Clinical features of insufficient milk supply

Suspect insufficient milk supply with the following symptoms:

• in infants
  • wants to feed very often - more often than 2 hourly with no long intervals between feeds (1)
  • consistently feeds for less than 5 minutes or more than 40 minutes (unless low birth weight or newborn) (1,2)
  • is unsettled - baby cries a lot and seems to unsatisfied with the feeds (1)
    
    
• in the mother
  • the breasts feel soft
  • unable to express her milk

The most common signs of insufficient milk supply are:

• poor weight gain
  • there can be some weight loss for the first few days after birth but babies regain their birthweight by 2 week of age
• low urine output
  • urine less than 6 times per 24 hours
  • especially the urine is dark yellow and strong smelling
• in addition, passing sticky black stools (meconium) 4 days after birth is also an indication of low milk intake by the baby (1)

Reference:

• 1. World Health Organization (WHO) 2009. Infant and young child feeding. Model chapter for textbooks for medical students and allied health professionals
• 2. Oxford Radcliffe NHS Trust 2008. Breastfeeding assessment form. UNICEF UK Baby Friendly Initiative