Concern about low milk supply is common among new moms. Here’s your guide to know if you’re making enough milk, plus remedies on how to increase milk supply for breastfeeding.
Breastfeeding can be stressful for a first-time mother, especially if you are worried about your milk supply to satisfy your baby’s hunger. At some point of our breastfeeding journey, we all have doubted or asked ourselves a question; Am I making enough milk? Is my milk supply low? Often time, there isn’t even a problem.
In fact, research study published in Journal of Pediatrics,2013 states that 60% of mothers starts breastfeeding and stops before they desire within the first few months. One of the most common reason to stop completely or partially is worry about “I am not making enough milk” among others.
The first few weeks of breastfeeding are important for breastfeeding success, especially when you and your baby are figuring out what works best for both. It is also a critical time when you’re establishing your breast milk supply.
For many mothers, milk supply is just fine. Even if you think it is not, good news is, there are plenty of natural ways to increase your milk supply. All you need to do is, just hang in there a bit longer!!
Read on to learn if you’re making enough milk and evidence-based remedies on how to increase your milk supply for breastfeeding.
Here’s what we will talk about and much more,
- How does your Milk Production Work?
- Is your milk supply really low?
- Causes of a low milk supply
- How to increase your milk supply?
How does your Milk Production Work?
As early as 10 to 22 weeks of gestation, your breast starts preparing for milk production. You will notice change in your breast as number of milk ducts increases in your breast.
Within few hours after your baby is born, mother produces small amount of fluid called colostrum. Milk production does not start until your serum progesterone level drops significantly (which is around 4 days postpartum).
Milk production is complex interplay between hormones and neurotransmitters. Prolactin, a hormone, is secreted in response to nipple stimulation and Oxytocin, another hormone, contracts muscle cells in your breast to let down milk. Oxytocin level is inhibited, if mother is stressed or experiencing pain. So, here you go, no stress while breastfeeding, mama!!
One-month postpartum, basal prolactin level return to pre-pregnancy state in non-breastfeeding mothers, while it remains elevated in breastfeeding mothers due to nipple stimulation by baby. As your baby nurses, your prolactin level increases, and more milk is produced. It is a continuing cycle of supply and demand.
If your baby is not latching properly and unable to empty your breast, expressing milk by hand or pump is important. An inhibitor of lactation is found itself in your breast milk, If the milk is not removed, the inhibitor will stop milk production.
Is your milk supply truly low?
First off, is your milk supply truly low? Or you think is low? Often, a maternal perception of insufficient milk is the most common reason for ceasing breastfeeding (source). If your baby is gaining weight on breastmilk alone, then you do not need to worry about it.
Unfortunately, baby can not say,” mommy, I am still hungry!” after a feeding. If you are wondering “How do I know if my milk supply is low?” Your baby will give you cues, if this is the case.
Here’s are the most common cues to looks out for,
Stalled weight gain:
Within first few days, baby loses 7-10% of their birth weight, but they should regain that weight by the time they are 10 days old. If baby struggles to put on weight, then low milk supply may be issue. Most newborns gain weight at a rate of about 1 ounce per day (4 to 7 ounces a week) and go through a period of rapid growth when they are 7 to 10 days old and again at 3 weeks and 6 weeks (source).
If your baby is not gaining enough or losing weight, then it’s an indication that he is not getting enough milk.
Fewer dirty diaper
First few days after birth, baby should have same number of wet diapers as his age. If baby is 3 days old, then he should have 3 wet diapers. By day 4 to 5, baby should have 5 to 6 wet diapers and 3 to 4 dirty diapers. Urine should be pale yellow with mild smell. The normal poop of breastfed baby is about the size of US quarter, yellow in colour and soft to watery /curdy or seedy in consistency. If your baby has enough dirty diaper, then he is likely getting enough milk.
Baby activity level
If your baby is not getting enough milk than they may not wake as often or not as active when they are wake. If baby is not alert, active and not meeting developmental milestones, then baby is not getting enough milk.
It is also worth mentioning that there are several UNRELIABLE ways that make you think if your milk supply is low. But these ways do NOT mean that your milk supply is low.
Breast feels softer
During early weeks of breastfeeding, most mothers feels fullness or engorgement in their breast. Reason being mom’s breast haven’t yet adjusted to baby’s need. As your baby nurses regularly and adequately, typically around 6 to 12 weeks, your milk supply will adjust to baby’s need and your breast will begin to feel less full and soft.
No let down and No leak
You do not feel a let down sensation anymore or you don’t feel it as strong as before. This does not mean that your milk supply is low, rather your body has figured out that how much milk is removed from your breast and just to make enough.
Once your milk supply has adjusted to your baby’s milk need, your breast will not leak or leak a little. No more breast pad, mama!!
Frequency and/ length of feeding
Sudden increase in frequency and/or length of feeding does not mean your milk supply is low.
Common times for growth spurts are during the first few days after birth and around 7 to 10 days, 2 to 3 weeks, 4 to 6 weeks, 3 months, 4 months, 6 months and 9 months. This is a guideline; your baby may have different time for growth spurt.
As your baby gets older, you will also notice that baby doesn’t nurse as long as she did previously. Again, this does not mean anything. As they get older, they get more efficient at extracting milk. Not to worry, mama!!
Breastmilk is digested quickly than formula. So breastfed babies need to nurse frequently (1.5 to 2 hours) than formula fed babies. So, when you hear about long stretch between feeding from your formula feeding friend, do not think about your milk supply being low, mama!!
Baby may take a full bottle after a nursing
Many babies will take a bottle of expressed milk or formula after nursing. This may not be due to hunger issue.
Newborn babies, breastfed or formula fed, are often fussy during late afternoon or evening. There can be many reasons for fussiness and usually not due to hunger or low milk supply.
Pumping output is low
When I started pumping to boost my milk supply (explained below) I noticed very little output at first. I was worried and asked myself, “Is my milk supply low?” Fortunately, I had a help from Dr.Goolge to answer my question and put my mind to ease.
The amount of milk that one can pump is not accurate measure of milk supply. A baby is way more efficient in extracting breastmilk than any pump. As I pumped more often, I got better at pumping. Yes, pumping is an acquired skill and it also depends on type of pump used.
So, now you know that some of these unreliable measure does NOT mean that your milk supply is low. Let’s talk about what causes low milk supply and how to increase your milk supply naturally.
Causes of Low Milk Supply
Delay in breastfeeding after delivery can cause a low milk supply for baby. Anything that prevents baby from extracting milk from breast can cause reduction in milk supply. Here are few reasons for breastfeeding delay,
- Mother’s health issue such as mastitis, retained placental tissue, postpartum excessive blood loss or pre-existing health issue such as hypothyroidism, polycystic ovarian syndrome, diabetes or use of hormonal birth control pill.
- Baby’s health issue such as jaundice, tongue tie, difficult or prolonged delivery or baby needing Neonatal Intensive Care Unit (NICU).
Some babies are very sleepy for first few weeks and wakes up to nurse infrequently rather than every 2 hours. Initially, when establishing milk supply, make sure to wake baby every 2 hours for feeding during days and every 3 to 4 hours at night.
Amount of milk produced by your body depends on amount of milk extracted from your breast by baby. Remember, more your baby nurses more milk your body makes (supply and demand). If you supplement your baby with 2 oz of formula, then your body will make 2 oz milk less and that will decrease your milk supply.
Early introduction of bottle
Early introduction of bottle (expressed breast milk or formula) can cause a problem in your baby latching at breast may lead to decrease in your milk supply. As milk flow in bottle is faster and easier than baby latching at breast and working hard to extract milk. Your baby may start preferring bottle over breast.
Feeding your baby on schedule like every 3 hours rather than on demand can affect your milk supply in long term. So, feed your baby on demand for first few weeks. During growth spurt, if your baby wants to nurse every hour, feed them. Do not worry about spoiling them. They are too little to think about it yet.
Dummies or Nipple shield
It reduces nipple stimulation and milk transfer thereby interfering supply-demand cycle.
Early introduction of pacifier can affect baby’s latch and reduces the amount of time spent at breast by your baby during breastfeeding.
Length of nursing
Cutting length of nursing by removing baby from breast before baby ends feeding himself can affect your milk supply.
Offering only one breast at each feeding can cause low milk supply specially when you are trying to establish your milk supply.
First few days with a newborn can be stressful and daunting, specially for first time mothers. Between lack of sleep and adjusting to the baby’s schedule, it can get quite stressful. Maternal stress, anxiety or discomfort can interfere with the let-down and cause you to produce less milk.
How to Increase Your Milk Supply?
Now that you understand how your milk production works and potential causes of low milk supply, it will be easy to do right things to increase your milk supply. Remember that, decrease in your milk supply is not a permanent problem. There are number of ways to boost your milk supply overtime.
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Let’s go right into this,
Make sure that your baby’s latch is correct. A poor latch is one of the main reasons why your milk supply is low. Baby cannot extract milk efficiently if latch is poor. If milk is not efficiently removed from the breast, then your milk supply decreases.
A sleepy baby, use of nursing aid (nipple shield, dummies), baby’s health and mother’s health can also interfere with baby’s ability to extract milk from the breast.
Amount of milk removed from your breast is directly proportional to amount of milk made by your breast. If your baby is unable to empty breast at feeding, you should express milk after feeding and/or between feeding to maintain milk supply.
If you are concerned about your baby’s latch, then contact doctor or a lactation consultant. Getting help from lactation consultant within first week after birth of your baby can save you from lot of trouble like crack in nipple, blisters, bleb, clogged milk duct
Breastfed, Breastfed and Breastfed
You may have heard this so many times from other moms and it is an ultimate truth to increase your milk supply. The more you feed your baby (demand), the more you are signaling your body to make more breast milk(supply).
In the first few weeks after baby is born, feed every 1.5 to 2 hours during days and every 3-4 hour at night to increase your milk supply. Take baby on a nursing vacation. Do nothing but feed. Lots of skin-to-skin contact within first few days, helps breastmilk to flow freely by releasing oxytocin.
Let your baby nurse as long as he desires. During the first few weeks after birth, newborn breastfeed for 10-15 to 60-12 minutes on each breast. The more time your baby spent at breast, more stimulation your breasts are getting.
If your baby falls asleep or loses interest, switch breast for 2-3 times during each feeding, using burping and a diaper change in between to keep baby alert.
Breastfeed from both breasts
Breastfeeding from both sides during each feeding for first few weeks, will help you build up a stronger supply of breast milk.
Do not always start breastfeeding on the same breast, as the breast that you offer first, gets more stimulation to make milk and may become larger than the other breast.
Breast compression can be helpful for sleepy or distractible babies to keep them interested. It helps your breast milk flowing, so baby can take in more milk while breastfeeding. Take a look at this breast compression teaching video by lactation consultant.
Use a breast pump
Just like me, if you are not a hand expression person, use a good breast pump after or in between feeding session. Pumping is very important when your baby is not efficient at extracting milk from your breast. The more you empty your breast, the more milk you will make. The purpose of adding pumping session is to remove more milk from your breasts.
Another method, specially for mom who can not nurse all day, is power pumping. It happens only once a day at same time every day. This can be done for a few days and aim is to signal your body to make more milk. This is how it works,
- Pump 20 minutes
- Rest 10 minutes
- Pump 10 minutes
- Rest 10
- Pump 10
Stimulate your breast after feeding
After feeding your baby, stimulate your breast to signal your body to make more milk. You can use breast pump or a hand expression technique to stimulate your breast. A hand expression technique is more comfortable and cheaper than a pump but takes a longer time to learn.
Do not supplement your baby
Give only breastmilk to your baby. If you skip a feeding or give your baby a formula, it interferes with supply and demand cycle. If you skip a feeding, consider pumping to compensate for it.
Avoid pacifier and bottle
As mentioned earlier, avoid introduction of pacifier during the first few weeks after birth, if possible, until your milk supply is established. If you give your baby pacifier, he may not nurse as frequently as he would without one. So, when your baby seeks a pacifier, offer him a breast instead.
If you need to supplement your baby for medical reason, consider using spoon, cup or dropper instead of bottle. Read more on Alternative feeding methods here.
Eat well and drink lot of fluids
Take care of yourself mama!! Drink lots of fluid when thirsty and eat a well-balanced diet. Making a breast milk requires a lot of energy. So, to make more milk and keep up with the supply, make sure you are getting plenty of nutrients in your food.
You can even add some milk boosting food or galactagogues supplements in your daily diet for much-needed extra calories such as,
- Whole grains
- Dark green veggies
- Sesame seeds
- Brewer’s yeast
Things to avoid
Many things such as medication, too much caffeine, alcohol, smoking can get in the way of establishing your milk supply. Taking a birth control pill within first few weeks after delivery can impact your milk production. Alcohol consumption is not only harmful during pregnancy but also while breastfeeding, as it passes through your breast milk to your baby and causes developmental delays.
Food such as parsley, peppermint, cabbage leaves are also said to affect your milk production adversely.
Who to Contact if You have a Low Milk Supply?
If your baby is losing weight or not gaining weight, contact your doctor. It may be a medical condition that require immediate attention and not the issue of low milk supply. In case medical condition requiring you to supplement your baby, use only expressed milk to supplement your baby if possible.
If you’re concerned about your milk supply, it will be helpful to contact your health care provider or a board-certified lactation consultant.
Believe in yourself Mama!!
Low milk supply is a common concern among first time mothers – so if you are worried, you are not alone mama! Most moms can build and maintain healthy milk supply while breastfeeding.
If you suspect low milk supply, contact lactation consultant for a support. Also, look for a support from other moms from breastfeeding support group. They may be going through same things as you and may encourage you to keep going on right direction to boost your milk supply.
Do not let fear or insecurity come in your way to build your milk supply. As long as you are – feeding efficiently, frequently and your baby is gaining weight you are doing great, mama!!
How About You?
Are you worried about your milk supply? What remedies worked for you? Let us know in comment below.