Signs Your Baby Isn't Getting Enough Milk

Updated: Jan 18

As a parent with a newborn baby, it can be worrying if you are unsure whether your baby is getting enough milk. But what are the signs? We have put together some tips to help you figure it out. These tips are for both breastfeeding and bottle feeding babies.

Wet Nappies and Dirty Diapers

The number of wet and dirty nappies your baby produces in 24 hours is usually a quick and easy way to know whether your baby is taking in enough milk. The table below has a quick guide based on your baby's age.

DAY	WET NAPPIES	DIRTY NAPPIES	STOOL COLOUR
Day 1-2	2+	1+	Meconium = black and sticky
Day 3-4	3+	2+ larger than a £2 coin	Green-ish
Day 5-6	5+	2+ larger than a £2 coin	Yellow, may be seedy
Day 7+	6+	2+ larger than a £2 coin	Yellow, may be seedy

Wet nappies should feel heavy, the urine should be pale, and they should not have a strong smell. You can tell if a nappy is the right weight by placing 3 tablespoons of water into a dry nappy and lifting it up. If your baby has very frequent wet nappies, they may be lighter.

Your baby's stool colour matters. If your baby is still getting the black and sticky stool (meconium) on day three or later, it may indicate that your baby isn't getting enough milk. Contact your midwife or a medical professional if this is the case. A baby who is fed formula milk will have browner (rather than yellow) and more formed stools.

A note of caution: after six weeks, babies' dirty nappies may become less frequent and it is normal for your baby to go a few days without a dirty nappy.

Weight Gain

It is normal for your baby to lose some weight after birth. They can lose up to 5-7% of their birthweight. Your baby should start gaining weight again around day five and should gain their birthweight back by two weeks of age.

Your baby's weight should be tracked by your healthcare provider using the WHO Growth Charts or your country's equivalent. Your baby's weight will be plotted onto a centile. The goal is for your baby to follow their centile line. However, it is okay if your baby's weight fluctuates around this centile line a little, for example when your baby is unwell, they may drop below their line and jump back when they are well again.

Signs of Dehydration

If your baby is dehydrated, you may see some additional signs. If you think your baby is dehydrated, please contact your healthcare team as soon as possible. Some signs of dehydration are:

Not having enough wet and dirty nappies
The soft spot on your baby’s head (fontanelle) sinks inwards
Your baby is drowsy and fussy
Your baby has sunken eyes
Your baby has a dry mouth
Your baby does not have any tears when they cry
Your baby has urate crystals after day three. This is when your baby's urine looks orange-brown or pink-ish. Be sure not to confuse this with pseudo menstruation which is when some baby girls pass small amounts of blood. This is normal and nothing to be concerned about.

Transferring Milk

This section is for breastfeeding babies only. Parents often think that just because their baby is sucking, they are getting milk. This is not the case. To understand if your baby is transferring milk, you need to watch your baby while they feed.

If they are feeding well, you will notice:

Your baby’s chin drops very low and pauses.
You will hear swallowing sounds.

If your baby is not transferring milk, you will notice:

Your baby’s chin moves very quickly up and down consistently throughout the feed.
Your baby's chin won't drop as low
You will not hear frequent swallowing
It is normal for this to happen for short periods during the feed (as your baby is asking your breasts for another let down) but should not happen throughout the whole feed.

You can watch the Really Good Drinking, Good Drinking, Nibbling videos by Dr. Jack Newman here to help you spot the difference.

When to Seek Help

You should seek help if you notice any of the below red flags:

Your baby is not having enough wet and dirty nappies
The colour of your baby's stool is still black after day 3
Your baby has lost 10% of their birth weight or has not gained their birth weight back by two weeks
Your baby is showing signs of dehydration
Your baby is not transferring milk at the breast

For further advice, call your midwife or a health professional. You and your baby may also benefit from a feeding assessment by a Lactation Consultant.