Hello Mommas! This incredible article comes to us today from a very special person! She was my personal birth class instructor, breastfeeding class instructor, doula and is a close friend of the family. She gives the most amazing hugs and has the most comforting soul on the face of the planet. She speaks with such grace and authority. I know you will enjoy this article from her and learn a lot!
Hello, dear, dear Snap Moms—Becki here… passionate advocater / supporter of all things Pregnancy / Birth / Breastfeeding! May I just congratulate you on making the choice to nourish and nurture (because breastfeeding is more than just about the milk!!!) your babies in the very way your body was created! Your choice has HUGE social, health, economic and environmental impact that will affect you AND your babies’ worlds for lifetimes to come. That said, let’s “dig in!”
Breastfeeding: Increasing Supply
by Becki Neely
Breastfeeding is meant to abundantly meet ALL of your baby’s nutritional and fluid needs for the first 6 months. (I know, amazing, isn’t it!!!) The American Academy of Pediatrics has adopted this standard for optimal nutrition for babies 0-6 months of age; the following are several early guidelines to help ensure an abundant supply of milk for your wee one:
- Keep mama and baby skin-to-skin for at least 1-2 hours following delivery, and then as often as desired after that (btw, this is an absolutely awesome way to snuggle and provides LOTS of additional oxytocin, the hormone that promotes bonding, as well as being important for breastfeeding!)
- Room in and encourage babe to nurse whenever he/she is willing (skin-to-skin helps with this as well — I had a friend who used to say, “Put the baby in the breadbasket and he will eat!”).
- Avoid ALL artificial nipples (bottles/pacifiers/etc) for at least the first month.
Did you know that the primary reason most mothers supplement (which, by definition, is the beginning of weaning) is a belief that they lack a sufficient supply of breastmilk? There are a myriad of reasons moms carry this misperception, most rooted in “anecdotal” (stories) rather than “evidence-based” (research) information.
The following may be helpful in assisting you to accurately assess whether or not your milk supply is adequate:
- Baby wets at least 5-6 (really wet!) diapers daily (after 1 week of age).
- AND Baby has at least 3-4 yellow stools daily (by 4th day).
- AND Baby is gaining weight on your milk alone.
If these criteria are met, you can relax! Your baby is receiving enough milk from you. If your baby is NOT meeting these criteria, you should contact your pediatrician / lactation consultant as soon as possible. Babies can become ill quickly from inadequate fluid intake and these professionals will work with you to both ensure your baby’s well-being (supplementation may be initially medically necessary) and increase your milk supply, as needed.
OK, so we’ve addressed early “how-to’s” for a plentiful milk supply and how to evaluate whether your baby is getting enough. Stay with me now, as I sketch out a quick review of how the breasts make milk. Contrary to what you may have heard, breastfeeding is not always “supply and demand”, at least not in the beginning. Initially moms begin making milk (colostrum) during mid-pregnancy (Lactogenesis I) and milk production increases dramatically about 30-40 hours after delivery (Lactogenesis II). These distinct phases of milk production are hormonally-driven and, as long as the appropriate hormones are present, will occur whether or not a woman initiates breastfeeding.
The maintenance phase of milk production (Lactogenesis III) is locally controlled. This is where “supply and demand” enter in — that is, breasts make milk in response to milk removal. The most influential factor here is emptying of the breast. The more frequently the breast is empty, the greater the milk production. In most cases, emptying of the breast is directly related to the baby’s hunger… which is why most women’s breasts will make the perfect amount of milk for their baby’s unique requirements.
Now, this is all assuming that hormones are in balance, birth / immediate post-partum period was uneventful, and mom spends her first few weeks with baby in an ideal setting (see why a supportive breastfeeding culture is so important?). BUT, what if you and your baby are one of the (many) nursing couplets who don’t get that “ideal” start and your milk supply has been compromised. How can you increase your supply of breastmilk?
Essentially, two factors are considered when aiming to increase the production of milk: frequency (how often?) and thoroughness (how empty?).
Remembering that “empty breast = stepped-up production” and “full breast = slowed-down production”, it stands to reason that the more frequently and thoroughly one empties the breast, the more milk one will produce, yes? That said, the primary method by which one may increase milk supply, is to increase the number of feedings and / or pumping sessions, while ensuring breasts are emptied as completely as possible each time. Listed below are some additional considerations / helpful ideas:
Take care of yourself! Rest, sleep, eat and drink healthfully.
Is baby is nursing efficiently (check latch, listen for audible swallowing)? If you feel baby has not fully emptied the breast at the feeding, end the feeding by pumping your breast, as an empty breast signals the need for greater milk production.
Avoid pacifiers / bottles — A hungry baby is your best ally for increasing your milk supply! All baby’s sucking needs should be met at the breast whenever possible. If supplementation is medically necessary, consider using spoon, cup or nursing supplementer to avoid problems later.
Allow baby to fully empty one breast (remember, empty breast sends the message to “make more milk!”) before offering the other side. Alternatively, consider “switch-nursing” where baby is switched to alternate sides every time he / she stops nursing or changes to non-nutritive (comfort) suckling. Aim for at least 2 times on each breast per feeding if employing this technique in order to facilitate thorough emptying.
“Hands-On” techniques massage and compress breasts while feeding / pumping and help to empty the breasts more completely. Research has demonstrated that their use can significantly increase milk production. Two links are included as reference:
- Breast compression while baby is feeding (for info sheet click here)
- Breast massage and compression while pumping (for video click here)
Consider the use of a galactagogue (a substance that may increase milk supply). Talk with your lactation consultant / LLL leader for more information about galactagogue usage. (click here to purchase Fenugreek)
In summary, remember that, like most breastfeeding issues, milk supply is best addressed early on. If you have questions / concerns, contact your local La Leche League leader, WIC peer counselor or Lactation Consultant.
Bless you and your nurslings!
Click here to read Breastfeeding: 8 “Booby” Traps
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Becki Neely, RN BSN IBCLC, is a Board Certified Lactation Consultant, Registered Nurse and Certified Childbirth Educator. Having graduated from University of Florida (Go Gators!) College of Nursing in 1981, she practiced nursing for 5 years, until the birth of her first child. Becoming a mother unveiled her passion for all things Pregnancy-Birthing-Breastfeeding and she owned a Childbirth Education business in the Florida Keys for 15 years. Following relocation to Central Florida in 2004, she taught childbirth and breastfeeding classes at a local hospital, during which time she prepared for and attained international board certification as a Lactation Consultant (IBCLC). She was recruited by a national nursing education provider to teach lactation seminars to nurses around the United States, but has now returned to her true passion – advocating for and providing one-to-one breastfeeding support to mamas and babies.