Signs your baby isn’t getting enough milk & what to do about it
Whether you’re a first-time or experienced parent, the idea that your baby isn’t getting enough milk is about as scary as it gets. But understanding the subtle signs of an underfed bub can help you take quick, proactive steps to support their nutrition and growth.
To lend a hand should this issue affect you and your little one, Women’s Health asked two experts — Laurie B. Jones MD, IBCLC, FABM and Willow Medical Advisor, and Dr. Lauren Davis, DO, board-certified family medicine and osteopathic doctor and founder of Latched Nourished Thriving — for their insights and advice.
How much milk does my baby need?
Breastfed babies
Newborn to one month: Starts with small amounts of colostrum, increasing to 30-60 mL (1-2 oz) per feed. By 4-5 weeks, they’ll eat about 90-120 mL (3-4 oz) per feed, totalling 750-900 mL (25-30 oz) daily.
One to six months: 570-900 mL (19-30 oz) daily. In exclusively breastfed babies, milk intake peaks during this period and stabilises until solids are introduced.
Six months and beyond: As babies start on solid foods, milk intake gradually decreases to less than 750 mL (25oz) daily.
Formula-fed babies
Newborn to one month: 30-120 mL (1-4 oz) per feed, increasing gradually.
One to six months: Increases to 150-240 mL (5-8 oz) per feed, with 4-5 daily feedings, up to 960 mL (32 oz) daily.
Six months and beyond: As solids are introduced, intake drops to 210-240 mL (7-8 oz) per feed, with 3-5 feedings daily.
Twelve signs your baby isn’t getting enough milk
If your baby isn’t getting enough milk, you may notice these signs and behaviours:
More frequent hunger cues: Babies may root (open their mouth and turn their head in search of the breast or bottle), suck on their hands or show other signs of hunger more often throughout the day.
Persistent fussiness: ‘A baby who is not getting enough milk will never settle,’ says Dr Jones. Instead, they’ll ‘cry even when being held after a feed.’
Variable feeding length and frequency: Long (over an hour) or very short (a few minutes) feeds may indicate poor milk transfer. Nursing fewer than 8-12 times per day or skipping night feeds can also be concerning.
Lethargy or sleepiness: Underfed babies may appear sluggish or sleep excessively (four or more hours at a time). ‘Some infants… conserve energy when they are underfed and [become] quiet and sleepy,’ explains Dr Jones.
Disinterest in feeding: Your baby may show weak sucking, seem frustrated or give up easily during nursing.
Poor weight gain: ‘Adequate weight gain is the number-one sign that a baby is getting enough’ to eat, says Dr Davis. See your paediatrician if your bub hasn’t regained their birth weight by 10-14 days old or gains less than 155-240g (5-8oz) per week.
Few nappies (for younger babies): Dark urine, reddish-brown ‘brick dust’ stains, fewer than three stools per day in the first month and dark, hard stools are other warning signs. There’s a caveat, though: ‘You can’t use wet and stool [nappies] for indicating well-fed status in older babies,’ Dr. Jones says. ‘You can count wet [nappies] and stools for babies under their birth weight. The stools are more reliable in the first 2-3 weeks.’
Signs of dehydration: Dry mouth, sunken soft spot (fontanelle), cool limbs and fewer wet nappies may indicate dehydration.
Slow growth: A significant drop in weight percentile over time is a red flag for underfeeding.
No signs of milk letdown (if breastfeeding): Milk transfer may be inadequate if your breasts don’t feel softer after nursing or if your baby doesn’t rhythmically swallow while feeding.
Breastfeeding pain: Persistent pain during nursing can prevent effective milk transfer. ‘An ideal latch does not hurt, pinch or feel bruised,’ Dr Jones notes. ‘Any of those signs would be an indication to see an IBCLC [International Board Certified Lactation Consultant] right away for healing protocols and ensure deep latch.’
Ongoing jaundice: Dr Davis notes that persistent jaundice (yellowish skin tone) after two weeks of age can indicate your baby isn’t getting enough milk.
What are the signs a baby is well-fed?
Soothed after eating: ‘Older infants in the one-to-three-month time frame typically relax into a semi-sleep state during feeding and are visibly relaxed, quiet and calm after a full feeding,’ explains Dr Jones. You may also notice their hands unclench and their body relax during feeding.
Weight gain: ‘We look for a baby to gain between 155 and 241 grams (5 to 8 oz) per week until weight gain slows around four months,’ says Dr Davis.
Healthy poos: Newborn stools start black and sticky (known as meconium) for the first three to four days. By day five, their stools transition greenish-yellow, then mustard yellow and may appear seedy or grainy. At least three bowel movements per day is a good sign.
Lots of wet nappies: By day five of life, your baby should produce about six wet nappies daily. Their urine should be pale yellow and mostly odourless.
Rhythmic sucking and swallowing: A well-fed baby actively, audibly sucks and swallows in a steady rhythm. This indicates they’re not having any trouble getting milk.
Eating often but not too often: Breastfed babies typically eat 8-12 times per day, while formula-fed babies feed about every 3-4 hours.
Waking up to eat: A healthy baby usually wakes on their own and actively shows hunger cues.
Feeding in clusters (if breastfeeding): Breastfed babies typically feed in short, frequent bursts — which can help stimulate milk production.
Shows signs of fullness: A full baby may release the breast or bottle from their grip, turn away or even push away.
Awake and alert: When awake, well-fed babies coo, play, squirm and respond to sounds, lights and attention.
Breast changes for mum (if breastfeeding): After breastfeeding your baby, your breasts may feel softer due to milk removal. While feeding, you may experience the let-down reflex, including a tingling sensation or milk dripping from your other breast.
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What to do if you think your baby isn’t getting enough milk
Here are some steps to take if you’re concerned your baby may not be getting their fill of milk:
Feed more frequently: Offer the breast or bottle more often, including at night.
Switch sides during breastfeeding: This can encourage milk flow and keep your baby actively nursing.
Use breast compression (if breastfeeding): Gently compress your breasts during feeding to help your baby get more milk and maintain interest in eating.
Don’t beat yourself up over your breast milk output: As Dr Jones says, ‘It’s important that moms give themselves grace for the things that are simply out of their control. You are not defined as a mother by how many ounces of milk you produce.’
Seek professional help: Most importantly, visit your paediatrician or other healthcare provider. ‘Regularly scheduled weight and wellness checks with your baby’s doctor or health provider is the most reliable way to determine if your baby is getting enough milk,’ says Dr Jones. ‘Many hospitals offer free weigh-ins at group lactation support groups.’ With a medical professional, you can also address concerns like dehydration or poor growth and check for medical issues (like tongue-tie for baby or hormonal imbalances for you) that might impact feeding.
FAQs
Do soft breasts mean no milk?
No, soft breasts don’t necessarily mean you have a low milk supply. It's normal for breasts to feel softer and less full as your milk supply adjusts to your baby’s needs.
Is my baby hungry, or do they just want comfort?
Look for hunger cues like rooting, lip smacking, hand-to-mouth movements or becoming more active and alert. If they’re seeking comfort, your baby might show signs like sucking slowly, glancing away while nursing or nursing for only a short time.
What are the side effects of underfeeding a baby?
Side effects of underfeeding a baby include tiredness, sluggishness, irritability, dry skin and a sunken fontanelle (soft spot on the head) in the baby. Over time, it can lead to malnutrition, poor growth, infections and growth and developmental delays.
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