The majority of women who stop breastfeeding early on do so because they believe that they do not have enough breastmilk, or that their milk isn’t nutritious enough. Medically speaking, only a very small percentage of these women truly have issues with breastmilk production. The rest simply had the wrong information and not enough support.
If you are pregnant and concerned about this topic, or if you currently have a small breastfeeding baby, read on as this information is key to breastfeeding success.
Three facts on breastmilk production
Lactogenesis, or the making of milk, is a complex process with different stages. Below a summary of what you need to know about breastmilk production.
Firstly, towards the end of pregnancy and in the first 3-4 days after birth your breasts contain colostrum, a concentrated form of breastmilk meant to nurture baby until a mom’s body starts producing her ‘normal’ milk. Colostrum is there, whether you see it or not. You may see no sign of this super-substance, but it is there. Although your breasts may feel empty, if a baby latches and sucks well, he will definitely get colostrum out. And a few millilitres of colostrum equals a full feed of normal breastmilk. It is like an espresso compared to a latte – a small amount packs an amazing punch.
Secondly, you can expect your ‘normal’ breastmilk to come in 3-4 days after your baby’s birth. During pregnancy the placenta produces high levels of the hormones progesterone and oestrogen. When the placental is expelled in the third stage of labour these hormone levels fall, allowing the hormone prolactin to increase. Prolactin is responsible for making milk. Within 72-96 hours after the birth you will suddenly feel your breasts becoming changing, and you may now experience milk leaking. Some initial fullness or engorgement is normal and lasts around 12-48 hours.
Lastly, after this initial physiological ‘coming in’ of milk, your body switches to a demand-supply system for making milk. This means that your body will use the amount of stimulation on the nipples (thus how often and how long your baby latches and sucks) to determine how much milk it should produce. So amazing is this system that one mom can feed a 2,5kg baby, another a 4.5kg baby and yet another one twins! You literally make the amount of milk that your baby orders you to make…or you do, if your baby latches well and if you feed on demand.
READ MORE: Top 5 Things You Need for Breastfeeding
Milk-supply – a misleading term
The term ‘milk supply’ in itself causes anxiety. A supply is something that can become depleted. Breastmilk is a bodily fluid, like tears or sweat. You don’t worry about running out of those, do you? You know that your body will make the amount that you need. The same goes for breastmilk. You should rather see it as your breasts’ milk producing capacity. There are some factors that can reduce this capacity, and others that can boost it. In most cases though, the body is able to produce a sufficient amount of milk.
Killing your supply
I firstly want to acknowledge that there are a few medical factors that can most certainly affect your breasts’ milk producing capacity, and if any of these apply to you it would be worthwhile to speak to a lactation consultant:
- Latching troubles (the most common reason)
If a baby is not latching and sucking well for any reason, there will be reduced stimulation and subsequently lower milk supply. A lactation consultant can evaluate the latch and help you with any corrective measures.
- Medical conditions
An underactive thyroid, certain congenital breast abnormalities, and polycystic ovarian syndrome (PCOS) may affect milk production.
- Previous breast surgery
Previous breast reductions and augmentations can influence milk production. I usually suggest meeting with a lactation consultant in your pregnancy already and having her help you to monitor breastfeeding after the birth to determine if and to what extend this is affecting your baby.
- Complications during the birth
Complications like a retained placenta and excessive bleeding after the birth have the potential to influence milk supply.
- An elective caesarean section or early induction of labour
This may play a role as the normal labour hormones kick-start breastfeeding; however, most women’s bodies catch-up fairly quickly and these interventions are unlikely to cause long-term problems if dealt with correctly.
- The use of certain medication
Some drugs can affect your production, including contraceptives and common over-the-counter cold-and-flu medications. Many healthcare professionals are not up-to-date on medication in mothers’ milk, and many women receive wrong information.
- Severe stress and anxiety
Severe emotional distress (for example losing a loved one) can definitely influence milk supply. The common day-to-day stressors that we all cope with are unlikely to play a significant role.
Sadly, most cases of low milk supply are not caused by the above medical conditions, but by a few bad practices that mothers choose to implement without knowing that it may be harmful to breastfeeding.
- Failing to feed on demand
Your body makes milk in response to how often and long your baby breastfeeds. Most breastfed babies need to feed every 1,5-2 hours in the early weeks of breastfeeding. While some feed for shorter periods, many will spend significant amounts of time on the breast. Trying to stretch baby’s feeds will negatively influence your milk supply and your baby’s growth.
- Not allowing baby to empty your breasts
Mothers are often told to limit the time that a baby feeds to e.g. 20 minutes per breast. The truth is that proper breast emptying is needed to ensure good milk supply. If the breasts are not emptied well the body will tone down supply to prevent engorgement. Always allow baby to drink until he comes off on his own.
- Formula top-up feeds
The most important goal is to fee the baby. But…your breasts make milk on demand; if part of the demand comes from elsewhere your body is simply going to end up making less milk. If a baby truly need top-up feeds you should first try to express breastmilk to give to baby as at least you will be supplying extra stimulation as well. In some cases where formula top-ups are really necessary mom should consider expressing extra with a breast pump to maintain her own production.
- The use of pacifiers
A pacifier can be a great tool, but shouldn’t be used to stretch the time between a baby’s feeds. Comfort sucking on the breast also counts as stimulation and can boost milk production. Keep in mind that pacifiers may add to latching difficulties, so wait until latching is established before introducing one.
ALSO READ: How to boost your milk supply
As I’ve mentioned many women falsely believe that their milk is not enough. But how do they come to this conclusion?
Below I have identified a few ‘false alarms’ for low milk supply:
- Baby drinks very often – remember that 10-12 times in 24 hours is considered normal
- Baby seems hungry 1 hour after feed – many babies cluster feed, thus have a few feeds on top of each other before settling for a longer stretch.
- Baby suddenly starts drinking more often – your baby may simply be going through a growth spurt
- Baby is fussy – there are many reasons why babies fuss. Mostly it has nothing to do with feeding
- Breasts are soft and not leaking – after the first 1-2 weeks your breasts should no longer become hard and engorged, and soft breasts simply mean that things are settling
- Baby takes a bottle after breastfeeding – most babies will swallow if given a bottle with milk flowing freely
- The mother cannot express much milk – how much you express differs widely between women and even between expressing sessions; you can never use the amount of milk you express to determine your milk supply
So how do you know that your baby is getting enough milk?
It’s simple – if your baby has 5-6 wet and/or dirty nappies in 24 hours, and if baby’s weight gain is adequate you can know that your baby is getting enough and that your supply is sufficient. So you can stop trying to fix what is not broken, simply trust a system which was specially designed to perfectly fulfil your baby’s nutritional needs, and just enjoy your breastfeeding journey.