necessarily be a pattern!

To echo what everyone else has said, for breastfeeding look at output.

The only thing I'd add about cluster feeding is it can help to keep swapping sides at that point. It's called switch nursing - at the point they are feeding constantly there's no fore / hind milk difference to worry about, and it's a more effective way of building supply and getting milk in to them. I also found it less uncomfortable swapping than having them suck on the same breast for ages. www.verywellfamily.com/what-is-switch-nursing-431853#:~:text=Switch%20nursing%20is%20a%20breastfeeding,breast%20again%2C%20and%20so%20on.