The American Academy of Pediatrics recommends breastfeeding for a minimum of 12 months and exclusive breastfeeding, without any supplemental foods or drinks, for six months. The World Health Organization recommends breastfeeding for a minimum of two years, to continue thereafter for as long as is desireable to mother and baby.
Per the CDC's 2010 Breastfeeding Report Card, only 13.3% of babies are exclusively breastfed at 6 months, and only 22.4% of babies are breastfeeding at all on their first birthdays. There is no data on babies still breastfeeding on their second birthdays. The numbers for babies breastfeeding, although not exclusively, at six months is somewhat better: 43%
Why are American moms having trouble meeting the AAP and WHO's recommendations? Per a study published in Pediatrics in 2008, the number one reason cited for early cessation of breastfeeding was concern over the quantity and quality of milk.
We have a tendency, as breastfeeding mothers, to blame everything on our milk. Fussy baby? Must not be getting enough milk. Gassy baby? Must be something mom ate. Night waking baby? Must not have gotten enough milk in that last evening feeding.
The truth is: there are a myriad of reasons a baby might be fussy, gassy or wakeful, most of them having nothing to do with a mom's milk. (And I've yet to hear someone feeling ill after a bowl of ice cream wonder "what that cow ate?")
The mother of a formula fed baby wouldn't wonder if her baby was fussing or waking out of hunger because she'd have seen the milk disappear out of her baby's bottle. As breastfeeding mothers, what is our equivalent of "watching the bottle drain"?
* Weight gain. Baby should gain 1/2 an ounce to 1 ounce per day (4-7oz per week) for the first three months of life.
* Wet and poopy diapers. You should expect to see: 1 wet and 1 poopy diaper on the first day of life, 2 wet and 2 poopy on the second, 3 wet and 3 poopy on the third, 4 wet and 4 poopy on the fourth, 5 wet and 5 poopy on the fifth, and 6-8 wet and 3-5 poopy on day six and beyond. Good thing that trend didn't keep up, you'd have had a very busy day 15! (Keep in mind: After about 6 weeks, some babies start pooping less often. As long as baby is producing plenty of heavy wet diapers and gaining weight, this is likely fine. Of course, check with your pediatrician if you are concerned.)
* Hearing baby swallowing during a feeding. Here is a great youtube video to help you identify the sound.
* The breast feels firm and full before a feeding, soft and empty after.
* Mom can feel her let down reflex. However, do not be unduly concerned if you can't feel your let down! Many moms can't feel let down (myself included!). So long as your baby is gaining weight appropriately, you are assuredly producing and releasing milk.
* Seeing milk drip or leak from the opposite breast as you nurse. (Although, again, lack of leaking does not indicate poor supply.)
* Seeing milk in baby's mouth after a feeding, or in the corners of baby's mouth during a feeding.
And, a final note to pumping mamas, pumped milk volume is actually a POOR indicator of milk supply. Letting your milk down for the pump is largely psychological. It is very much possible for a mother with a bountiful milk supply to yield only drips when she pumps. Pumping strategy is another blog post, but for this post, let it suffice to say that one shouldn't invest too much worry over scantily filled collection bottles.
Chunky, milk-fed monkey.