What DOESN'T help you and your breastfeeding support professionals work out if you have enough milk
The amount of tightness or fullness of your breasts doesn't help you work out if you have enough milk
It's true that studies of women who pump their breastmilk have shown that more milk can be removed from a breast that feels full prior to pumping.
However, waiting for your breasts to feel full before breastfeeding may cause your supply to drop off. This is because high pressures inside the milk glands send messages which cause the breasts to produce less milk. You can find out about this here.
Tightness or fullness of your breast is not a good indicator of how much milk you're producing.
After about six weeks of breastfeeding, many women find that their breasts are mostly not particularly tight. This is because they are offering their breasts to their baby frequently and flexibly, and their milk supply has calibrated to meet their baby's need. Any overshoot of milk production volume has been downregulated.
Counting milk ejections doesn't help you work out if you have enough milk
Most women won’t be aware of most of all of their milk ejections, and baby’s swallowing will be variable because many milk ejections don’t release large volumes of milk.
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You can find out about your letdowns here.
Test weighing in a consultation doesn't help your breastfeeding support professional work out if you have enough milk
A breastfeeding support professional performs a test weigh by taking your baby's weight fully clothed before a breastfeed, and then again immediately after the breastfeed.
However, the amount of a milk a baby transfers in any one breastfeed is highly variable. Some breastfeeds don't involve much milk transfer at all in exclusively breastfed babies gaining weight beautifully. Test weighing before and after a single feed is unhelpful and may be misleading, for this reason.
Test weighing before and after feeds over a 24-hour period is a useful research tool, giving us one 24-hour milk intake volume. (There's every reason to think this may vary somewhat day to day, but it is more useful than a single test weigh.) However, test weighing at home can be disruptive to baby (waking baby up after a breastfeed, and causing baby to dial up a lot before a breastfeed). It also requires the primary carer to spend the day at home, which may cause baby to dial up and result in a stressful day.
I don’t recommend test weighing, because in my experience there are other more effective ways to work with weight gain challenges.
Counting suck-swallow ratios in a consultation doesn't help your breastfeeding support professional work out if you have enough milk
The research shows that suck-swallow ratios are highly variable in normal babies gaining weight well. Also, even when things are going well, some breastfeeds don't involve much milk transfer, and this may be the case during a consultation.
Placing pressure on any feed to be a 'meal' can cause breastfeeding to fail. You can find out about frequent and flexible breastfeeding here.
Using a stethescope in a consultation doesn't help your breastfeeding support professional work out if you have enough milk
Your breastfeeding support professional doesn't need a stethoscope to listen to baby's sucking. Noticing how much or how little swallowing and milk transfer is occuring requires listening for the 'k' sound of a swallow, and observing jaw movements, without a stethescope.
Milk transfer is variable between breastfeeds, and some breastfeeds don't involve much milk transfer at all. What matters for you and your baby is the pattern of milk transfer occuring over a 24-hour period. Your health professional's assessment of milk transfer will include multiple factors, such as urinary and stool output, the baby’s satiated or dialled up behaviour, the plot of the percentile chart, and weight relative to a previous weight.
You can find out how to know if your baby is receiving enough milk here.