If you're struggling with your breast milk supply, follow these tips and advice. By Beth Cooper Howell
Many moms give up breastfeeding because they believe that they don’t have enough milk. The truth is that the majority of women do produce ample milk for their baby. If you’re struggling with your supply, there are ways to ensure that you produce plenty of quality milk on tap.
“Generally, if breastfeeding is seen as part of loving your baby – a natural extension of the complete care that she experienced in the womb – then problems with supply are rare,” says medical doctor and International Board Certified Lactation Consultant Nan Jolly. “You will hold your baby almost all the time and be sensitive to indications of readiness to nurse – restlessness, rooting and sucking – and respond immediately. Breastfeeding is more than food and water.”
Myths surrounding breast milk supply
Dr Jolly says the belief that their supply is too low is a common reason for women giving up breastfeeding. Often, thinking that she’s doing the right thing, a mother will supplement with formula, which fills her baby up so she isn’t hungry for the subsequent breastfeed.
“Delaying or missing a breastfeed slows milk production so that the belief that your supply is inadequate becomes self-fulfilling,” explains Dr Jolly. “In contrast, if you see that your baby is still hungry after she’s been fed – and you believe that you have enough milk – you will just offer her the breast again. She will suckle until she is satisfied and if your milk supply was temporarily low, it will immediately start increasing.
“A mother’s milk supply fluctuates. If she is busy, sick or tired it will not stop her supply, but it may slow it down temporarily. If she compensates by feeding as often and for as long as her baby wants, her supply will catch up to her baby’s needs. If she panics and supplements with formula, a downward spiral can begin. Some encouragement can make all the difference at this stage.”
If you’re worried, she says, the best experts to consult are your local La Leche League or a qualified, and preferably International Board Certified, lactation consultant.
Reasons for low milk supply
● Imposing a routine and stretching time between feeds.
● Timing feeds.
● Incorrect latching and/or positioning of your baby at your breast.
● Using a dummy instead of your breasts.
● Having preconceived ideas about how often your baby should be fed.
● Delaying or missing feeds because you are busy.
Medical causes of low milk supply include:
● Retained placenta
● Medication such as hormonal contraception, diuretics or antihistamines
● Thyroid imbalance
● Emotional shock.
All medical issues can be effectively dealt with, says Dr Jolly, and judging supply is complex – health, the development and growth of your baby, and breastfeeding details must be carefully assessed for more than one consultation at your home. Most importantly, remember that inadequate milk supply is reversible.
Is my baby getting enough milk?
Your baby’s weight is not the main yardstick for determining whether she’s getting enough breast milk.
The main clues to look out for are:
● On average, five to six wet or dirty nappies daily
● Sparkling, moist eyes
● Reaching her milestones
● Alertness and energy during her awake times.
If you use weight as the sole indicator of your baby’s health, you may feel stressed by not seeing the growth you expect and this can result in decreased confidence in your breastfeeding. In turn, this leads to a diminished supply.
Dr Jolly says weight should be assessed according to the new World Health Organisation charts, as the previous measures were based on a group of formula-fed babies.
Increasing your milk supply
Moms often worry about their supply because they may interpret their baby’s frequent feeding as her being hungry or not satisfied at the breast. However, says Dr Jolly, babies need to nurse as often as 10 to 12 times a day. These feeds won’t be regular by the clock but will often be clustered. The pattern will develop as every three hours in the morning, two-hourly in the afternoon, half-hourly in the evening and then, hopefully, a five- to six-hour stretch at night.
If your supply drops, nurse more often, but get help from a consultant if there is no improvement within a few days. A full assessment by a lactation consultant working with your baby’s paediatrician is essential if there’s any doubt about your baby’s food supply.
Improving the effectiveness of the latch will help your baby get more milk from the breast, which will increase your supply and her growth, explains Dr Jolly.
Top tips for trouble-free supply
● Feed your baby as often as possible to increase her food supply.
● Have a “babymoon” – go to bed with your baby for at least 48 hours and do nothing but nurse, sleep and eat.
● Get help with latching and positioning at the breast.
● Compress your breasts during feeds to encourage the transfer of milk.
● If your baby’s suckle is weak, ask your lactation consultant about supplemental feeders such as teaspoons, droppers, syringes and even bottles.
● Milk banks are healthy alternatives if you can’t express adequate milk. Close friends or family who are breastfeeding may also donate – to pasteurise, fill a clean glass jar with 150ml of breast milk, place it in a pot of water, bring the water to the boil and remove the jar of milk. Use when it’s cooled to body temperature.
● Don’t drink too much water – this does not increase supply and may actually reduce it. Drink to thirst.
Should I use galactagogues?
These odd-sounding substances help to increase milk supply. They do work and some are safer than others, says Dr Jolly. It’s best to try all other physiologic means of increasing your supply before using drugs as a last resort.
“Galactagogues only work if the milk is removed from the breasts anyway. They are indicated if everything inhibiting milk production has been dealt with and the normal means of increasing supply have not worked.”
Many substances are recommended, with some possibly working through a placebo effect. Others work through antagonising dopamine receptors and increasing prolactin secretion.
Useful prescription drugs are domperidone, metoclopramide and sulpiride. The herb fenugreek has been shown to be effective, according to some reports. Goat’s rue and milk thistle are also recommended, though there’s less substantial evidence for their efficacy and safety. There are also various tonics, such as alfalfa, available from pharmacies.
Dr Jolly cautions moms to work closely with a qualified caregiver when taking galactagogues, and these substances should be decreased gradually rather than stopped suddenly.
Beth Cooper Howell is a freelance journalist based in the Eastern Cape. She has a keen interest in holistic health and progressive parenting. She has written a book on breastfeeding, enjoys interviewing experts on cutting-edge parenting topics and believes that nothing beats being barefoot in the veld.