The amount of breast milk a woman can produce after childbirth depends on a variety of factors. Some are not within her control, but some can be managed with extra planning and support from friends and family.
Feeling stressed or anxious
Stress is the No. 1 killer of breastmilk supply, especially in the first few weeks after delivery. Between lack of sleep and adjusting to the baby’s schedule, rising levels of certain hormones such as cortisol can dramatically reduce your milk supply. I’ve seen women who, within 24 hours, have gone from having an ample milk supply to literally none due to stress.
After your baby is born, the breasts operate on supply and demand. Exclusively breastfeeding drives higher demand, so the breasts create more milk. However, supplementing with formula for multiple feedings every day (such as while the baby is at daycare) tells your body that it doesn’t need to produce as much milk, and your supply will begin to decrease.
Many mums worry they have a poor milk supply, but it can be hard to know for sure. Read on to find out whether you really have low milk supply and what you can do about it
Once your breast milk has come in, your breasts start to make milk through a process of ‘supply and demand’. Each time milk is removed, either by your baby feeding or by expressing, your breasts make more.
The way your baby nurses also affects your supply. The more frequently and effectively she breastfeeds, the more milk you’ll make. If your baby doesn’t take enough milk during a feed, it’s essential to express regularly to protect your milk supply – see below for more advice.
Signs your baby isn’t getting enough milk
Even though low milk supply is rare, your baby may still struggle to get enough for other reasons during her first few weeks. She may not be breastfeeding frequently enough, or for long enough, particularly if you’re trying to stick to a breastfeeding schedule rather than feeding on demand. She may not be latching well, or might have a condition that makes it harder to take in milk.
- Poor weight gain. It’s normal for newborns to lose 5% to 7% of their birth weight in the first few days – some lose up to 10%. However, after that they should gain at least 20 to 30 g (0.7 to 1 oz) per day and be back to their birth weight by day 10 to 14.5,6,7 If your baby has lost 10% or more of her birth weight, or she hasn’t started gaining weight by days five to six, you should seek medical advice immediately.
- Dehydration. If your baby has dark-coloured urine, a dry mouth or jaundice (yellowing of the skin or eyes), or if she is lethargic and reluctant to feed, she could be dehydrated.6 Fever, diarrhoea and vomiting, or overheating, can cause dehydration in infants. If you notice any of these symptoms, seek medical advice quickly.
- Insufficient wet or dirty nappies. The number of poos and wees your baby has per day is a good indicator of whether or not she is getting enough milk – see our article explaining the pattern your baby should be following in Breastfeeding your newborn: What to expect in the first week. Seek medical advice if you’re concerned or if you have noticed her dirty nappies decreasing in wetness and heaviness.
- Baby seems very sleepy or lethargic. Babies who aren’t getting enough milk will have low energy. Baby regularly will sleep 4 or more hours at a time.
- Baby takes too little or too much time at the breast. A baby who is not feeding well may fall asleep shortly after beginning to feed, or may take longer than 30-40 minutes per feed.
- Baby is not stooling often (they should have 3-4 stools per day by four days old). Baby’s urine is not pale, and/or you see reddish-brown “brick dust” in the diaper
If you are worried your baby isn’t getting enough milk, consider hand expressing your milk. You can feed the expressed milk by teaspoon, cup or directly into his mouth.
If you suspect you aren’t making enough milk or your baby isn’t gaining weight properly, call your doctor and a lactation consultant right away. You may have a problem like a thyroid or breast-duct dysfunction. Alternately, your baby could have an infection or a weak sucking reflex that needs to be addressed.
How to increase your milk supply
Make sure that your baby is latching on to your breast correctly. Latching your baby on properly is the most efficient way to increase your supply. A poor latch is often the main reason a mother’s supply of breast milk isn’t as abundant as it can be. Without a proper latch, your baby cannot remove the milk from your breast well
Your body makes breast milk based on the laws of supply and demand. Increase the demand, and you’ll increase the supply. As long as your baby is latching on to your breast well, the more you breastfeed, the more you’re telling your body that you need more breast milk.
Use a breast pump or a hand expression technique to continue to stimulate your breasts after you finish breastfeeding your baby. The extra stimulation will tell your body that you need more breast milk.
Learning how to express your breast milk by hand can prove useful. Many moms prefer using hand expression over using a breast pump since it’s more natural and it doesn’t cost anything. During the first few days of breastfeeding, hand expression may be more comfortable, and it may help to remove more breast milk than a breast pump. However, it’s a skill so it could take some time to learn.
Last but not least, Talking to your doctor, a lactation consultant, or other mothers in a breastfeeding support group may be all that you need to put your mind at ease and keep you going on the right track to establishing a healthy supply of breast milk and breastfeeding successfully.