A – Many new mothers worry that they do not make enough milk.  It is only natural to want make sure everything is going well.  There are several clues to watch out for. Checking the breasts can be very helpful.   During pregnancy the breasts should grow by at least 1 cup size as they become more glandular.   Soon after delivery, the baby starts to breastfeed and this triggers the production of colostrum and then milk.  Mothers usually notice that their breasts fill up by the second or third day.  The breasts feel firm before the feed and should feel softer after the feed. During the feed, you can watch for rhythmic suckling and swallowing followed by pauses.  This allows the baby to catch his breath before the next suckling bout. Listen for the sound of swallowing.  A satisfied baby usually falls off the breast with a contented look and sleeps quietly for about 2-3 hours.  The more food he eats the more he poops and pees.  Babies who do not get enough milk are hungry, they fuss and chew their fingers and fists.  They may sleep fitfully and can go for more than 24 hours without a bowel movement.  The very best way of knowing if your baby is getting enough to eat, it to have the baby weighed naked using electronic scales.  After the first few days, babies gain about 20-30 gms a day.

Some mothers and babies do have difficulty breastfeeding and may not have quite enough milk.  If you are concerned, do not wait.  Contact your public health nurse or physician and have the baby weighed.  Most breastfeeding difficulties are temporary and can easily be corrected, with some professional guidance.

Dr. Verity Livingstone is the founding Medical Director of the Vancouver Breastfeeding Centre. She is an Associate Professor in the Department of Family Practice, University of British Columbia and is an Internationally recognized expert in the field of Breastfeeding Medicine. She is an elected Fellow of the Academy of Breastfeeding and a Fellow of the College of Family Physicians of Canada. 

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