Is My Baby Moving Milk?

There will be diaper trackers and feeding logs, but how can you know during a feed if your baby is actually eating? The number one comment I heard in postpartum units went like this:  “She had it in her mouth, but I couldn’t tell if she was doing anything.” Despite the feeds tallied in their books, new moms felt unsure their babies were nourished.

In the first day of life, you’re waiting on one poop and one pee to confirm that things are going right. That’s not a lot of feedback for all the hours you’ve spent positioning, holding, rousing, and cajoling your baby to suckle, and it can take close to a day to get even that. So how does a newborn mother know if she’s doing a good job while she’s nursing?

There are patterns to sucking that will be completely foreign to you, as you’ve likely never seen a newborn breastfeed before. Here’s what we’re looking for, and we’ve got a video to illustrate them, too!

Non-nutritive, or comfort, sucking. 

This is normal and healthy, and does a lot of very productive things such as stimulate gastric juices to aid digestion, soothe and settle, and stimulate oxytocin release. However, it isn’t moving much milk. If a letdown is not triggered by this type of suckling (perhaps due to a suboptimal latch, or a baby who isn’t hungry, or a baby who is too tired to keep suckling because they haven’t been eating well) then the baby will often fall asleep and you will be confused as to whether the feed is over or never started.

Here is what non-nutritive sucking looks like: Short, rapid jaw movements, arrhythmic, intermittent sucks, with frequent pauses. This may feel like fluttering at the breast.

Nutritive, or productive, sucking. 

This is where the magic happens. Baby has triggered a letdown of milk, your body moves the milk down the breast, and the suck changes. If you are watching, it almost looks like a shift in gears. The short, fluttery jaw movements will become bigger, deeper, and rhythmic.

Here is what nutritive sucking looks like: a burst of steady sucking, perhaps five, 10, or even more sucks in a row, and then a pause. The pause is your baby catching his breath. He will initiate another burst of sucking on his own, without stimulation from you, when milk is flowing well.

This burst, pause, burst rhythm is your most compelling sign that your baby is actively drinking, not just nibbling. You will feel a strong tug as he is sucking.

Milk flow keeps babies engaged. When there is little milk moving, they fall asleep. So the baby who sucks a few times and needs to be rubbed to keep sucking, will instead keep falling asleep. When the tap is on, their little jaws will keep going without your input.

This wonderful video illustrated these two different types of sucking. The comparison starts at minute two, but the whole video is a good overview of assessing milk intake in the first days of life. Bookmark it, and watch it as many times as you need!