So, you've started to get the hang of breastfeeding. Most importantly, you're learning to recognize your baby's signs of satisfaction after feeding. At this point, it's a good idea to watch for signs that he's getting enough milk overall—enough for him to grow steadily and thrive.
The cues that your baby is getting enough overall are simple to look for, and it's important to monitor them in the first days and weeks. They are: diapers, weight gain, and infant behavior.
This is the earliest and easiest sign to measure. In a nutshell, what goes in must come out. So if your baby is taking in enough food, you'll be able to tell from his diapers.
Here's the part of parenthood that shows unconditional love—you need to check your newborn's diapers on a regular basis. It's amazing how much information you can get from a series of dirty diapers.
The rule of thumb is that the number of stools your baby has should correspond to the days of your baby's life. So on Day 1 there should be at least 1 stool, on Day 2 at least 2 stools and so on. But don't worry; it levels off at around 4 to 8 stools per day, so there's no need to worry that he'll be having 27 stools on Day 27!
These numbers are minimums; if your baby has more stools than this, it's fine. Some babies have stools after every feeding, which could add up to about 10 on Day 7. Just make sure in these first few weeks that he's having at least 4 good-size stools each day, and that they're the size of a large button or coin or even a bit bigger. After a couple of months, the number will reduce to one or two stools per day.
Here's what the stools should look like:
Day 1: Meconium
This is what your baby swallowed in utero. When it comes out it's black, tar-like and sticky, and there's a lot of it. Even though it's not a stool caused by feeding, it's important to make sure it comes out. Your baby should have at least one meconium stool or more on his first day of life.
Days 2 and 3: Transitional Stool
The color of this stool is brownish-black. It's now moving away from being meconium and showing the effects of what your baby has begun to eat in his first few days of life and getting more and more brown. But don't worry if it appears dark green too, that's normal.
Day 4: Yellow Stool
Your baby's stool will turn bright mustard yellow and be about the same consistency as that condiment. It looks like diarrhea, but that's normal too. The change to a yellow runny stool means your milk has come in, and the stool will stay this way until your baby begins to eat solid foods. If it's a little green sometimes or looks like it has small seeds in it, that's normal.
If your milk hasn't come in by the fourth or fifth day and your baby's stools aren't what they should be, talk to your doctor about supplementing with formula until your milk starts flowing.
The output of urine should be the same as stool, and it should increase as the days pass. The problem many parents face is that disposable diapers are so absorbent, it's tough to tell if they're wet or not. If you're unsure about your baby's urine output, try this trick: Put a facial tissue or a piece of toilet paper in your baby's diaper. If it feels wet, he urinated.
The urine should be clear or light yellow. If it's dark yellow or any other color, talk to your doctor because it could indicate a problem.
In the early days before your milk comes in, you might notice what looks like blood or red-brick dust in your baby's urine. Don't panic—it's not blood, it's uric acid crystals, which are common. These crystals are normal in the first few days, but if they appear past this point, it could mean your baby's food intake isn't where it should be. Talk to you doctor if you're concerned.
Check all of your baby's diapers for at least the first few weeks, until you're sure he's having the minimum number of stools and urine output on a regular basis and his weight gain and behavior are progressing.
Source: Heather Kelly is an International Board Certified Lactation Consultant (IBCLC)