Milk supply
what is it?
In some cases a mother is not able to produce enough milk to meet the needs of her baby. Almost all mothers go through a period of questioning whether their milk supply is adequate, especially when they begin breastfeeding. But according to many experts, true milk insufficiencies are rare. Many women think their milk supply is low when it is not. This can happen if you stop feeling a strong letdown reflex or lose the feeling of fullness in your breasts, or if milk stops leaking from your nipples — but these are actually natural, common signs that your body has adjusted to your baby's feeding requirements. A baby going through a growth spurt may also want more milk than usual, and some babies simply become more efficient nursers giving you the sense that you don't have enough milk.
Others, however, including marianne neifert, a pediatrician, lactation specialist, and author of Dr. Mom's guide to breastfeeding, believe that low milk supply is a real phenomenon for some women and that to ignore it may put babies at risk for malnutrition. For the vast majority of these women, better breastfeeding management can correct the problem, but only 2 to 5 percent are physically incapable of producing enough milk.
What causes it?
A mother's milk supply may decrease temporarily because of infrequent feedings brought on by nipple pain, a lethargic nurser, or a poor latch-on technique. Estrogen-containing birth control pills or an illness can also affect milk production. For a few women, biological or physical conditions such as hormonal disorders or breast surgery cause their milk supply to be low.
For most women, though, the real problem is delivery, not production. They produce plenty of milk, but for some reason, such as an incorrect latch-on technique the baby isn't getting enough.
What should I do?
First, rule out false alarms about your milk supply. Here's how to tell if your baby is getting enough — and therefore you are producing enough — breast milk:
•your baby gains an ounce a day in the first three months of life and half an ounce a day from three to six months. (newborns will typically lose between 5 and 10 percent of their birthweight in the first few days before gaining it back.) weight gain is the best way to make sure your baby is getting enough milk.
• he nurses frequently — every two to three hours for a total of at least eight to 12 feedings a day
• you hear him swallow and you sometimes notice milk in the corners of his mouth
• he appears healthy and active
• he wets approximately five to eight diapers a day
if you feel you are not producing as much milk as you (and your baby) would like, try the following technique:
step one: feed your baby often. Frequent nursing sessions will stimulate your body to produce more milk.
Step two: get the best latch-on possible. Check for proper positioning at the breast.
Step three: when your baby's sucking and swallowing pattern slows down, use breast compression to increase milk flow to your baby and to completely drain the breast (see how to express milk by hand for more information).
Step four: when your milk flow with compression seems to be slowing, switch sides and repeat. Keep switching back and forth between breasts until your baby is satisfied.
To increase your milk supply, let your baby nurse as often and for as long as he wants but allow him to finish one breast completely before moving to the other; give him only breast milk; and pay attention to your own need for rest, relaxation, proper diet, and fluids.
A sleepy baby may need to be awakened and encouraged to nurse more vigorously (thus stimulating your glands to produce more milk). To arouse him, try switching sides frequently, alternating positions, or even undressing him. Some mothers play with their baby's feet during feedings to keep him awake.
Mothers who determine that their milk output is actually low may want to have their thyroid levels checked. Low thyroid levels are known to impede milk supply.
If you are not sure your baby is sucking well, or are still concerned about your milk supply, don't hesitate to call on a lactation consultant for help.
Will it affect my baby?
Yes, if your baby regularly needs more milk than he gets, he could fail to thrive, a condition that can inhibit physical and mental development. Call your doctor and schedule a checkup right away if he's not gaining weight, or is losing weight. Often improved breastfeeding techniques will help, but in some cases slow weight gain may indicate a serious health concern.
Can I still nurse?
Yes, especially if you're suffering from a temporary decrease in milk supply, nursing frequently is the key to boosting milk production.
-kristin