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Monday, 11 November 2013 20:31

How to Increase Breast Milk Supply

As if society does not place enough pressure on breastfeeding mothers, add in that nagging “good mother’s voice” and times of low milk supply with a demanding infant ready to nurse, and one has the ultimate recipe for a milk supply strike. First and foremost, women have been breastfeeding for thousands of years. The body is perfectly engineered to give baby what baby needs, when baby needs it. Demanding the breast and constantly wanting to nurse is a sign of a healthy eater who wants to breastfeed. It may mean less restful sleep for mom, or possibly sore breasts, but it is important to stick with it, and know that baby will help the body produce more milk. A woman’s body is designed and destined to work with the baby. As the baby demands more milk, the body produces it. Sometimes, it may feel as though the body is not keeping up with baby, and then - as if with a snap of fingers, the white gold flows.

Babies go through an average of five to seven growth spurts within the first year of life.1Growth spurts are directly correlated to the sleep and eating patterns of babies. One of the most common reasons for ending nursing early, supplementing with formula, and causes for stress for a breastfeeding mother is what is thought to be a low milk supply. Often, during growth spurts, the body takes a bit of time to catch up to the always-changing demand of the baby. It is vital that the baby be allowed to continue to attempt to nurse, especially during times of growth spurts, in order to solidify the longevity of breast feeding. Supplementing takes away from time at the breast, which is a contributing factor to low milk supply in the first place.

 

There are many reasons one may have a low milk supply; stress, baby not nursing due to lip tie, hormones, recent surgery, lack of time at the breast/pumping, poor nutrition, etc. Regardless of the reason, there are plenty of ways to help pick that milk supply back up in order to nurse on! After determining (the best one can) the cause of the drop in production, consider some of the following to aid in getting back on track.

Nutrition

Staying hydrated is important for anyone and everyone, but especially so for breastfeeding mothers. Skip the caffeine whenever possible. Too much caffeine can deplete the body of vital nutrients and cause dehydration. Drink plenty of water throughout the day. For those who easily bore with basic water, add in some almond milk, coconut water, or a juice of a variety of fruits and vegetables. It is natural and normal for mothers to feel dehydrated when nursing. Keep a water bottle handy and within reach, and sip the day away.

Just as there are natural remedies for ridding the carpet of that pesky stain, and for lessening the duration of the seemingly ever-lasting cold, increasing milk production has its own herbal best friends. Fenugreek and blessed thistle are classified as galactogogues, or milk makers.2 Other beneficial natural herbs include fennel, brewer’s yeast (used most often in “lactation cookies”), raspberry leaf, alfalfa, hops, stinging nettle, motherwort, milk thistle, basil, chamomile, and goat’s rue. These herbal ingredients can be consumed as a tea, mixed in with water, used in foods, or taken as a supplement. Do some further research on each to determine if it is the right choice, and become familiar with the galactogogue of choice. Mother’s milk tea, from Earth Mama Angel Baby, is widely recommended, as it encompasses a few galactagogues in one, easy to drink tea.

Along with staying hydrated and adding herbs to the diet, eating proper and healthy meals throughout the day is also important; not just for maintaining and producing breast milk, but for the baby, too. Anti-inflammatory foods may help; like garlic, ginger, and turmeric. Eating plenty of fruits and vegetables, along with an adequate amount of protein, will produce great results, and help mom and baby to feel fantastic all day long.

Boob, Boob, and More Boob

One of the easiest, yet tedious and tiring, ways to produce more milk is to trick the glands into thinking that it is growth spurt time. Offer the breast at every given possibility, even if baby only nurses for a short time. Pump or express milk, too. Massage the breasts in between nursings and/or pumping/expressions. This will help to reduce the likelihood of clogged ducts (another reason for a dip in supply). Think happy baby thoughts while pumping and/or nursing to help with the let down and stimulation of milk ducts. Look at pictures of the lovely little one, or read a magazine or article about babies or breast feeding.

Stress Less

Being stressed is bad all-around, not just for breast feeding. The higher the stress level, the less milk is produced. How, though, with such little time in the day, do moms find time to unwind? Taking a few moments to meditate can be as calming as taking a long run, just as doing yoga with or without baby is a stress reliever all the same. Other things to reduce stress are to journal, talk with a friend, go for a quick walk, take a bath or shower, drink some tea, read a book, take a class, do a craft, do an at-home facial, sit in silence for five minutes, cuddle, cook a favorite meal, paint nails, look at old pictures, plan a vacation, do some pushups or a quick ab workout, color or paint a picture, write a letter to baby or a friend, or do something else that requires some “me time”.

If absolutely necessary, there are natural herbs and foods that can help alleviate stress, like L-Theanine, Inositol, St. John’s Wort, lavender, and magnesium. Of course, as always, do personal research, as other medications being taken may interact. The main point in taking such herbs is to lower stress levels. Long-term use of such herbs may not be best for everyone. Therefore, finding stress relieving avenues that do not involve herbs and medications, and fits well with one’s lifestyle and schedule, is recommended.

Other Ways to Increase Milk Production

Skin to skin contact with baby may help make baby want to nurse more, and may help to stimulate milk production in mom. Some mothers opt for acupuncture as a means to stepping up the breast milk game. If back issues and pain are contributing to a decrease in milk supply, seeing a chiropractor may help. Antibiotics and other medications can contribute to a dip in production, too. Taking probiotics daily can help the body to combat the effects of such medications.

Decreasing the use of nipple shields, bottles, and pacifiers may aid as well, as sometimes cause barriers to nursing at the breast. If there is an issue in regards to nipple confusion or baby pacifying, try limiting the use of such products. "Babywearing" helps to keep baby near the breast, which - like skin to skin contact - helps both mom and baby with wanting to nurse.

An old Irish wives tale is to drink half (about six ounces) of a craft beer daily. It is thought that not only will it help mom to relax, but the barley and hops (typically higher in content in craft and specialty beers) helps with milk production as well.3 Doing so is at the discretion of the mother, and should be done with proper timing, as to avoid possibly (although unlikely) contaminating the breast milk. As TBS can not condone drinking while nursing, please do thorough research and always be responsible, as TBS knows moms are with every decision.

Consuming the placenta has been known to help increase milk supply as well as many other fascinating benefits. The placenta can be dehydrated and encapsulated, initially eaten raw as part of a smoothie, or consumed more long-term as a tincture. 

If all else fails, yes, there are medications that have been known to help increase breast milk supply. Speak with a physician or lactation consultant, and research further about medication. There are many known side effects, and medication is not personally recommended, but it is an option. Physicians can determine if low levels of prolactin or other hormone imbalances are a part of the problem. Some medications that are commonly prescribed for low milk supply are Metoclopramide (Reglan), Sulpiride (Dolmatil, Eglonyl, Sulpitil, Equemote, Sulparex), and Domperidone (Motilium). Empowering and educating oneself is the first step in determining whether or not medication is the right path to take.

Chin Up and Feed On

Breastfeeding moms with a dip in supply can most definitely bounce back to nursing bliss. Surrounding oneself with support and positivity can work wonders, along with the help of nature, exercise, baby, and sometimes, doctors. Do not suffer in silence, or stress over “not producing enough for baby”. There are already so many factors working against breastfeeding mothers, that mothers’ thoughts need not be one.

Nurse away, and do so with the confidence that breastfeeding and baby’s health are absolutely worth it. Seek help if needed, confide in others, and rest assured that more mothers suffer from low milk supply than one would think. Again, there are many factors that are attributed to a decrease in milk production, but the majority of them can be resolved easily and painlessly.

With these suggestions, next stop: How to Manage an Oversupply

Sources:

1Life Stages Feeding. Brittney Kirton. Everything you need to know about infant growth spurts. <http://www.lifestagesfeeding.com/blog/everything-you-need-to-know-about-infant-growth-spurts/>

2 Ask Dr. Sears. 2013. Herbs to Increase Milk Supply <http://www.askdrsears.com/topics/feeding-eating/breastfeeding/while-taking-medication/herbs-increase-milk-supply>

3 Mother Food - A Lactogenic Diet. Hillary Jacobson. 13 Oct. 2011. Beer as a Galactagogue - A Brief History. <http://lactogenicdiet.blogspot.com/2011/10/beer-as-galactagogue-brief-history.html>

Published in Feeding Baby
Saturday, 01 September 2012 10:05

Do You Think You Have Low Milk Supply?

“Not enough milk” is one of the most common causes for stopping breastfeeding or choosing to supplement with formula. Unfortunately often it is a perceived notion of not having enough milk which is  loosely based on one or several of the following:

  • feeling as if the breasts are not as full as they used to be
  • baby feeding more frequently
  • low maternal confidence
  • misunderstanding/mismanagement of growth spurts
  • Lack of support from partner/family/society
  • baby pulling away from the breast/restless at the breast/fussing between feeds
  • limited amounts of breast milk when pumping to assess the amount (never a good idea).

More often than not, the milk supply is adequate but is perceived as being low by the mother.  With limited support available and a lot of misleading advice on available on the internet, a perceived low supply can easily become an actual low supply due to incorrect management. 

Low milk supply, whether perceived or actual, is an issue that needs to addressed and managed if prolonged breastfeeding is to occur.

Causes

Insufficient removal of milk from the breasts leading to a reduction in milk production is the most likely cause of low supply. This is associated with:

  • Poor attachment
  • Insufficient breastfeeding and restricting breastfeeds
  • Sleepy infant
  • Mother-infant separation
  • Unresolved engorgement
  • Use of infant formula, teats and dummies/pacifiers
  • Ankyloglossia (tongue-tie)and other infant oral cavity abnormalities

If you think that your supply is less than before or not enough then use the following list to assess if the problem is real or perceived. Note that there is a vast difference depending on the age of your baby as their needs are constantly changing.

For newborn babies:

  • Fewer than 3 wet nappies/24 hours by day 3
  • Fewer than 5-6 heavy wet nappies/24 hours after day 5
  • Concentrated urine
  • No change to normal breastmilk stools by day 3-4 and scant stools thereafter
  • Dry mucous membranes
  • Weight loss greater than 10% birth weight
  • Further weight loss after day 3-4
  • Less than 20 gm weight gain/day after day 3-4
  • Failure to regain birth weight by 2 weeks of age
  • Limited evidence of milk transfer during feeds
  • Prolonged or continuous feeding with little evidence of satiety
  • Persistent jaundice
  • Persistently sleepy or lethargic infant
  • Excessive crying, weak cry
  • Infant appears unwell
  • No signs of lactogenesis II on day 3-4 (breast fullness and heaviness)
  • Breasts remain soft in between feeds (normal after around 3 weeks).

Week 1- 3

  • Fewer than 5-6 heavy wet nappies/24 hours
  • Concentrated urine
  • Scant stools (expect 2-3 breast milk stools in 24 hrs often while feeding)
  • Dry mucous membranes
  • Limited evidence of milk transfer during feeds
  • Prolonged or continuous feeding with little evidence of satiety
  • Excessive crying, weak cry
  • Infant appears unwell

Growth Spurts

Growth spurts occur at around week 2, 3 and 6 weeks and are a very real cause for concern and perceived low milk supply because during a growth spurt, breastfed babies nurse more often than usual (sometimes as often as every hour) and often act fussier than usual.

The increase in baby’s milk intake during growth spurts is temporary. Physical growth is not the only reason that babies may have a temporary need for increased nursing. Babies often exhibit the same type of behavior (increased nursing with or without increased fussiness) when they are working on developmental advances such as rolling over, crawling, walking or talking. Mom’s milk is for growing the brain as well as the body!

They occur again at month 3,4, 6 and 9 so take note and do not despair. Go back to the list, meet up with other mom’s with babies of similar age and find support to reassure yourself.

Things to do when you have perceived or actual low milk supply

  • Correct positioning and attachment, and management of any nipple trauma
  • Increase the number of breastfeeds: wake the infant more often and/or offer the breast for comfort instead of using a dummy/pacifier
  • Understand and read your infant hunger and satiety cues and the signs of effective milk transfer
  • Decrease non-medically prescribed or unnecessary use of artificial infant formula
  • Implement ‘switch feeding’ if infant is sleepy: change the infant from one breast to the other several times during a feed to keep the infant alert during the feed while milk supply is low
  • Increase skin-to-skin contact
  • Breast compression during feeds may increase milk transfer
  • Additional breast stimulation and drainage through regular expressing after or between breastfeeds

Good maternal nutrition, rest, relaxation and domestic support and reduce smoking, caffeine and use of alcohol

I cannot stress enough the value of rest and diet when there is a perceived or actual low milk supply. Breastfeeding takes time and energy. Slow down. Watch your baby.

If none of these help then seek advice from lactation consultant who will take a full history, watch your feeding and give you a plan to work with going forward with regular follow up.

 

Published in Feeding Baby

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