WHEN NOT TO WORRY
Women commonly worry about their milk supply between 6 weeks to 2 months when the breastmilk supply/demand system evens out. At this time their breasts may no longer feel hard before a feed, and they may stop leaking milk. These concerns are due to their breasts only producing the volume of milk their baby needs, and only producing it when their baby needs it and is not a sign of a low milk supply. Mothers who are concerned that they have a reduced milk supply at this stage should base their concerns on the number of wet and dirty nappies their baby is producing. Babies may fuss a little at this stage if they are used to a very strong let-down. Mothers can help their babies by using breast compressions to provide them with milk quicker until they adjust to the slower flow or develop a stronger suck.
Some women worry that because they can't pump any milk, that they don't have any, however not being able to pump doesn't necessarily mean you have a low supply. Pumping milk is a learnt response for many women, and pumping sessions may be practically dry until the woman starts to respond to the pump and the milk lets down.
Growth spurts, where babies want to feed much more than usual, are another reason that mothers may worry about their milk supply. The increased feeding will increase the amount of milk produced, meeting their demand usually within a day or two.
A low milk supply is most commonly due to insufficient stimulation of the nipple. This may be due to restricted breastfeeding, poor latch, nipple shields, tongue-tie, the over-use of dummies or unnecessary supplementation. Women who have had a caesarean may take longer to establish their milk supply as they are deficient in many of the breastfeeding hormones released during labour.
INCREASING YOUR MILK SUPPLY
The best time to increase your milk supply is in the first 6 weeks to 2 months after your baby is born. At this time the supply/demand system is still evening out, and the hormones that establish milk supply are at their greatest.
As breastmilk supply is directly related to demand, the single most important thing a mother can do is to place her baby at the breast and feed as frequently as possible. For a sleepy baby, this may require you to work at keeping them awake. Using breast compressions can help babies stay interested in feeding. Babies should be fed a minimum of 8 to 12 times a day when young, with no gap between feeds longer than 5 hours. Both breasts should be fed from at each feed to increase stimulation, and you should ensure your baby is latched on correctly.
Using a breast pump can help by providing additional stimulation and milk demand.
Some herbs, fenugreek being the most widely used, can help. This is available fresh, in nursing teas, or in tablets. A prescription drug, domperidone, helps some mothers by increasing prolactin levels.
Practical measures include drinking plenty of water and keeping warm. Warm breasts encourage blood flow and milk production and help with milk let-down.
Your midwife, Lactation Consultant, or a La Leche League leader can provide further information to help increase your milk supply.
If the mother must supplement, then the best supplement to give is her own pumped milk, followed by donor human milk if available, with formula milk the last option. The ideal method to provide supplementation is via a lact-aid system. This is an inverted bottle with a feeding tube that is placed on the mother's nipple, inside the baby's mouth. This system ensures that the mother's nipple is stimulated and the baby learns the correct sucking technique.
Other supplementing methods include using a feeding tube and a finger, an eyedropper or syringe, or a spoon. Using a bottle with an infant can easily lead to flow preference, and should be avoided where possible. If a bottle is used to supplement, ensure you feed the baby using a 'paced-feeding method'.
Overfeeding a baby supplements will lower your milk supply It can be easy to overfeed a baby using supplementing systems, as these systems often encourage the baby to drink quicker than at the breast. Just because a baby keeps on drinking doesn't necessarily mean they are still hungry, they may just be displacing the breastmilk from your next feed.
Supplementation volumes should be based on nappy numbers, if there are regular wet and dirty nappies in a newborn, then the baby is getting enough and additional supplementation is not required.
Information provided by Summer Warmth is not meant as a substitute for professional help from your health care professional. Please seek advice from your health care professional if you are having problems with breastfeeding or if you have continuing concerns.
If you would like to write your story for this page I'd love you to send it in.
I had a low milk supply after my son, Olly, was born. Olly was born via a caesarean, so we missed out on some of important breastfeeding hormones that are produced with a natural birth, and were both a bit drugged up at first. I had absolutely no confidence with latching him, I'd read books before he was born, but nothing seemed to translate to the reality of trying to get a nipple into a small, moving target. I would get the hospital midwives to latch him on, and when they asked if it felt right, I'd just say "yes" because I really wanted to breastfeed, and figured a little pain wouldn't do me any harm.
Within the next few days I had terribly cracked nipples and a baby who had lost over 10% of his weight with just two wet nappies that day.
The lactation consultant at the hospital started me using formula via a lact-aid, and showed me some latching videos, I started trying to hand-express some milk, and I started taking Domperidone. At day five, as we were leaving the hospital, I felt I was finally getting the hang of what a good latch looked like. My milk still hadn't come in, and I was supplementing 400 mls a day via the lact-aid. I found the lact-aid an absolute nightmare to use, but religiously stuck to it, and was greatly assisted by my husband, who seemed to have the knack of getting it working.
Olly thrived on the supplementation, we had lots of wet and dirty nappies, and he started putting on weight and filling out. I still never felt that my breasts were ever 'hard', but I was starting to leak milk sometimes, which I felt was promising. However Olly would always skull back the formula whenever the lact-aid was in place, no matter how much I gave him. Eventually I figured out that he really would just keep on taking as much as I could give him, and it was safe to start cutting this back. I had also really had enough of using the lact-aid, especially as my husband was now back at work and couldn't help. So, one day, at about 3 weeks after Olly was born, I simply took the plunge and stopped giving formula. I now know that this isn't the recommended method, but I was keeping track of Olly's nappies, and simply never felt that he was going hungry.
One of my strongest memories of breastfeeding Olly is of him lolling off the breast like a drunken sailor, with milk dribbling down his chin, completely satisfied. Such fond memories make our difficult breastfeeding start pale in comparison. I went on to breastfeed Olly until he was almost two years old, and I was pregnant with my daughter.