So many mothers struggle with fears that they will not produce enough milk for their baby. As a Family Support Worker, assisting moms in their breastfeeding journeys, I am so thankful for the vast resources available today to help them with breastfeeding.
Whether you are already holding your baby, or are in your last trimester, these are concerns and fears that all moms face. Breastfeeding is harder than you have been told, but the most rewarding journey you and your baby can take together. Here are a few “knows” for your journey.
Know Your “Why”.
If you do not know “why” you chose breastfeeding, it will be difficult to maintain when you have struggles. It is important to know that each mom has a different “why”.
Maybe cost is a factor, with rising prices of formula, breastmilk is a very affordable solution. Feed mom and the milk is free.
Maybe you are worried about the disadvantages of formula for your baby. Studies show babies given only formula have more ear infections, greater risks of asthma, gastrointestinal issues and lower IQ scores.
Maybe you are interested in the health benefits for you. Moms who breastfeed recover from labour faster, lose the extra baby weight and have a reduced risk of breast and other cancers.
Maybe you have read about the great advantages for breastfed babies. Babies who are breastfed are more content, have less tummy issues, less allergies, reduced risk of SIDS and so much more.
Your “why” is important. Your “why” sustains you through the difficult times. It is important to discuss your “why” with your partner. In hospital, you may need your partner to advocate for you and baby if you are too tired or distressed.
Know Your Goal
The goal is the same for all moms – a healthy baby. I have counselled many women in their breastfeeding plan only to have it all fall apart in hospital.
After the ordeal of labour, if moms struggle at all with breastfeeding, they may resort to formula because they are worried baby will suffer. This is a natural feeling. This is where your “why” and your goal are vital. Remember, your goal is a healthy baby.
Your baby has been well nourished in the last months, gaining ½ lb. a week. He is born with extra resources of water, nutrients and fat to get him through the first few days. So, do not panic. Take the time to build your milk supply.
Difficulty breastfeeding does not have to mean your only option is formula. You can express some breast milk and feed baby with a spoon, syringe or tube. Relax, remember the goal.
Know Your Body
When my second child was born, he was premature. He spent his first days in the NICU. The nurse handed me a specimen bottle and an electric pump and asked me to bring milk for my child. I turned on the pump and 3 drops came out.
If you have been struggling with lactation, we probably cried similar tears. My solution – I let that pump run and cried silent tears as I handed the nurse the specimen bottle with 3 hours of pumping and less than a tablespoon of milk.
I tell that story to all my moms. You might have a similar story because maybe no one told you how your body produces breast milk.
Your body began preparing for breastfeeding during pregnancy. Some women have some drops of early breastmilk in their last few weeks of pregnancy, but most do not. Your body gets the big neon sign to produce milk after delivery of the placenta.
Your body first produces colostrum, a sticky yellow milk that is packed with calories and protective factors for your baby. The important fact my nurse did not explain to me was that my body was only supposed to produce about 3-6 drops of colostrum in each breast to start.
In the first few days, your baby’s tummy is about the size of a cherry and can only hold less than 1 teaspoon of milk. If you are panicking like I did about 3 drops, relax, 3 drops are perfect! Your body gets the message to make more, only when you empty what you have. Your body is stingy with that liquid gold. If you don’t use it, you don’t get more
It is also important to know your body has only a short window in which to receive that request for more milk. Ideally, you should breastfeed, pump or hand express your colostrum within the first hour of birth and the window closes after 6 hours.
It is not impossible to initiate breastfeeding after this point, but you will need some professional help and possibly medication to assist.
Know your body, know how the breastfeeding cycle works, know you need to empty what you have to order more
How to Induce Lactation
Every mother lives with this inner fear that someone will discover they have absolutely no idea what they are doing. Let it go. No mother learns how to breastfeed during pregnancy and no child is born knowing how to breastfeed.
I am sure you have read about some mothers who just make it sound easy or you saw a video when it just happened. Breastfeeding is a skill, an advanced skill, it takes time, effort and some know-how to master. Expect 4-6 weeks of learning before you are confident.
If you are worried about lactation, you might think I am jumping ahead. Why worry about how, if there is no milk? In most cases, difficulty with lactation is all about latch, positioning and frequency of feedings.
If you get the “how” right, your milk will come. Only in rare cases are lactation issues about something systemic with the mother’s body. Just like your body knew how to grow a baby, you have what it takes to master this too.
It is important to know that lactation, the releasing of milk from the breast, is triggered by a few things.
Your baby is the most powerful cue. Keep your baby with you, have them room with you, keep them near. The sounds they make, and their breathing, are triggers to your body to produce and release milk. I do not recommend bed sharing at this age, but close to you is enough.
Another thing that triggers let down is skin to skin contact. Your baby has been hearing your heart beat for most your pregnancy. That is his safe place. Strip baby down to a diaper and lay baby on your bare chest.
Skin to skin contact regulates baby’s temperature, aides in digestion, provides comfort and so much more. When feeding, do the same – baby in a diaper next to your bare skin. Place baby tummy to tummy with you. This position aligns baby’s spine and digestive system to ensure ease of feeding.
Position is vital for milk supply. There are many different positions for breastfeeding (check this video for ideas). Most moms are aware of the cross-cradle hold, where baby’s head is in the crook of your elbow. This position is great for expert breastfeeders. In a few months, baby will be able to support and move his own head to maximize milk flow.
However, the cross-cradle hold is very difficult for newborns and new moms. I recommend any position that allows you to easily move baby’s head. The secret to a good latch is that baby’s head is tilted back, with his chin in your breast.
If baby’s head is tilted forward, he will be unable to properly attach. This will cause pain for you and no milk for him. A good latch is vital to milk supply. If baby is stimulating the milk ducts behind your nipple, your body gets the message to make more milk. If not, baby will probably tire before full and fall asleep.
Pumping and Hand Expression
If you are concerned that baby is not effectively emptying your breasts, you can keep your milk supply up while you wait for professional assistance. There are two ways to stimulate milk flow when baby is not doing it effectively on his own.
Breast pumps come in many sizes and prices. Do not go middle ground. There are effective pumps in the lower price range and in the upper range but in practice I have noticed the mid-price range will give you only stress. I usually do not recommend purchasing a breast pump until you need one. There is a more cost-effective method that some mothers prefer.
For myself, I found the breast pump mechanical and cold. Very quickly I moved to hand expression. You can hand express as much if not more than a mechanical pump. Hand expression also offers benefits for inducing lactation. In hand expression you use your hands to stimulate your “let down” and then massage milk breasts.
Sit in a comfortable position in a room that is warm. With flat fingers, begin to massage around your nipple with small depressions. Move completely around the nipple. You may notice some drops of milk beginning to flow.
Continue moving in outward circles, fingers flat, depressing inwards. This is process is similar to how you or your doctor would do a breast exam. You will notice small hard lumps underneath the skin. These are ducts filled with milk. With pressure inwards and then slightly towards your nipple you can massage these ducts until they open.
Another technique is to make a “C” with your hands and then place your thumb on one side of your breast about 1 inch from your areola and the rest of the “C” on the other side. Press back towards your chest and then squeeze as you release.
It is important not to change the size of the areola, don’t stretch it. Here is a great video on hand expression. Hand expression can be very important to inducing lactation, increasing milk supply and storing extra milk for work or outings.
Know when to get help
It is easy with a bottle-fed baby to determine if they are eating enough but breastfeeding is trickier. If you have been worried about lactation, likely you are concern you will not be able to provide enough milk for baby. I have given you some tips and encouragement but how do you know when you need expert help?
To determine if baby is getting enough milk, we look at a few things.
Here is a great chart to put on your fridge to guide you. You should see at least one poop a day in the first week, moving from black in colour to bright yellow. You should see one wet diaper on the first day, two on the second, three on the third, continuing like that until the sixth day. After that, six to 10 wet diapers are excellent. If your baby is pooping and peeing, you can be confident baby is getting what he needs.
Other signs baby is getting enough milk are contentment after feedings and regaining of birthweight in two weeks.
Know where to get help
There are many things I use Google for; it is an app on my phone that gets used multiple times in a day. But there are times when Google is not your friend. Lactation and breastfeeding are not Google’s specialty. It is important to know who to ask when you need help.
Most doctors are not trained in breastfeeding but if you are struggling with milk supply your doctor can prescribe some medication to assist. By itself, medication won’t solve the problem, but it can boost your other efforts like hand expression and more frequent feedings. Let your doctor know before you leave the hospital if you have concerns.
Local Health Unit/Pregnancy Support Centre
Call and ask if they can connect you with a lactation or breastfeeding consultant. Lactation consultants have received additional training in breastfeeding. They may be able to come to your home, see you at the clinic or answer questions over the phone. Reach out as soon as you have any concerns. The clinic may also be aware of any support groups in the area
La Leche League is an international, mom-led breastfeeding support group. They offer online resources as well as information on groups in your area. Often local chapters will have a Facebook group as well. I have seen more detailed support come from these groups than professionals and even someone saying “I’ve been there” can help.
Local Health Region
Your local health region may have supports online or in person. Some areas will have more information than others. For example, every health region in Canada has some pregnancy/breastfeeding information but Ontario, Alberta and Newfoundland have the best resources.
International Health Organizations – UNICEF, Stanford Health
These organizations are motivated by improving health rather than selling a product. They are research-based and provide up-to-date information.
There are some amazing breastfeeding experts, for example Dr. Jane Morton M.D. who produce professional resources based on science and years of medical practice
There are many lactation supplements on the market: herbs, cookies, tea, cereal, and smoothies. Check the links attached for further information. I have no experience that these products make a difference. Like medication, they would only be an aide to the hard work of building your own milk supply.
There are some amazing videos online for increasing milk supply, Stanford Medicine has much of Dr. Jane Morton’s videos and Global Health Media videos are also ones I strongly recommend.
The Breastfeeding Handbook is a comprehensive free PDF.
If you have been worried about lactation and milk supply, you are not alone, and you are not lacking. This is a skill that requires instruction, practice and expertise. Ask for help, keep trying and its ok if baby cries while you figure it out.
If you are reading this article too late, and like me, you didn’t get the information in time to save your breastmilk supply do not worry. I already know you are a good mom because you took the time to read this. Now, go snuggle that little one because they grow up too fast.
- Jane Morton, MDhttps://app.box.com/s/ljm2e2iy0ug12rxto395/file/9680874139