August 16, 2019
“Buy this nursing pillow.” “This nursing cover is the best.” “Nurse exactly 15 minutes on each side and then switch.” Friends and family are always full of advice when it comes to breastfeeding your new little one, but one thing many people avoid mentioning is that breastfeeding is hard.
Sure, breastfeeding is supposed to be “natural” and therefore assumed to be easy. Maybe for some it is, but for many it’s not. In fact, many mothers don’t breastfeed for as long as they would like as a result of these challenges. And one of the top challenges cited is milk supply.
Milk supply issues can happen for a number of reasons. For some issues, there might be a fix and for others, there might not. That’s okay, too. The most important thing to keep in mind is to do what’s best for you and for your baby.
Milk in the First Few Days
The first thing that comes as a surprise for many moms is that your breasts aren’t just automatically full of milk as soon as you have your baby. That’s perfectly normal. After birth, your breasts produce something called colostrum.
Colostrum is super concentrated and has the vitamins and nutrients that are just what your baby needs. You won’t produce much and that’s perfectly normal. In fact, your baby only needs about a teaspoonful at each nursing.
After a few days, your breasts should start producing more milk. So, if you’ve just had your baby and you’re worried about your supply, it’s probably just that your milk hasn’t come in yet.
Signs You Don’t Have a Milk Supply Issue
If you’re still worried about a supply issue after the first week or so, take a moment to consider if your supply really is low. A breast that does not feel full is not necessarily a sign of a milk supply issue, neither is a lack of feeling the let-down reflex, the tingling sensation in your breast that accompanies the signal to release the milk. If your baby cries frequently, it isn’t necessarily because she’s not getting enough milk. The amount you’re able to pump is also not a good sign of your supply. A baby is much more efficient at removing milk from the breast than a pump.
Nursing can be stressful and it’s easy to take every little sign as a problem; you’re not the first mom that has worried and you won’t be the last. We’ve all been there. If your little one is gaining weight well and has plenty of wet and dirty diapers, you probably don’t actually have a milk supply issue.
Find a Certified Lactation Consultant
If your pediatrician has concerns about your baby’s weight and growth, the first step is to see a certified lactation consultant (CLC) or an International Board Certified Lactation Consultant (IBCLC). A low supply could be linked to a shallow latch when your baby nurses. Signs of a good latch are if you can see your baby’s tongue if you pull his lip down, his jaw moves in a circular motion rather than just his chin moving up or down and you don’t hear any clicking or smacking sounds.
A lactation consultant can easily identify a bad latch or nursing position and help you fix the issue. Not only can a bad latch cause problems with supply, but you’re probably going to end up with some pretty sore nipples as well.
Sometimes your little one can have a bad latch because of a tongue or lip tie. A lactation consultant can usually identify this, too. Although, you may need to see your pediatrician to have it corrected.
There are also a number of maternal health issues that can affect supply. Anemia, hypothyroidism, postpartum hemorrhage, previous breast surgery and even hormonal birth control can affect your supply. Talk to your doctor to check for and address these issues.
Milk is Supply and Demand Driven
Your breastmilk production is supply and demand driven. This means that the more your baby nurses (the demand), the more your body produces (the supply) to meet that need. If demand increases, like if your baby nurses more or if you pump between nursing sessions, the supply will usually increase. And if the demand decreases, for example if you’re supplementing with formula, your supply will also decrease.
Sometimes, when new moms have trouble nursing, the pediatrician recommends supplementing with formula. This is absolutely okay because you need to do what’s best for you and baby. It might be a good idea to use a breast pump if you do, to avoid sending the message to your body to produce less milk.
If you’re concerned about your milk supply, you should talk to your pediatrician and your doctor to evaluate if the supply is low. You can also work with an IBCLC to help figure out the cause and develop a plan to address it.
If you’re still establishing your milk supply in the first 2-3 weeks, and you’re trying to boost production, you might try to add in an extra nursing session or two. As a new mom, I know the last thing you want to do is wake up once more to nurse at night, but it might be just what your body needs to produce more breast milk.
Other things that can potentially affect your supply are cutting your nursing session short before your baby is actually done nursing. There is no set time for feeding. Your baby will let you know when he is done. Stopping too early can mess up the supply-demand relationship.
Offering only one breast per feeding is also not a good idea if you’re concerned about supply. Some moms need to do this because they produce too much milk, but if you’re worried about low supply, let your baby finish one side and then always offer the other.
Changing Your Diet Can Help
If you do have a low milk supply and have tried nursing or pumping more frequently, more completely, and for longer, is there anything else you can do? Those are considered the most effective ways to boost supply, but your lactation consultant might also recommend changing your diet. There isn’t a lot of scientific evidence supporting dietary changes, but it’s safe and there’s a lot of anecdotal evidence supporting it.
Oats are believed to help with milk supply because of their high iron content. Adding oats doesn’t have to be boring, either. You can add some berries to a bowl of oatmeal in the morning or spice it up and make a batch of lactation cookies, which are loaded with oats.
Fennel is also believed to increase milk supply. You can cook it up by itself or find it in a tea. Breastfeeding moms have quite a few “lactation” teas with fennel to choose from. Save yourself a trip to the normal grocery store, though. It’s easiest to find at a specialty grocery store, natural food store, or farmer’s market.
Brewer’s yeast is another option to increase supply. You can use the yeast in baked goods, including the lactation cookies, or even a smoothie. Another plus of brewer’s yeast, it’s high in Vitamin B, which helps energy levels. It’s easiest to find at a natural food store or a vitamin shop.
Adding more iron to your diet can help boost your supply. You can find iron in red meat, beans and leafy greens like spinach or kale. Remember, your diet affects your little one through breastfeeding, so adding more iron to your diet can be beneficial for your baby, too.
Adding Supplements to Help Boost Supply
If changing your diet doesn’t do the trick, it might be time to consider a supplement. Keep in mind that there is very little scientific research that proves these supplements are successful in increasing milk supply, and they’re also not well regulated, but many moms say they have used them with success.
Fenugreek, blessed thistle and anise are some of the more common supplements used by breastfeeding moms.
It’s also a good idea to talk to your doctor before starting any supplement to make sure it won’t interfere with any health issues and remember to keep your eye out for any side effects, such as nausea, headache or vomiting.
Whatever path you take, the only thing you have to think about is the well being of you and your little one. If that means you push on and keep nursing, great job mama. If that means you supplement with formula or switch completely, you rock! You’re raising a little human being and you’re amazing.
The U.S. Department of Health and Human Services Office on Women’s Health. Your Guide to Breastfeeding. Retrieved on August 12, 2019 from https://www.womenshealth.gov/files/documents/your-guide-to-breastfeeding.pdf
Gatti L. (2008). Maternal perceptions of insufficient milk supply in breastfeeding. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 40(4), 355–363. doi:10.1111/j.1547-5069.2008.00234.x
The Royal Women’s Hospital. Low milk supply. Retrieved on August 6, 2019 from https://www.thewomens.org.au/health-information/breastfeeding/breastfeeding-problems/low-milk-supply
NHS. Breastfeeding: The First Few Days. Retrieved from https://www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-first-days/
KellyMom. Increasing Low Milk Supply. Retrieved from https://kellymom.com/hot-topics/low-supply/
Parents.com. 5 Food that Could Help Increase Your Breast Milk Supply. Retrieved from https://www.parents.com/baby/breastfeeding/tips/5-foods-that-could-help-increase-your-breastmilk-supply/
American Pregnancy Association. Breastfeeding Latch. Retrieved from https://americanpregnancy.org/breastfeeding/latch/
LactationLab. Do Supplements Really Work to Increase Milk Supply? Retrieved from https://www.lactationlab.com/blog/2018/3/9/k1353wt1t8os2dapxm8zh6vw93qfja
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