Breastfeeding can be overwhelming for new mothers. She may worry about her low breast milk supply. Unlike bottle-feeding, where one can tell precisely how much the baby is drinking, no one can actually know how much milk a mother has and how much her baby is taking.
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How Breast Milk Supply Works?
When a woman conceives and gives birth, several things happen to permit her milk to stream. The hormone prolactin increases, and progesterone levels decrease.
Breast milk is secreted in the glandular tissue (areolas) of the breast. This smooth muscle tissue around each little milk-creating cell contracts, when hormones are discharged.
Letdown happens when these withdrawals impel milk down the milk ducts to the areola openings and are usually activated by the infant’s cry and touch, areola stimulation, and sucking.
During feeding, a mother will have a few letdowns; however, during the initial letdown, she may see a throbbing or tingling sensation in her chest. This is typical and felt due to the milk channels dilating as the milk streams.
Since milk creation works based on supply and demand, frequent breastfeeding will stimulate milk creation and supply up.
Reasons For Low Breast Milk Supply
Breast milk coming in late
A few days after birth, the volume of breastmilk increases and is commonly known as “milk coming in” When this increase in volume does not occur in a few days, it is termed as late or delayed lactation.
Delayed lactation could lead to low milk supply, especially if the mother does not have the right help and support.
Poor breastfeeding management
One of the most critical factors for low breast milk supply is not draining enough milk from the breasts in the initial days after birth.
Good milk supply depends on standard, proficient breast draining for several weeks. Check more about the different types of breastfeeding positions to have good breast milk supply.
Baby’s breastfeeding skills – Poor milk transfer could be due to factors unique to baby or difficulties with a mother’s unique anatomy. Causes for poor breastfeeding skills happen when
- Medications used during birth can make a baby sleepy or too tired to suck correctly.
- The infant is in agony or uneasiness following a medicinally traumatic birth.
- The baby is premature or being little for dates.
- A shallow lock or improper positioning (sore areolas ordinarily demonstrate an issue with a latch).
- An infant with low or high muscle tone.
- Anatomical variations, for example, a little jaw (micrognathia), or congenital fissure.
- Tongue-tie or improper tongue function.
Nipple challenges – At times an infant may feel hard to breastfeed and deplete the breasts effectively because of variations in the mother’s anatomy making breastfeeding difficult like:
- Inverted or flat areolas
- Large, long, or distinctively shaped areolas, e.g., twofold nipples or areolas with a skin tag, can make it increasingly hard for an infant to latch profoundly.
- Large areolas make it hard to fit the baby’s mouth.
- Exceptionally tight inelastic breast tissue can make it harder for the infant to latch.
- Nipple piercing may have prompted the scarring or conclusion of areola pores, which can block the milk stream.
Insufficient glandular tissue
There are times when the milk does not appear to come in after birth. This might be because of insufficient glandular tissue (IGT).
Different names for this condition are lactation insufficiency, primary lactation failure, hypo plastic breasts, or mammary hypoplasia. IGT is uncommon, and usually, there may be a few information in the mother’s clinical history.
Pointers may include having hormone or endocrine issues, little and widely spaced breasts, if one breast is different to the next, if the mother’s breasts have not developed and been delicate during adolescence or pregnancy or if there wasn’t an inclination of feeling fullness after the birth.
Breast surgery or trauma
Successful lactation depends on specific structures in the breast being intact and fully developed. Any previous surgery to the chest area can potentially damage critical nerve pathways and ducts and compromise glandular tissue in the breast.
Hormonal or endocrine disorders
A few hormones are essential for the production of milk (like prolactin, thyroid hormones, insulin, and cortisol) and discharge of the milk (oxytocin).
If a mother has a fundamental hormonal imbalance or required fertility treatment to get pregnant, this could signal an issue with milk creation or setback of milk.
Diet and herbs, vitamins, and minerals
What we eat can affect milk quality in subtle ways and, in some cases, can change the quantity of milk.
Research shows that several nutrients are essential for optimal milk production, such as protein, zinc, fiber, iron, and calcium. Diet can likewise influence our metabolic wellbeing, which may, thus, influence milk production.
Misconceptions about low breast milk supply
Infants ordinarily feed regularly – around 10 to 12 times each day – and this is undoubtedly not a sign that a mother does not have enough milk.
Always remember that a baby nurses for comfort as well, and it’s difficult to calculate a baby’s milk intake during every feed as quantities can differ.
The below circumstances are all normal and are not signs of inadequate milk supply:
- baby wants to feed frequently
- baby doesn’t want to be put down
- baby is waking in the night
- short feeds
- long feeds
- baby will take a bottle after a feed
- breasts do not feel full as they did in the early weeks
- breasts do not leak milk, or they used to leak and have stopped
- a mother cannot pump much milk
- a mother has small breasts
Signs a baby isn’t getting enough milk
- Baby seems very sleepy or lethargic. Babies who are not getting enough milk will have low energy. A normal baby usually sleeps up to four hours or more at a time.
- Baby takes very little or more time during breastfeeding. An infant who is not fed well may nod off soon after starting to breastfeed or take longer than 30-40 minutes per feed.
- Latching is painful or appears shallow. A poor latch can prevent the baby from getting enough milk.
- Baby has not regained their birth weight by 10-14 days old, or weight gain is slower than expected. 155 – 240 grams per week is reasonable.
- Baby is not stooling often (they should have 3-4 stools per day by four days old). The baby’s urine is not pale.
What to do if a mother has low breast milk supply
The following are things that a mother can do to increase breast milk production.
Boosting her milk supply depends on how little the amount is, to begin with, and what contributes to the low breast milk supply or production. Most of these methods should start working within a few days.
1. Breastfeed more often
Breastfeed often and let the baby decide when to stop feeding. Breastfeeding a new baby 8 to 12 times a day can help establish and maintain milk production.
But this does not mean that more or fewer feedings indicate a problem.
2. Pump between feedings
Pumping between feedings can also help increase milk production. Warming the breasts before pumping can help make a mother more comfortable and pump easier, too.
Try pumping whenever:
- A mother has milk left over after a feed.
- A baby has missed a feed.
- A baby gets a bottle of breast milk or formula.
3. Breastfeed from both sides
Have the baby feed from both breasts at each feeding. Let the baby feed from the first breast until they slow down or stop feeding before offering the second breast.
The stimulation of having both breasts breastfed can help increase milk production. Pumping milk from both the breasts at a time has also helped increase milk secretion.
4. Foods, herbs, and supplements
Some foods and herbs may increase breast milk production. Some of these foods and herbs are:
A mother should always talk to a doctor before taking a new supplement, especially when breastfeeding since even natural remedies can cause side effects.
Refer to our blog on important diet tips for nursing mothers to learn more about the food that help increase breast milk.
How to increase milk supply with a breast pump
Pumping of breast milk can be an essential strategy for increasing the breast milk supply. These tips may help improve a mother’s breast milk supply.
Using the correct breast pump
Always utilize a hospital-grade pump or a high-quality electric breast pump. A pump operated by hand or a small electric or battery-powered pump is suitable for intermittent pumping, but it is not good enough to build or increase breast milk supply.
A double pump might be a good investment if a mother is pumping exclusively.
Using the pump correctly
Always follow the instructions given by the manufacturers on how to use the pump correctly, and make sure the pump is in good working condition. If a mother has questions, contact the manufacturer or ask a lactation consultant.
Be sure that the pump shields, the part of the pump that goes over the breasts and nipples, fits appropriately. If not, it could lead to breast issues such as sore nipples or damaged breast tissue.
Preparing before pumping
Before a mother starts to pump, she has to wash her hands and choose a breast milk storage container that fits her needs.
She will be pumping for 20 to 30 minutes, so it is necessary to get into a comfortable position.
A mother might feel thirsty or hungry while pumping, so it is better to place a glass of water or juice and some healthy food next to your pumping spot.
The mother’s body needs lots of fluids and some extra calories to produce milk.
Research shows that ‘kangaroo care’ can increase the amount of breast milk that a mother can pump.
If her baby is in the hospital and cannot breastfeed, talk to the hospital staff about using kangaroo care as often as her baby can tolerate it.
If possible, pump while the mother is near her baby, or even holding the baby.
When a mother is pumping away from her child, try to relax and think of your baby as it could stimulate the mother’s letdown reflex and get the breast milk flowing.
Applying Warm, Moist Heat
Before a mother pumps, place warm, wet washcloths on the breasts. This moist heat can help bring about the flow of the breast milk. This is especially helpful if she has difficulty with letdown.
Keeping the breast pump equipment clean
After each use, follow the manufacturer’s instructions for wiping down and cleaning the breast pump and tubing.
Wash the breast flanges and breast milk storage containers in hot water. Then, rinse them thoroughly, allowing it to dry so that they’ll be ready to use when a mother needs them next.
When a mother is taking care of a little one, there’s always so much to do, which can make her easily to put herself at last.
But if she does not take care of herself, it can affect the breast milk supply. It is always necessary to eat a well-balanced diet with extra calories, drink plenty of fluids, and rest.
If a mother has any questions about her breast milk supply, breast pumps, or pumping, talk to OB/GYN, a lactation consultant, or a support group such as Jammi Scans Interactive Forum.
These resources can help her decide on the pump that is right for her. They can also provide additional help and support as the mother works to build and maintain her milk supply.
Chennai Women’s Clinic is now Jammi Scans