Maintaining a good breastmilk supply
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Breast feeding is a learnt skill. Some find it so easy, but for many mums, there can be many tears shed with episodes of frustration and despair.
When first beginning to breast feed, or when a baby changes its feeding pattern, mums often believe that they are not producing enough milk. Furthermore, as baby gets older and becomes a more efficient and faster feeder, a mum may feel that she isn’t meeting baby's feeding needs.
Mums can also feel that their supply is insufficient if milk stops leaking from their breasts, if they stop feeling the letdown reflex, or lose the 'fullness' feeling. The loss of these feelings is a normal sign that a mum’s body has adjusted to a baby’s feeding requirements.
LaLeche League believe that only 1-2% of women are unable to produce enough milk for their baby. This minority of women does not include those mums who have breast infections, difficulties getting baby to latch on, or a mum’s lack of, or low confidence in her ability to breast feed.
There are also a few medical conditions that can cause a low milk supply.
- Low or high thyroid levels.
- Drugs, for example, combined contraceptives or cold remedies that contain decongestants such as Pseudoephedrine.
- Large blood loss during and after labour.
- Birth by Cesarean Section, especially if carried out in an emergency.
- Premature birth.
One of the common reasons for a mum to give up breast feeding is because she feels that she isn’t producing enough milk. For some mums, this indeed may be true, but for others, it may just be case of how and when she is breast feeding and what else can she do to help improve her milk supply.
Environment and position
- Ensure that you are sat in an room in which you feel relaxed and happy to breast feed.
- Sit in a comfortable position.
- Just before breast feeding, gently massage your breasts for about 5 minutes.
- Prior to feeding, have a warm drink to relax you, and have a glass of water available, since breast feeding can make you feel thirsty.
- Make sure you have quiet time with your baby so that you can both concentrate on feeding without being distracted.
Tiredness can affect your breastmilk supply. It can be extremely difficult to get some sleep whilst caring for a baby, trying to breast feed and dealing with everyday tasks!
- Try to sleep whenever baby does.
- Don’t be afraid to ask family or close friends to help and take up any offers of help.
- It is important that your husband/partner knows about the importance of rest so that they can support and help you. Ask your partner to massage your shoulders and back as often as possible.
- Try to have a relaxing bath or shower each day.
Frequency of breast feeds
During the first few weeks a baby will feed as often as 6-12 times a day. The more baby is put to the breast, the more milk you will produce.
- Make sure baby is correctly latched, as you may develop sore nipples.
- If baby sucks on your nipples as opposed to the alveoli your supply will be affected.
- Whilst your milk supply is becoming established, let baby feed for as often and for as long as he/she needs.
Fluids and diet
Try to drink approximately 3L of fluids (but not too much caffeine, or carbonated drinks) in every 24 hours and have about 500 calories more to eat than what you would normally have.
Diet can affect breastmilk volume so it’s important that you take good care of yourself. There is no need to diet when breast feeding.
Skin to skin care
Also called ‘Kangaroo Care’. This can really help with increasing your milk production.
- Strip baby down to just a nappy.
- Lie baby directly onto your tummy / breasts and cover his / her back with a soft blanket.
- As well as helping to increase your milk supply, you will find this relaxing and babies love it too! This direct contact also helps babies who are suffering from colic.
- You can also try expressing breastmilk whilst having skin to skin care. This can also help to increase your milk supply.
There are a number of remedies available which may help to improve and enrich your supply:
- Milkmaid Tea contains a blend of organic fennel seed, organic fenugreek, organic nettles, organic red raspberry leaf, organic orange peel and more. This tea can be drunk hot or cold.
- More Milk contains blessed thistle, nettle leaf and fennel seed. This does not contain fenugreek (do not confuse with More Milk Plus) and is particularly beneficial for those mums who have suffered from its potential side effect of loose stools.
- Fennel tea and Fenugreek tablets can also help to stimulate the production of breastmilk by boosting your prolactin levels.
There are a number of drugs available which help to increase the levels of prolactin which may help improve your supply.
These drugs can have side effects though, so it is essential to discuss the benefits of starting on this medication with your breast feeding councillor or your doctor.
During a growth spurt, a baby will often feed continually for long periods. It is a baby’s way of helping a mum to produce more milk.
When a baby has a growth spurt he / she will want more milk and will feed more frequently.
Cluster feeding is a method that baby naturally uses to encourage mum's breastmilk supply.
Cluster feeding can also be called 'bunch feeding' and is very common. It occurs at a certain time of day, normally in the evening, when a baby will bunch a number of feeds altogether over a few hours instead of spreading the feeds out.
Afterwards a baby may sleep for a longer period than normal. It is especially common when a breast fed baby is getting ready to start sleeping through the night.
During cluster feeding or a growth spurt, mum has two more options to help improve her supply.
- She can put the baby to the breast as often and as frequently as the baby demands.
- She can consider expressing her breastmilk.
There are two specific methods of expressing that can be used to boost supply during this cluster and growth spurt period: Power Pumping & Cluster Pumping.
- Power pumping requires regular expressing throughout the day, i.e., 2 hourly, including night time, for at least 48 hours. Double pumping is particularly effective.
- Cluster pumping requires is expressing for much shorter periods i.e., every 30 minutes, for 10 minutes, for several hours a day. (Casemore, Exclusively Pumping Breastmilk, 2004).
Try to avoid using a dummy for the first 4-6 weeks as this can affect the amount of time a baby will spend sucking and feeding (which may then affect the amount of milk produced at each feed).
It is easy to get into a 'vicious circle' of insufficient milk production and a restless baby.
Babies still need to have cluster feeding days when they need a lot more time at the breast in order to increase the amount of milk especially during a growth spurt. By giving them a dummy during a growth spurt may make baby unsatisfied and unsettled.
This advice is supported by FSID, who believe that dummies should not be used by breast feeding babies for the first four weeks, in order to allow for breast feeding to become established.
For some mums though, breast feeding can take longer than four weeks to establish. For these mums, the introduction of a dummy, if indeed needed, may well be when the baby is over 4 weeks old.
Finally, when wanting to improve and increase your breastmilk supply, this information should help, but ultimately you will need to ensure that you are frequently breast feeding your baby or regularly expressing your breastmilk.
If you require any further information or support please contact Janette here. Additional contributions from health professionals are especially welcome.
If linking to this guide, please use the full page URL: http://www.pumps4mums.co.uk/increasing_supply.htm (as opposed to linking to the downloadable version, which may be moved).
This guide ©Copyright 2009 Janette Cassidy, BSc (Hons), RGN, DN, HV, Specialist Practitioner (Public Health).
The text set out above may not be reproduced for commercial purposes without prior agreement.