Busting booby traps of low supply
We're busting the booby traps of low breast-milk supply with our special guest blogger, Pinky Mckay, IBCLC - Australia's most recognised breastfeeding expert.
The most common reason women say they give up breastfeeding is because they don’t think they have enough milk. Is it any wonder that a breastfeeding mother’s confidence can be shattered when almost any variation in her baby’s behavior (read, sleep or feeding patterns) will be explained by unhelpful advice such as, “are you sure you have enough milk?”
While there are certain medical conditions that may create challenges to breast-milk supply, such as PCOS, diabetes, thyroid disorders, low iron levels, high blood pressure and a condition called Insufficient Glandular Tissue (red flags include a lack of breast development during puberty and pregnancy and/or tubular shaped breasts that are widely spaced), there are also a lot of ‘booby traps’ that have mothers reaching for the bottle when what they are experiencing is perfectly normal or can be fixed quite simply with the right advice and support.
If you are having a hard time, you don’t need to ditch your nursing bra just yet. Try to remember, whether you can exclusively breastfeed or not, every drop of mummy milk is liquid gold and there is help available. Calling in an expert such as an IBCLC (International Board Certified Lactation Consultant) could make a world of difference to your confidence and your breastfeeding experience.
Meanwhile, let’s bust some ‘booby traps’.
My baby feeds all the time:
Your newborn’s stomach is the size of a marble and after about ten days it will only be the size of his tiny fist (or a ping pong ball if you don’t yet have a baby and can’t visualize this), so he will need frequent feeds - around 8 to 12 feeds in 24 hours. Also, in the early weeks your baby is mastering the art of sucking, swallowing and breathing so he needs lots of practice to become an efficient feeder. It’s also worth understanding that women have different breast milk storage capacities so although most women produce enough milk, a woman with a smaller storage capacity (this isn’t necessarily related to breast size), will need to feed her baby more often than a woman with a larger storage capacity, whatever the age of the baby.
Tip: Watch your baby, not the clock. In the early weeks, there is still some breast development going on and by feeding according to your baby’s hunger cues, you are setting your breasts’ capacity for milk production. This means that the more milk your baby removes, the more milk your breasts will be signaled to make and the higher you will ‘set’ your ongoing milk production. But if you space out feeds (by implementing a feeding schedule) or you top your baby up with formula, she naturally eats less at the breast, your breasts will respond by making less milk. If you do need to offer supplements (first rule is ‘feed the baby’), expressing, as well as putting your baby to the breast, will help increase your supply.
My breasts feel soft:
At first your breasts will feel hard and swollen as your milk comes in but a lot of this swelling (engorgement) is extra blood circulation and tissue fluid as your body gets used to this new experience. As your baby and your breasts become synchronized so you are making the amount of milk your baby needs, your breasts will naturally soften and feel less swollen. As long as your baby is feeding effectively and you respond to his hunger signals, you will usually make exactly the amount of milk your baby needs.
Tip: If your baby is only drinking breast milk and having at least one soft yellow bowel motion and 6 to 8 very wet cloth or 4 to 5 heavy, wet disposable nappies a day, he is getting enough milk (what comes out must be going in!).
My baby has suddenly started feeding more frequently:
Your baby may be having a growth spurt and a corresponding appetite increase or he may be coming down with a bug and need an immune boost: the transfer of saliva from your baby’s mouth to your breasts signals you to produce antibodies to any bugs your baby is exposed to and he will receive these antibodies as he drinks your milk.
Tip: Take your baby to bed or relax with a stack of DVDs (Netflix and chill has a whole new meaning!) and rest with your baby, snuggling skin to skin (this will boost your milk making hormones) and allow him to feed whenever he shows hunger signals. This will help your body catch up with your baby’s increased need to feed.
My baby only has short feeds:
Although in the early days, feeds seem to take forever, often at around 10 to 12 weeks, many babies seem to quite suddenly feed more quickly. As long as your baby is having wet nappies (see above) and gaining weight, they have most likely become an efficient feeder so don't need to suck as long. However, if your baby seems to be having short feeds and isn’t gaining weight steadily, consider, is he latching and sucking well, has he been checked for an issue such as tongue tie, is he distracted during feeds?
Tip: Any time you are concerned about your baby’s feeding patterns, get a professional such as a lactation consultant to observe a feed to make sure your baby is attaching, sucking and transferring milk effectively.
My baby grunts and squirms and seems frustrated when he feeds:
Although some babies become impatient as they wait for the milk to start flowing, others can feel uncomfortable for various reasons. For example, your baby may be affected by tummy discomfort because as he starts sucking, this also starts peristalsis (food or wind moving around the gut) so he is struggling a bit to coordinate feeding and farting at the same time. Tired babies or babies who have been crying (crying is a LATE hunger signal), will often squirm at the breast because they are having difficulty organizing feeding behavior. This often happens in the evening, leading mums to believe they don't have enough milk.
Tip: Observe your baby’s feeding cues (rooting towards the breast, moving his hand to mouth and making little noises) and respond quickly. If you have been giving your baby bottles, he may be developing a preference for the fast flow from a bottle so if you do need to supplement, start at the breast then ‘finish at the breast’ so that he associates a full tummy and comfort with Mummy and breastfeeding.
My baby gulped down a full bottle of formula after a breastfeed:
Sucking is an involuntary newborn reflex. Its particularly strong in babies under three months. This means that when you pop a bottle teat into your baby’s mouth, it will automatically stimulate a sucking reflex. As the baby sucks, his mouth fills with milk, which he then has to swallow. The swallowing triggers the suck reflex again so your baby keeps on sucking and swallowing. It looks as though he is ‘hungrily’ gulping the bottle of formula when, actually, he simply can’t control his natural sucking reflex. Of course, after drinking a bottle of formula, your baby will fall asleep for hours because he is ‘full’ and also because formula takes longer to digest than breast milk, so it’s only natural that you will start to doubt your ability to produce enough breast milk.
Tip: It’s never too late to get help – watch your baby, not the clock, eat nutritious foods, drink to your thirst, surround yourself with supportive people and seek help if you have any concerns about your milk supply. If anyone asks, ‘are you sure you have enough milk?’ tell them, ‘my nurse/doctor/pediatrician’ says we are doing fine, thankyou,’ then quickly change the subject.
Pinky McKay is Australia’s most recognized Breastfeeding expert. She’s an IBCLC lactation consultant, best selling author of Sleeping Like a Baby and Parenting by Heart and creator of Boobie Bikkies, natural, organic and lactogenic cookies to boost energy and support a healthy breast milk supply.
For tips to boost your breast milk supply, download Pinky’s FREE ebook ‘Making More Mummy Milk,Naturally’
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