Worried your baby isn't getting enough milk? Diaper signs tell you more than expressing to check

Late at night you sneak a try at expressing and get only a few drops, and your heart sinks. Then an older relative at home chimes in: “Crying like this, maybe you don’t have enough milk.” Almost every mom has this fear that baby isn’t getting full in the first month.

But there’s a much clearer way to check than expressing, and it’s right under your nose: your baby’s diapers. Let’s go through what to count, how many there should be on each day, and when to take baby to the doctor.

Why can’t expressing tell you if baby is getting enough?

Quick Answer: Because a baby who feeds well at the breast removes more milk than your hand or a pump can. So the amount you express isn’t the same as the amount baby actually drinks.

In the first 2 to 3 days after birth, your breasts make colostrum, which comes out in small amounts but is very concentrated, just right for a newborn’s tiny stomach. So getting only drops when you express is normal. It doesn’t mean your body has nothing for your baby.

The same goes for breasts that feel soft or not full. After a few weeks, breasts usually get softer because your body has adjusted production to match your baby. It doesn’t mean your milk is drying up. If you want to know more about the time before your milk comes in, continue to Your milk hasn’t come in yet after birth

How many wet diapers, and what kind of poop, means baby is getting enough?

Quick Answer: From day 5 onward, baby should have at least 6 heavy wet diapers a day and soft yellow poop at least 2 to 3 times a day.

The numbers below are a summary from the NHS, AAP and CDC, whose recommendations are similar:

Baby’s age	Pee (wet diapers)	Poop
Day 1 to 2	1 to 3 diapers a day	Sticky blackish-green (meconium), 1 to 2 times
Day 3 to 4	Gradually increasing	Starting to change to greenish-yellow, at least 2 times
Day 5 onward	At least 6, heavy and wet, pee clear or pale yellow	Yellow, soft or with small seedy bits, at least 2 to 3 times

A tip from the NHS: disposable diapers absorb so quickly it’s hard to tell how wet they are. Try pouring 2 to 4 tablespoons of water into a new diaper and lifting it. That weight is what a “heavy wet” diaper feels like.

If you’re too tired to keep count (everyone is), try noting it on your phone or making tally marks on a piece of paper stuck to the fridge, one row per day, counting only pee and poop. It makes talking to the doctor or nurse much easier.

Besides diapers, what other signs show baby is feeding well?

Quick Answer: Baby feeds 8 to 12 times a day, you can hear swallowing, baby’s cheeks stay rounded rather than sucked in, and baby comes off the breast on their own looking relaxed.

• Frequency: newborns feed about 8 to 12 times in 24 hours, or every 2 to 3 hours. At some times baby may feed often, back to back, especially in the evening
• Sucking rhythm: quick sucks at first, then changing to long, slow sucks with swallowing now and then
• Cheeks: round and full while feeding, not sucked in
• After feeding: baby lets go of the breast on their own, hands relaxed, and looks content for about 1 to 3 hours
• Mom’s breasts: feel softer after feeding

If feeding makes your nipples very sore, or you hear clicking instead of swallowing, baby may not be latching deeply. Try 5 breastfeeding positions that help baby latch deeper

What should baby’s weight look like in the first two weeks?

Quick Answer: A small weight loss in the first 3 to 4 days is normal, but it shouldn’t be more than about 8 to 10 percent, and baby should be back to birth weight within about 10 to 14 days.

The best confirmation that baby is getting enough milk is being weighed at the hospital or a baby clinic at your appointments. The AAP recommends taking baby for a checkup within 48 hours of leaving the hospital to check weight. In Thailand, many hospitals schedule a checkup in the first week anyway. Don’t forget to bring your pink book (the Thai Mother and Child Health Handbook).

There’s no need to buy scales and weigh baby yourself every day. The numbers swing with diapers and feeds, and watching them will only make you worry for nothing. Check diapers every day, and let the doctor check weight at your appointments.

Does frequent crying and feeding mean you don’t have enough milk?

Quick Answer: Not always. If diapers and weight are on track, crying or wanting to feed often is usually normal baby behavior.

Babies don’t only feed at the breast because they’re hungry. Sometimes they feed for comfort, and at some times they want to feed several times back to back (cluster feeding), especially in the early evening. That’s actually baby’s way of stimulating your breasts to make more milk.

Some older relatives may say, “Give the baby a little water so they’ll feel full.” They really do mean well. But breastfed babies don’t need plain water, and Ramathibodi Hospital advises not giving water at this age, because water fills baby’s stomach without providing nutrients, so baby feeds less.

Call your doctor or go to the hospital right away if…

Quick Answer: If there are fewer diapers than expected, baby is drowsy or hard to wake for feeds, or jaundice is getting worse, don’t wait for your appointment.

Go to the hospital right away if

• Baby is drowsy, hard to wake, or refuses to feed for several feeds in a row
• From day 5, there are fewer than 6 wet diapers a day, or no pee for many hours
• Dry mouth, or a sunken soft spot (fontanelle)
• Jaundice is getting worse, spreading to the arms and legs, or comes with drowsiness. See more in Jaundice in newborns
• Fever in a baby under 3 months old

See a doctor or breastfeeding clinic soon if

• After day 4 you still see blackish-green poop, or fewer poops than expected
• Baby feeds for a very long time at almost every feed but still doesn’t seem full, and isn’t gaining weight
• Mom has very sore or cracked nipples, or a red, hot breast

Many public hospitals have a breastfeeding clinic that can help check positioning and latch. If you’re not sure, just call the hospital where you gave birth.

If baby really isn’t getting enough milk in the end, what next?

Quick Answer: Talk to a doctor or breastfeeding nurse to find the cause. Most cases can be fixed by adjusting the feeding position, feeding more often, and expressing or pumping more. And if you need to supplement with formula, it isn’t a failure on mom’s part.

Common culprits are a shallow latch, too much time between feeds, or mom and baby being separated for a long time, and almost all of these can be fixed. Sometimes the doctor may recommend supplementing temporarily, to keep baby safe while mom builds up more milk. Just follow the doctor’s advice, and don’t feel guilty. A full, safe baby is what matters most.

For the big picture of caring for your baby at this stage, read Your baby’s first 3 months: a guide

However tired you are, don’t forget: the fact that you’re sitting here counting diapers means you already care about your baby so much.