Monday, April 8, 2013

Breastfeeding and the Low Supply Myth

I have been so disappointed and saddened lately by all the stories I have been hearing from friends and acquaintances regarding their lack of (or plain wrong) support and breastfeeding advice coming form health care professionals. So many women are being told (or are assuming) they don't produce enough milk. It is estimated that there is only 1% of the breastfeeding population that actually has a physical inability to produce enough milk to feed a baby.

Getting off on the right foot with breastfeeding starts immediately after your baby is born.  Get baby to the breast as soon as possible. This is much more difficult with a c-section. Talk to your Dr. before baby's birth to see if they'll let you nurse your baby in recovery after a c-section. If not, you may want to do some shopping for a new Dr. Also ask if they'll do a VBAC for future pregnancies if you have a c-section, if they don't, find a new Dr., but I digress...

Babies are born with very small stomachs.  It doesn't take but a small amount of colostrum to fill your baby's tummy. The first day is mostly about getting baby to properly latch and practice. Baby's have the urge to suck, your breast is the perfect place to do this which helps establish your milk supply, so do not introduce a pacifier until well after nursing is established.

Don't be concerned if your milk takes a few days to come in. You'll know when it happens because your breasts will become uncomfortably engorged. As baby continues to nurse your body will start to regulate your milk production based on how much your baby is eating. As long as you continue to put baby to breast whenever s/he act hungry, and allow baby to feed as long as s/he wants, your milk supply will adjust to baby's needs.

While in the hospital:
  • Don't allow nurses, Dr.'s, or staff give your baby a pacifier.
  • Keep your baby in your room with you rather than in the nursery.
  • Nurse, nurse, nurse.
  • If baby seems to have a latch problem, ask to have a Lactation Consultant visit you as soon as possible. They'll help you get a proper latch and make sure there aren't any oral issues with the baby.
  • Definitely do not allow anyone to supplement formula, unless recommended after a visit with the Lactation Consultant.
 Don't be surprised if your baby has jaundice upon leaving the hospital. Jaundice is fairly common. As long as you continue to nurse your baby on demand (or at least every 2-3 hours) the jaundice will pass. Jaundice leaves the body through output, so just make sure baby is having enough wet diapers.

Common reasons people think they don't produce enough:
  • Baby wants to eat all the time! Well, newborns do. Your baby should eat 8-12 times a day and if they're anything like my baby, they'll take an hour to eat. So baby is eating all day long. This is very normal. Don't be discouraged, it does pass. Your baby won't always nurse 24 hours a day. If you are feeling exhausted try the side laying nursing position. This is the easiest way to get some rest while baby is nursing.
  • Breasts no longer feel full. After a few weeks your breast milk supply will adjust to baby's intake. You will no longer feel engorged or full between feedings.
  • Breasts no longer leak. After your milk supply has adjusted to baby's needs and you no longer have an over abundance of milk, your breasts may no longer leak. 
  • I don't feel my milk 'let down' anymore. Let down sensation is different for all women. As time goes by you may not notice or feel it as much. Instead of waiting for the sensation of let down, pay attention to baby's swallowing. When your milk lets down your baby is swallowing after every one or two sucks.
  • I don't get anything when I pump. Pumping is no where near as effective as a baby when it comes to extracting milk. Never let your pumping output determine your milk supply. Some women have great success while using a breast pump, other women, like myself, do not.
  • My baby has had a fairly regular nursing schedule, but now nurses all the time again! Babies have growth spurts. During a growth spurt your baby will nurse more often. The growth spurt will usually last a few days and your milk supply will increase with your baby's demand.
  • My baby was sleeping through the night, but is now waking to nurse multiple times a night. After a few months babies become more distracted by what is going on around them. They may nurse less during the day or latch-on, latch-off all day. This results in less eating during the day, so when will they make up for it... at night! For some this phase lasts a month, for others it may last longer. For us it lasted about 3 or 4 months before he slept through the night again, and not every night, just once-in-a-while.
Don't supplement with formula unless you are directed to by a lactation consultant. If you do supplement with formula (or even expressed breast milk), your milk supply will decrease. Your body produces milk based on supply and demand. If baby is eating off the breast, there is less demand for breast milk. If there is less demand, your body will produce less. See how this becomes a downward spiral?

Not all pediatricians are fully supportive of breastfeeding and will recommend supplementing. I fortunately had a very supportive ped. My newborn was not gaining weight in the beginning. His ped. said he would only recommend supplementing if my baby lost weight, as long as he was maintaining we would just monitor him. My pediatrician also said that if I had to supplement he suggested finding a friend who was nursing that could donate some breast milk to us rather than giving my baby formula.

When you should be concerned you aren't producing enough:
  • Your baby doesn't have enough wet/dirty diapers.
  • Your baby isn't gaining enough weight.
  • You don't hear your baby changing swallowing patterns. During a milk let down your baby will go from infrequent swallowing to rapid swallowing.

Before you start breastfeeding read as much as you can. Some of my favorite breastfeeding resources include, The Leaky Boob, and The Leaky Boob on Facebook. A great quick reference guide is The Alpha Parent: Timeline of the Breastfed Baby.

The sources above can also give you information on boosting a low milk supply and re-lactation.  

Before you let someone tell you that your body isn't producing enough milk, talk to a Lactation Consultant in your area, talk to a friend who has been there, or send me a message and I'll help get you in the right direction.


  1. I wish I had done more research before I had my baby. We got off to a rocky start because I followed the directions the lactation consultant and nurses gave me. My daughter was preterm, and I was told to supplement with a bottle. As soon as I stopped doing that things got much easier.

  2. Although I find this article informative, it is certainly not realistic considering most moms have to go back to work soon after their baby is born and the only option they have is to pump which typically leads to low supply and eventually supplementing with formula. As I see that you have multiple kids, I am assuming that you are privileged to be a stay at home mom and can afford the luxury of on demand breast feeding for months on end without any worry or issues. Sorry to say - but most people can not do this.

    1. I totally agree with you. A pump would not work for me. If I was not a stay at home mom, there is no way that I would have kept my supply up. This is more based on the supply and demand from baby. Everything can be thrown out the window if you have to replace nursing with pumping. While pumping is not an indicator of low supply, it can chaise low supply because the demand isn't there from a nursing. My hopes with this post is to encourage those who have the ability to, to keep missing on and not let the idea of low split intimidate them in the first weeks, especially if they are exclusively nursing. Working and pumping mom's face many challenges. I would encourage part time nursing, but understand how difficult it is to keep up a supply of you are only pumping, because that was my experience with my first.