Low supply is easily one of the most common fears for new breastfeeding mothers. Breastfeeding intake is intangible. There is no way to clearly know exactly how much baby is eating.
Openly breastfeeding is not the societal norm in this country and women have no way of learning what normal looks like. Today’s mothers are drowning in too much cyber information and not enough hands on support.
Perceived low supply can lead to unnecessary supplementation and untimely weaning. In my experience, the biggest problem is generally not mother’s supply but her lack of confidence in her ability to feed her baby.
Below are 5 MISTAKEN signs of low milk supply
Baby nurses frequently
Breast milk is made to be easily and rapidly digested by infants. For this reason, it is not uncommon for babies to feed every 1.5-2 hours. During growth spurts, some babies will want to “cluster feed,” which is a nice way of saying they want to be at the breast all day long. What you need to understand is that this is totally NORMAL. Babies are made to feed frequently especially during the first 3 months while milk supply is still being established. Babies also seek comfort from non-nutritive suckling (nursing without eating) at the breast. Infants are programed to need their mother and crave her touch. Being at the breast is one of the most comforting places a baby can be. There are strong physiologic powers at work driving your baby to crave this time. You cannot spoil an infant by meeting their need. They will develop past this desire. I promise your child will grow up into a well-adjusted adult even if you carry him around and nurse on demand during these early days. While it may not be conducive to getting anything done, baby nursing frequently is not an indicator that you are not making enough milk.
Baby is fussy
This is a tricky one. Babies are fussy for lots of reasons and I am not in the camp preaching colicky babies are normal. With that said, many parents misinterpret infant fussiness as a sign of hunger. Normal infant crying tends to be a lot more than most parents expect and at times is seems to be for no discernible reason! Evening hours are especially prone to baby becoming increasingly fussy. I personally have experienced that many babies are tired and over stimulated by the end of the day making it a time when fuses are short. Kids seem to exhibit this trait LONG past infancy. One of the commonly missed causes for infant fussiness is a baby that is not getting enough sleep. Most new parents are unaware of how much sleep an infant needs and mistake overtired cues for hunger cues. Excessive fussiness should not be ignored but low milk supply should not be first on your list of culprits.
Not pumping enough milk
Output from pumping is NOT an adequate predictor of milk supply. REPEAT…how much milk you pump does NOT tell you how much milk you are making. Breast pumps are nowhere near as efficient as a baby with a healthy suck at drawing milk from a breast. Have you ever pumped and then tried to hand express after? If you do, you would note there is quiet a bit of milk still left in the breast! Breast pumps work at extracting milk differently than an infant. While it does an adequate job, it is unable to completely replicate a baby’s suck.
Many women have an unrealistic expectation of what constitutes normal pumping output. On average, one can expect to pump ½-2 ounces total during a pump session. It is normal to require several pumping sessions to make one bottle for baby. I know this sucks but there are ways to help maximize your output (check out hands on pumping). With that said, only getting 20 mls from a pumping session is not considered an indicator of low supply.
It is also normal for pumping output to decrease overtime. In the early days of lactation before the body has regulated milk supply, many women make more milk than they baby needs. Women get use to pumping and getting enough to make a bottle. Panic sets in when milk supply regulates and normal output volumes ensue. This downscaling of production is normal and also not a sign of dwindling supply.
My breasts feel soft and do not leak milk anymore (or ever)
Again, this is a totally normal physiologic change that accompanies the regulation of milk supply. The feeling of breast fullness many women experience early on in lactation is a result of too much milk. As supply streamlines, breast fullness and leaking will subside. There is also variability amongst women. Some women with adequate supply never experience fullness or leaking. This is not an indicator of how much milk they are producing; it is just a variance amongst mothers.
Baby chugs a whole bottle after nursing
Many parents concerned of low supply will ultimately offer baby a bottle after a feed. This usually coincides with episodes of fussiness. Parents witness baby readily latch to the bottle and chug it down. Clearly the baby was starving, right? Nope. In most cases, the baby is responding to it’s suck reflex when the nipple is placed in the mouth. The suck leads to a mouthful of milk and a subsequent swallow and suck. Eating from a bottle is different than nursing. While a breastfed baby will not overeat, studies have shown the same is not true for bottle fed babies. They will gobble down the bottle responding to physiologic reflex cues eating well past satiety. The overfed baby ultimately falls asleep in an experience similar to what many of us experience when we overeat. To the parents, the seemingly ravenous baby ate a whole bottle and promptly fell asleep. This reinforces the idea that the baby was hungry and was satisfied from the bottle. As the parents begin to offer more bottles to the baby instead of the breast, mother is emptying her breast less frequently. Now supply IS actually decreasing because there is less demand for the body to make milk. It is a cycle of misunderstanding that creates a self-fulfilling prophesy of low supply.
So how do I know if I should be concerned about my supply?
The most reliable indicators we use to assess supply are baby’s weight gain and output. Baby should be gaining weight appropriately and having 6+ wet diapers and 3-4 yellow seedy stools a day. If baby is not meeting these milestones, there maybe an actually supply issue. Call an IBCLC to assess your infant, observe your breastfeeding experience, and preform a weighed feed. A weighed feed consists of a lactation consultant weighing the infant before and after the feed to assess how much milk is being transferred while nursing. This is a VERY accurate method of determining milk intake and ultimately mother’s supply.
If low supply is truly a problem, an IBCLC is trained to help ferret out the cause not simply treat the symptoms. Getting experienced help can give you the confidence you need to breastfeed your baby successfully and without fear.
References:
Increasing Low Milk Supply. KellyMom.com. (2017, December 02). Retrieved December 7, 2017, from http://kellymom.com/hot.topics/low-supply/
Jessica Wimer is a mother of two amazing kiddos, a board certified lactation consultant and a labor and delivery nurse in her free time. She is a country girl convert with a SoCal upbringing. A combo of liberal chillness and backcountry honkey tonk, she uses this dichotomy to help her traverse the daily challenges of motherhood. Follow her on Facebook (https://www.facebook.com/