Maintaining your milk supply
Many mothers call when their babies are 3-4 months old. They had plenty of milk in the beginning, maybe even too much. When they call, they are worried that their milk supply has dropped. Sometimes they have returned to work, often they are full-time mothers. Because these questions occur so often, and because it is so so distressing to women to have their milk supply go down, we have prepared these guidelines -- to help when it happens and hopefully help prevent it.
The main thing that drives milk production is milk removal -- through breastfeeding or pumping. Babies come to the breast for thirst and comfort as well as nutrition. Those brief, intermittent times at the breast boost supply. That's why pacifiers can affect milk supply.
Some women find that herbs or medications (such as domperidone) help increase supply. (To learn more about this go to breastfeedingonline.com or kellymom.com and read the articles of Dr. Jack Newman. Also see Diana West's website lowmilksupply.org or breastfeedingusa.org and read the article on "the magic number" and maintaining milk supply long term.
Bottlefeeding norms applied to breastfeeding
Bottlefed babies tend to eat large quantities less frequently. When this mode is urged onto breastfed babies, sometimes it is disruptive. It is normal for breastfed babies to continue to nurse 7 times/day for several months. (Some of the those feedings may be 5 to 10 minutes.) When not restricted, three month old babies typically feed 8 to 10 times a day for a total of 120 minutes/day. If less breastfeeding is happening (and pumping isn't being substituted) this drop in stimulation and milk removal may decrease your supply.
Sleep training is compatible with fewer, bigger feedings. However, it often reduces milk supply and affects the exclusively breastfed (or exclusively breast milk-fed) baby's weight gain. Mothers who have an average breast storage capacity may not be able to sleep through the night and maintain a good milk supply. For more info, read the " Magic Number" article at breastfeedingusa.org
Wht to do if your supply goes down?
1. Nurse more frequently. Encourage nursing for comfort. Reduce pacifier use.
2. Offer both breasts if you have been feeding on one breast.
3. Pump after feedings to drain the breast.
4. Consider pumping during the night, even if your baby is sleeping.
5. Hold your baby a lot, skin to skin.
6. Consider renting a hospital grade pump. Replace yellow valves and white membranes in existing pump. Make sure you are using the best size breastshield on the pump-- nipples shouldn't be rubbing the sides of the breast shield on the pump.
7. Consider herbs or domperidone.
8. Sleep is NOT an option! Take naps (preferably with your baby. For safe co-sleeping methods, ..........
Beverly Solow, IBCLC