Do I have low supply?
As a new mom, breastfeeding can be a nerve-wracking experience. Unlike a bottle, where measurements are delineated, it's hard to know how much breastmilk your baby is getting straight from the tap. Many moms worry that their supply is low. Actual medical reasons for a supply too low to sustain your baby exist, but are rare. Here are some often cited tips on milk supply for the early days of your breastfeeding journey:
- Breastmilk is the perfect food for your baby, and is created by your body based on supply and demand. The more your baby drinks, the more your body will make. The BEST way to boost supply is to get your baby to the breast whenever he is hungry. Nursing every 2-4 hours is normal, nursing three times in an hour is normal, nursing all night long is normal. Try to get the baby latched BEFORE he is fussy - look for hunger cues like rooting or putting his hand to his mouth. It is much easier to get a baby to latch when it's not screaming from hunger!
- In the first days of its life, a baby's tummy is tiny - the size of a cherry (see our favorite images for details). That means it fills up quickly, but also empties quickly. Because of this, it will seem like all your baby wants to do is eat (and poop, and cry about eating and pooping). The colostrum you make before your milk comes in is amazing nutrition for your newborn and is all the baby needs, if you breastfeed on demand and have no outlying issues.
- Milk transfer can be inhibited by latch issues and tongue or lip ties. If your baby is having weight gain issues, or you're having pain and cracked nipples (or really if you have any questions or concerns), consult a Certified Lactation Counselor (CLC) or International Board Certified Lactation Counselor (IBCLC) in addition to your pediatrician. Check our local resource list for names. Tools such as a nipple shield, SNS, and syringe feeding might be recommended by lactation professionals on a case-by-case basis to help you find your stride.
- Supplementing with formula, while necessary in some cases, will disrupt the supply and demand process, so try pumping breastmilk to supplement if you need to. However, the amount you pump is not necessarily an indication of your supply. A baby with a good latch will transfer milk more effectively than a pump will. Pumping can be maximized with a high quality (ideally medical grade) double electric pump (get one free from your insurance company), the right size flanges for your breast size, and maintained parts, such as hoses, membranes and valves. Some moms find having a video of their baby crying or a cute photo help improve letdown. Try closing off one side of the pump to pump on one breast and nurse the baby on the other to help increase output (and multitask!).
- Try doing a weighted feed, which is a way to very closely approximate the amount of milk your baby is transferring at the breast. To do so, locate a baby scale with a half ounce accuracy, such as one found at the local WIC office or pediatrician's office (or even the vet!). Weigh your baby. Feed your baby. Without changing any clothes or even a dirty diaper, weigh the baby again. The difference in the two weights is the amount of milk the baby drank. Bear in mind that the baby won't drink the same amount at each feeding, often nursing sessions after a long sleep might be more, sessions in the middle of the day in a strange place like a doctors office might be less.
- When your milk comes in you might feel engorged... or REALLY engorged... or maybe not engorged at all. That feeling of fullness could subside after a few days, and return periodically as your baby's demands change, or you spend a few hours away from your little squish. Engorgement is a sign of a breast full of milk, but lack of engorgement doesn't mean you are empty. The milk is there, trust your body.
- Eat a nutritious diet and stay hydrated, including healthy fats (avocados, nuts, etc), dark leafy greens, and other galactologues - foods that have been shown to help milk supply - such as oatmeal and flax. Drink plenty of water, and avoid activities such as smoking. Some moms like to eat lactation cookies as an indulgent way to get some extra nutrients.