Supply

Breast milk supply seems to be a big question for new mothers, do I have enough milk for my baby is a common question.  I think the biggest hurdle is that you cannot see your milk, therefore you don’t know how much is there. We are very focused on numbers and mls but this is not how to adequately assess your supply, this is a guess.

Let me first explain about supply, 95% of women can establish a milk supply if the breasts are stimulated correctly.  The notion of ‘drying up’ or that you just didn’t ‘produce enough’ is not correct.

Your milk supply is triggered when your placenta is removed from your body, this creates a hormonal surge which culminates in your ‘milk coming in’around 72 hours post birth.  This happens regardless of whether you stimulate your breasts with breastfeeding.  As well as this happening your body is also producing milk in response to what your baby takes out.  So there is two ways in which you make milk in the first 2 weeks.

It is best to have unrestricted access to your breasts in this time to bring on your milk well.  It is important to note that your baby’s appetite is coming into play here and it is best to just go with your baby.  They may feed every 1-4 hours at this stage.  Don’t try to restrict the feeds, don’t try to get into any pattern just learn how to attach well and know that all this feeding will give you a good milk supply.

After the first 2 weeks your body stops telling you to make milk and it is just supply and demand.  What you take out you replace so your milk supply actually decreases over the first few weeks in response to your baby’s appetite.  A lot women feel their milk supply is not enough as their baby feeds longer and more often but it is just the body settling down.

Pumping in the early days will create more of a supply and this is not a good thing as you will then produce more than your baby needs and you will have to keep pumping to relieve the pressure in your breasts.  This is where a lot of women run into problems, pumping becomes too time consuming and they have enough milk so they stop pumping which then can lead to blocked ducts and mastitis.  If you have an oversupply or pumped often in the early days contact a lactation consultant for advice.  You may need to wean down your pumping slowly and this can be done over a few days.

In the first few weeks take your focus off your milk supply and pay attention to your baby’s weight and output.  If your baby is pooing and weeing well and putting on weight then it doesn’t matter how much they are getting they are just getting enough.

Baby’s have black poo in the first few days and have only 1 wee in the first 24 hours, then 2 wee’s in the next 24 hours and so on.  The poo will start to change colour as your milk comes in, from black to green/brown to yellow.  A baby 6 days to 6 weeks will wee 6-8 times a day and poo at least once a day.  This poo will be big or the poo will be smaller and more often, the poo equals the gap in time.

Supply can be increased with herbs and medication, seek advice from your lactation consultant to guide you through this.  But just remember that if you feed more you will make more.

There are some medical conditions that may cause low supply such as PCOS (polycystic ovarian syndrome), thyroid conditions and issues related to infertility.  These conditions may or may not hinder your milk supply, it is really a ‘wait and see’ game.  If you have any of these conditions it is important to contact your lactation consultant who will discuss a plan for you to maximise your milk supply.

If you feel your supply is low and you are told to compliment with artificial baby milk just remember that this is just a bandaid treatment and will decrease your supply.  What generally happens is that you have to keep complimenting as your supply issues have not been addressed and your supply drops further leading to early weaning.  This is where mothers may say their supply ‘dried up’ but in fact it was mismanagement.  Always question why artificial baby milk is needed and before you give it seek other options from a lactation consultant.

Early formula use in hospital is one of the biggest reasons for low supply.  Just one bottle of formula, even just 20mls, can affect your supply.  Your baby takes a long time to digest formula so they may sleep longer, reducing the stimulation on your breasts and will be tired for the next few feeds again leading to reduced stimulation.  Also your baby’s stomach will stretch and will want more than you have which often leads to more formula use.

If you have used formula or have pumped, it is not all over, you just need a plan to head in the right direction and then it will all work.  It is hard to understand all the information out there but remember to ask questions and seek support from someone whom you can build a rapport with, someone who you and your family trust.  This will give you the confidence to fulfil your breastfeeding dreams.