"How do we know its working?"

Most new breastfeeding parents have some concerns about knowing if their baby is getting "enough" breastmilk. For obvious reasons, breastfeeding does not allow for measuring how much milk the baby is getting the way a bottle feeding would. There are some very easy ways to begin to detect if your newborn is getting enough milk at the breast.

1. Frequency: 8–12 nursings every 24 hour period. Newborns need to breastfeed every one to three hours. If your newborn is sleepy and two and a half hours has passed since the start of the last feeding, pick her up, unwrap her and attempt to wake her for nursing. Delaying nursing will not help matters. In a week or so, she will awaken on her own every 2-3 hours, demanding to be fed (thus the term "feeding on demand"). Watch for early cues that she may be ready to nurse: licking lips, sucking motions and the "rooting" reflex where she turns her head and opens her mouth wide.

2. Listen for swallowing sounds. After your colostrum has transitioned to breast milk (3-5 days after birth) you will hear good bursts of swallowing or gulping during the feeding. Watch his jaw line and see that he is taking long, drawing sucks, extending as far back as his ear. Short, choppy and light sucking tends to be comfort sucking rather than nutritive sucking and swallowing.

3. Count wet diapers! A simple way to know if he is getting enough is keeping a record of the number of wet diapers in a 24-hour period. By day 6, we are looking for at least 6 wet diapers, increasing daily from there. Most parents change baby’s diaper at every feeding, so whether you or your partner change baby, just jot down if the diaper was wet. In the early days, you may need to rip open the diaper if it’s disposable, to see if the insides have become jelled with the urine.

4. Stools. Two to three in 24 hours is typical in the early days and more is common. If baby is getting milk, stools change from thick, black, and tarry (meconium) to loose, yellow and seedy.

5. Weight gain. It is normal for babies to loose weight after birth, but within a week or two, well-fed babies will begin to gain at ½ ounce to an ounce per day or more.

6. Signs of satiation. When breastfeeding is going well, you will notice your baby become relaxed at the breast and less tense as the feeding goes on. At the end of the feeding, the satiated baby will be "milk drunk" with relaxed limbs and body.

7. After engorgement passes, your breasts will be noticeably softer and lighter after a good nursing.

Be patient with yourself and your little one as you learn to master this natural but learned technique together. Think of the first few weeks as a special learning time. Partners, be prepared to give lots of hugs and encouragement as well as shoulder rubs to the new mom. Don’t hesitate to call a knowledgeable and experienced postpartum doula or breastfeeding consultant to get extra support during this important time. Acknowledge the challenge she may be experiencing and remind her that you believe in her ability to learn to breastfeed successfully over time!

Renee Christine Mandala, M.A. CD (DONA) is a Certified Birth and Postpartum doula. She holds a Master's Degree in Spiritual Psychology with an emphasis in Consciousness, Health & Healing. Renee provides heart-centered care through the transformational journey of birth and early parenthood. She is currently undergoing certification with the UCLA Lactation Educator Program.