As a lactation consultant I speak with many new mothers.   I have consistently heard one of their biggest concerns. That concern is “worry about adequate milk supply”.  This, (as well as concern about returning to work) can be a stumbling block to a successful breastfeeding relationship.

So how do new mothers become more confident about supply? When a mother and baby come to me with a milk-supply issue I first like to review basics with her.  I ask about baby’s weight gain, check to see if the baby is nursing frequently and for an adequate length of time.  I ask if she thinks she is eating well, drinking to thirst and getting some sleep, even if it is sporadic?

We might discuss the fact that the number and length of feeds vary early on, but tend to increase over the first week or two.  It especially helps to remind her that frequent feeds actually help build the supply.

Next I may show her an example of a newborn’s tummy size with Belly Balls. This illustrates how tiny that is, about the size of a “shooter” marble on the first day.  Moms begin to understand that they do not have to produce copious amounts of milk right away, to satisfy the needs of a newborn.   By the end of the first week to ten days the tummy size is said to increase to about the size of an egg (60-80 ml.)

At this point, we might discuss generally accepted guidelines for nursing.   8-14 feeds in 24 hours and 6-8 wet, soaked diapers along with positive weight gain are a common goals.  Mom’s also like to know that most experts say that a newborn should regain its birth weight by two weeks and then gain ½ oz or more a day during the first month.  This might be 5-7 oz per week and 1 inch per month.*

Especially after experiencing some initial engorgement, some mothers feel as it their milk is disappearing because they don’t feel as “full”.  According to Nancy Mohrbacher, IBCLC ** breast size is determined by the amount of fatty tissue in a woman’s breast.  Most every woman has a similar amount of milk making tissue.  Storage capacity, she says, is determined by the amount of room in the milk-making glands.  This allows for the differences in number of feeds a baby might need/demand.

Once the milk supply is established, most babies will fall into a 10-30 minute feed with occasional shorter or longer sessions.  A mother who has a larger milk storage capacity may not fit the mold of nursing as many as 8 or more times in a day.  A mother with less storage capacity, (she may be the mom who complains of her baby nursing all the time) may have more than the usual feedings

When allowed to nurse freely and not on a timetable a baby usually will take what is needed until the next nursing session.

If a mother simply cannot believe she is making enough milk she might pump or hand-express a little milk so it can be seen and believed.  Every mom and baby are different.  I have found that as a new mother’s milk supply builds, so does confidence in the process.

When an obvious milk supply problem presents itself, of course, various approaches can be taken.  These approaches include extra pumping or hand expression sessions,  power-pumping, taking a home-babymoon (a day off to only relax, nurse and hold baby), adding an herbal galactagogue regimen such as fenugreek, alfalfa, blessed thistle, goats rue etc. ,  drinking mothers milk tea (herbal tea blends that have been used for years in Europe) and  even eating lactation cookies. We are fortunate to have an original source for these cookies in our area.  Milkin’ Cookies*** were developed by two local physicians and are baked right here in Roanoke and shipped all over the country.

Points to Remember

• The bottom line in building milk supply is nurse, nurse, nurse.  Lots of breastfeeding encourages the milk supply to build and at the same time meets the specific growth needs of the infant.
• Keep baby skin-to-skin as much as possible.  This triggers hormones in both mom and baby and assists in supply.
• Don’t be afraid to offer each breast more than once if needed.
• Let your heart and your baby lead you.  Advice from friends, websites, books etc. can be confusing so  be sure to listen to “you” and discern other comments.
• If pain or other issues arise don’t wait for it to go away, seek help.

Results of a new study published in the Journal of Public Health found that “patients connected with International Certified Lactation Consultants (IBCLC) were three times  more likely to be exclusively breastfeeding at three months…” ****  So trust your instincts, get help early if needed and enjoy the numerous benefits of breastfeeding.

*  www.nancymorhbacher.com

** Morhbacher N and Stock J., The Breastfeeding Answer Book, Third Revised ed.   Shaumburg, IL; La Leche League Int., 2003, p. 148

*** Milkin’cookies.com

**** http://uslca.org/wp-content/uploads/2014/02/2.4.14-APHA-re-IBCLC-Impact.pdf

You may also be interested in reading Peterson and Harmer, Balancing Breast and Bottle Reaching Your Breastfeeding Goals

This article addresses situations involving healthy, term infants and healthy moms. It is not meant to replace the advice of your healthcare provider.  If you have a problem, seek help quickly as every situation and baby/mom pair is different