How do I know if I have enough breast milk?
Is my baby getting enough from breastfeeding?
Can I over or under feed my baby?
Does formula affect the amount of milk I produce?
These are just some of the frequently asked questions we are asked by expecting and new mums.
Some of these questions cannot be answered until the baby has arrived and breastfeeding has begun. However there are some things you can do to ensure you can give your body the best start to breastfeeding.
The amount of breast milk produced is dependant on several things, including hormones, feeding frequency/duration, time of the day and of course the baby. Because we cannot see how much milk our breasts hold/produce we can never know how much there is. This can be very hard for new parents to understand. In hospital the baby's weight will be checked and feeds regularly documented. We tend to focus on numbers too much, however this is not always an accurate measure of your supply, it is only always an estimate.
Often we hear our friends or mothers/sisters say that they didn't produce enough breast milk or their baby was too hungry or that the milk dried up. In reality there are very few instances where a mother cannot produce an adequate milk supply. There are some medical conditions that may impact breastfeeding such as Poly Cystic Ovarian Syndrome, Thyroid disorders and some hormonal conditions, but these are the exception and still may even not impact feeding. Unfortunately for those friend/family who say they didn't produce enough milk, it is usually due to mismanagement, conflicting advice or inadequate education about breastfeeding and what to expect from a newborn baby.
There are several processes that your body undertakes in order to produce milk. The first one is delivery of the placenta either by vaginal delivery or c-section, this in turn creates a hormonal surge which initiates your milk production or 'milk coming in' generally 3 days after baby is born. In conjunction, whatever baby is removing from the breast at each feed also sends a message back to the brain to produce more milk. This hormonal response is generally within the first 2-3 weeks following delivery.
During this time it is best to allow unrestricted access to your breasts to allow your milk production its best chance. Throughout this time your baby may feed every 1-4 hours. They are regulating their appetite. Do not restrict the time that the baby is at the breast or try to establish a 'routine' or strict feeding regime during this time, just allow baby to feed regularly in turn giving you a great milk supply!
After the hormonal response has settled, generally around the 2-3 week mark, your body makes milk according to what is removed at the feed prior. Supply = Demand. At this time some women feel their milk supply is inadequate as baby tends to feed longer and more often, but this is just the body self regulating and producing according to baby's appetite.
Pumping in the early days will increase supply. This can be both good and bad. Good in the fact that your supply increases in the short term for the baby, therefore increasing weight gains (those pesky numbers again!). Bad because you can produce more than your baby requires, and your breasts will become uncomfortable if baby does not adequately empty the breast. This can be where women have problems such as mastitis or blocked ducts. Supply is outweighing demand in this instance. A lactation consultant can help you manage this and wean your pumping frequency slowly over a few days for comfort.
Other factors to be mindful of:
adequate wet/dirty nappies
6-8 heavy wet nappies a day
frequent loose yellow bowel actions (1-8 times a day!) Colour starts as black(meconium), then greenish(transitional), then yellow. Can be very watery. This is normal newborn, breastfed bowel actions. It is not diarrhoea or lactose intolerance.
happy, content baby between feeds
feeds frequently 6-12 times in 24 hours
There are several key factors to ensure a successful breastfeeding relationship.
support from family
Lots of rest/sleep
eating well, keeping hydrated
supply = demand
frequent breastfeeding in the early days = good supply. Better to have too much than not enough
correct positioning and attachment
As a Board Certified Lactation Consultant recommendations of herbal remedies and alternative therapies are out of our scope of practice. However, some women have had success with increasing their supply with Naturopathy and Chinese Medicine. Herbs such as Blessed Thistle and Fenugreek are frequently suggested. Other women have had a significant increase in their breast milk production after eating Lactation Cookies (many recipes can be found online), it is thought that the active ingredient is Brewer's Yeast.
The complimentary feeds of artificial baby milk are often commenced in hospital or shortly after leaving hospital as your milk supply is not yet in and health professionals often worry about baby's weight loss. This can sometimes be a 'quick fix' and may decrease your milk supply production. The most important thing is addressing why you have supply issues. Usually you have to keep complimenting feeds, your supply drops even further which leads to early weaning. Help from a Lactation Consultant can ensure you have been given the right advice.
Just one bottle of formula, even just 5 mls can affect your milk supply and alter the gut pH of your baby for up to 2 weeks. Introduction of formula in hospital or the early postpartum period is one of the biggest reasons for inadequate low milk supply. Baby's gut is not designed for formula and it can take a long time to digest, therefore the baby may (or may not!) sleep longer thus in turn reducing the stimulation at your breasts. Or baby might be too sleepy for the next couple of feeds again reducing the stimulation at the breast. Eventually the body thinks it does not need to produce as much milk due to the decrease in stimulation/feeds. Baby's have small stomachs and are designed to have smaller more frequent feeds, not large bolus' of artificial milk. Their stomach's will over-stretch, therefore demanding more milk or seeming as though they are hungrier, thus planting the seed of doubt in your mind that your breast milk is inadequate, so you therefore you naturally give more formula. And so the cycle continues.
Understandably breastfeeding is confusing and can be difficult, Adelaide Lactation Consultants & Midwifery can assist you to ensure you give baby the right start, or we can help you make a new start. Accurate advice and the confidence to succeed.