In my work as a postpartum nurse, it was awe-inspiring to see the nearly universal obsession parents have with feeding their babies. There is a strong instinctual drive to bring baby to breast after birth. But for many, along with this strong desire to breastfeed comes uncertainties. Are these few drops of colostrum enough for my baby? How soon will my milk come in? How do I know if the baby is getting enough to eat? Even when things are going well, it is not uncommon for parents to be concerned about low milk supply.
Is my baby getting enough milk while breastfeeding?
Breastfeeding is hard to quantify. There is variety in how babies feed. Some newborns will feed frequently, and others less often, usually 8 to 12 times per 24 hours. Feedings can last anywhere from 10 to 45 minutes. Some babies are fussy, and some are sleepy. Babies may feed continuously, or feed more slowly, with pauses and breaks. Milk requirements also vary according to the size, age, and energy expenditure of the baby.
The only real proof that baby getting enough to eat is a normal pattern of weight gain. Babies typically lose up to 7% of their birth weight in the first few days after birth. When milk volume increases around day 2 to 5, babies should begin to gain 2/3 to 1 ounce per day, regaining their birth weight by two weeks of age. Babies who do not gain weight as expected must be followed closely by their doctor, and mother should be referred to an International Board Certified Lactation Consultant (IBCLC).
Treating low milk supply with an IBCLC
If milk supply is truly low, the first step is to feed the baby. An IBCLC can help you find ways give your baby supplemental feedings without interfering with breastfeeding. An IBCLC will also help you increase your milk supply by suggesting ways to nurse more effectively, such as improving the latch. If baby is not able to latch well due to prematurity, anatomical issues, or some other reason, your IBCLC may suggest pumping after nursing sessions. Regular removal of milk from the breast signals your body to increase milk production.
Rarely, even with frequent feedings and/or pumping, mothers may struggle with low milk supply. In this case, the first step, with the help of an IBCLC and your medical care provider, is finding out the cause. Sometimes, an IBCLC may refer you to your doctor or midwife for hormonal or other lab tests. If the cause of the low milk supply is unknown, or cannot be modified (for example, breast reduction surgery), your IBCLC may suggest consulting your doctor or midwife about the use of galactagogues. These are herbs or medications that increase milk supply. Galactagogues vary in effectiveness from person to person, and work best when combined with frequent milk removal.
Breastfeeding experts guess that about 1 to 5% of mothers, despite their best efforts, are physically unable to produce a full supply of breast milk. But a low milk supply is not the same as no milk supply! Even a mother who cannot breastfeed exclusively can enjoy a satisfying breastfeeding relationship with her baby. What’s more, babies benefit from any amount of breast milk they receive. If you have concerns about milk supply, do yourself and your baby a favor and contact an IBCLC. You’ll be glad you did.