Do I have enough? Is he/she getting enough? How can I increase my supply?

[KaidaMidnight]

Again, with it being Breastfeeding Awareness Week, I thought I'd post about a problem that a lot of new moms face. :)  

I want to know if my breasts are making milk normally. Do I have enough milk?
This is a common breastfeeding concern. Many women wonder if their experiences are within the "normal" range. Here are some common concerns:

My breasts are no longer leaking. Am I not making enough milk? Leaking has no relationship to how much milk a mother is making. Once your milk supply is well established, leaking normally diminishes or ceases. Some mothers experience leaking longer than others.

When I pump I find that one breast produces more milk than the other. Is something wrong? Every woman's breasts are a little different, and since humans are not symmetrical, breasts aren't either. It is common for one breast to have more milk-producing tissue than the other. In fact, sometimes babies will prefer the more- or the less-productive breast, and this is perfectly normal.

My breasts no longer feel "full" when it is time for a feeding. Is my milk supply decreasing? When a mother's milk supply adjusts to her baby's needs, the feelings of fullness or engorgement she may have felt early on will subside.

I no longer feel the let-down, or milk-ejection reflex. This may occur as time goes on. Some mothers do not feel a let-down at all, but they can tell by watching their baby's pattern of suck and swallow when their let-down is occurring.

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How can I tell if my baby is getting enough milk?
This may be the most asked question for La Leche League Leaders. It is understandable, since breasts are neither see-through nor marked off in ounces. Thank goodness there are other signs that indicate baby is getting enough milk.

Typically during the first few days, while the baby is receiving mother's thick, immunity-boosting colostrum, he will wet only one or two diapers per day.

Once mother's milk comes in, usually on the third or fourth day, the baby should begin to have 6-8 wet cloth diapers (5-6 wet disposable diapers) per day. (An easy way to feel the weight of a wet disposable diaper is to pour 2-4 tablespoons of water in a dry diaper.)

In addition, most young babies will have at least two to five bowel movements every 24 hours for the first several months, although some babies will switch to less frequent but large bowel movements at about 6 weeks.

A baby that is sleeping rather than feeding every 2-3 hours or is generally lethargic may need to be assessed by a health care provider to make sure that he is adequately hydrated.

These are additional important signs that indicate your baby is receiving enough milk:

• The baby nurses frequently averaging at least 8-12 feedings per 24-hour period.


• The baby is allowed to determine the length of the feeding, which may be 10 to 20 minutes per breast or longer.


• Baby's swallowing sounds are audible as he is breastfeeding.


• The baby should gain at least 4-7 ounces per week after the fourth day of life.


• The baby will be alert and active, appear healthy, have good color, firm skin, and will be growing in length and head circumference.

The physical act of breastfeeding is more than the quantity of milk that is supplied, as you will find once you hold your baby in your arms. Breastfeeding is warmth, nutrition, and mother's love all rolled into one. Understanding and appreciating the signs of knowing when your baby is getting enough to eat is the one of the most important things a new mother can learn. If you have any concerns regarding your baby, they should be addressed with your health care practitioner.

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How Can I Increase My Milk Supply?
This is a common breastfeeding question. When mothers observe certain normal changes and behaviors, they may assume their milk supply has decreased. This is often a "false alarm." Other times, a mother's milk supply may truly need to be increased. This part of the note will help you determine if you need to increase your milk supply as well as give you ways to increase your milk supply if appropriate.

The above part entitled Is My Baby Getting Enough? also pertains to milk supply. Reading that part will help you learn the indicators that your baby is receiving enough of your milk. If your baby is thriving on your milk then you can be assured that you have an adequate milk supply. The most up-to-date information on increasing your milk supply, including podcasts, journal articles and book reviews can be found on the Milk Supply Issues Web resource page of the LLI website.

At times, mothers are unnecessarily alarmed about their milk supply. They may not be aware of the normal process of breastfeeding. For example, by about the time a baby reaches 6 weeks to 2 months in age, mother's body has learned how much milk to make. Around this time, many women no longer feel "full." In addition, baby may be only nursing for five minutes at a time. These are not signs of decreased milk supply. They simply mean that both mother and baby are becoming more adept at breastfeeding. Mother's body has adjusted to the requirements for her baby and baby has become very efficient at removing the milk.

Some mothers become concerned about their milk supply if their baby begins to have fewer bowel movements. By about 6 weeks after the birth, colostrum is no longer present in a mother's milk. So this may mean that baby's bowel movements will decrease to one every day or even a few times each week. This is normal.

Another age-related "false alarm" is that babies will experience several "growth spurts" in the first few months of life. Generally, these occur around two to three weeks, six weeks and three months of age or they may happen at any time. These are days when baby wants to nurse longer and more frequently to build up mother's milk supply. Follow baby's lead on this by letting him breastfeed as often and as long as he wants. This will help bring up milk supply quickly. The breasts work on the law of supply and demand. The more baby "tells" mother's breasts to make milk, the more milk she will have.

By allowing your baby to nurse more frequently for a few days, your body will receive the message that more milk is needed for your growing baby. Once your supply has increased, your baby will usually return to his usual routine.

If, after reviewing the Is My Baby Getting Enough and ruling out the false alarms mentioned above, you find that you do need to increase your milk supply, get help. If your baby is not gaining well or is losing weight, you will want to keep in close contact with your baby's doctor. Often, improving breastfeeding techniques will help resolve the situation quickly, but in some cases slow weight gain may indicate a health problem.

Here are some ideas that may help you to increase your milk supply. Look them over and consider which might work for you.

1. Contact a local La Leche League Leader for information and support.


2. Encourage your baby to breastfeed frequently and for as long as he will.


3. Offer both breasts at each feeding. Allow baby to stay at the first breast as long as he is actively sucking and swallowing. Offer the second breast when baby slows down or stops. "Finish the first breast first," is a good general rule. (This technique gives baby lots of the fatty "hindmilk.")


4. Baby should end the feeding. He may do this by falling asleep and detaching from the breast after about 10 to 30 minutes of active sucking and swallowing.


5. Be sure baby is latched on and positioned correctly at the breast, that is, lips should be on the areola (the darker skin area), well behind the nipple. An LLL Leader can help fine-tune positioning as well as suggest ideas to ease soreness. Breastfeeding isn't supposed to hurt.


6. A sleepy baby may benefit from "switch nursing" that is, switching breasts two or three times during each feeding. Switch breasts when baby's sucking slows down and he swallows less often.


7. All of baby's sucking should be at the breast. Limit or stop pacifier use while encouraging baby to nurse more effectively. If you are supplementing, even temporarily, you can give the supplement by spoon, cup, or with a nursing supplementer. Contact an LLL Leader for assistance in using these.

This may be a stressful time. Take care of yourself. Pay attention to your own need for rest, relaxation, proper diet and enough fluids.

Breastfeeding your baby is meant to be an enjoyable experience. If you have any concerns, contact your local La Leche League Leader or Group for support and information. At LLL meetings you can talk with other mothers who have the same concerns, and you all learn from each other.

[momx3gx1b]

Aug. 5, 2009 at 7:25 PM

This is perfect accurate information!!!

[bamsmom2001]

Aug. 5, 2009 at 7:28 PM

"When a mother's milk supply adjusts to her baby's needs, the feelings of fullness or engorgement she may have felt early on will subside."

Thank God it does that, LOL! Great post, voted you up!

[KaidaMidnight]

Aug. 5, 2009 at 7:34 PM

LOL.. I know right Natalie! :D And thanks!  And thanks momx3g1b! Just trying to help get the word out! :)

 

 

(Original Poster)

[Ellabean]

Aug. 6, 2009 at 8:03 AM Great information! I have been a mom who went through this twice. I only nursed for 9 months and supplemented my first and only 12 weeks with my second and had to be with an SNS. I had retained placenta with my first, then took herbs, domperidone and pumped, but still she wouldn't nurse from me. I pumped for 5 months and comfort nursed till she refused after 9 months. My second DD was born with a head birth defect creating a high palate and after day 5, needed supplementation (per LC) based on decreased wet dipes and no bms. I sns'd her to avoid nipple confusion, but she never took less formula and more bm and it was so hard and she was very uncomfortable. I still to this day feel so horrible and wish it would have been differently. My sister is a bf peer counselor and I am very educated...several Lc actually think in addition to my babie's concerns that I have insufficient glandular tissue/hypoplastic breasts. This would make most sense, but still horrible. I have friends who give up so easy or don't try and I now worry about failing again IF I have a third. Sorry to vent, just loved seeing this and thanks for sending it.

[catholicmamamia]

Aug. 6, 2009 at 11:13 PM

Happy World Breastfeeding Week!
Great information, voted this popular!