Low milk supply – it’s something that every breastfeeding mother thinks about at least once, and for many it’s a constant, nagging worry. It’s probably the most common reason women give for stopping breastfeeding earlier that they wanted to: “My milk ran out” or “I didn’t have enough milk”. On online breastfeeding support groups and forums, it’s one of the most common questions: “How can I increase my milk supply?”
Start by asking the right questions
Whenever a mom asks me how she can increase her milk supply, I always give the same answer: “What makes you think your milk supply is too low?” Because, you see, often there is not a milk supply issue at all – the milk is there, it’s being produced, but something else is going on.
Based on experience (but, admittedly, not any formal research studies), I find that many (most?) women who complain of low milk supply really do not have any supply problem whatsoever. The baby is clearly getting enough milk; the problem is with the mom’s expectations or with misinterpreting the baby’s behaviour. Things that have nothing to do with milk supply are often blamed on low milk supply – and then the breastfeeding relationship is often abandoned long before mom or baby was really ready.
So it is very, very important for a breastfeeding mom to be able to judge whether her baby is really getting enough milk. I’ve written about the correct, reliable ways to know whether your baby is getting enough milk in another post – please go look at it, because it’s very important to understand! This post will address all the rest – all those “false alarms” that cause many mothers to panic about their milk supply unnecessarily.
False alarms! This is not low milk supply.
This is always an interesting topic to address: all the things that people think are signs of low milk supply. The problem is, any of these signs can be present in a baby that isn’t getting enough milk – but they can also be due to a myriad of other causes that have nothing to do with breastfeeding, as I will explain. That’s why you always need to go back to the things I discussed in this post know whether baby is getting enough: if baby’s diaper output and weight gain are okay, then milk supply is not the problem!
False alarm 1: Baby wants to breastfeed “too often”
I’ve put “too often” on quote marks because there’s really no such thing! How often should you breastfeed? As often as your baby needs to, as simple as that. The problem comes when we (or our doctors or families or the writers of some silly baby books) expect our babies to settle into a three-hourly or four-hourly routine. Sorry, but breastfed babies simply don’t work that way. Sometimes they’ll go a bit longer between feeds, sometimes it will feel like they want to feed every 5 minutes. Breast milk digests a lot quicker than formula (it moves through the stomach in about 90 minutes, give or take), so it’s natural for breastfed babies to be hungry again sooner. The bottom line is this: if your baby is healthy, happy and growing well, it really doesn’t matter how often they feed. Really. I’ve known some babies to thrive on 8 feeds a day while others (like my firstborn!) need 20 feeds a day. Whatever works for your baby is okay. If you want more details, check out this post.
Also remember that breastfeeding is not just about food, it’s also about love and comfort and safety. Those needs are just as legitimate as the need for milk.
False alarm 2: Baby cries a lot
Babies cry for many reasons, including overstimulation, pain, wet nappy, too hot, too cold, boredom and simply wanting to be cuddled. In my experience, the most common culprits are winds or stomach cramps and tiredness. Also, keep in mind that all normal babies have times (usually late afternoon) and days (including growth spurts) when they are extra fussy. Generally, the best way to handle fussiness is with skin-to-skin and breastfeeding.
False alarm 3: Baby does not sleep for long periods and wakes up a lot at night
It’s important to have realistic expectations about babies’ sleep. Babies are not designed by nature to sleep for long periods; it’s a built-in protection against SIDS. For a baby to sleep more than 1-2 hours at a time is the exception, not the rule. And babies are individuals, just like adults: some babies simply need less sleep than others – so just because your friend’s baby sleeps 6 hours doesn’t mean that it’s a problem of your baby doesn’t! The amount that a baby sleeps is not determined by how much he eats, and sleeping through the night is a neurodevelopmental milestone, not a nutritional one. Baby will sleep through the night when he’s ready.
False alarm 4: Baby is not settled at the breast and is difficult to feed; baby comes on and off the breast and cries.
Babies can be unsettled at the breast for all sorts of reasons, some more serious than others. First rule out all the obvious culprits: check that the diaper is dry, and burp baby to make sure there isn’t a wind. Any pain in the mouth can also cause baby to fuss at the breast – this includes pain from oral thrush and from teething, or from being suctioned after birth. Other problems in the baby’s mouth, such as tongue ties, lip ties and submucosal clefts, can also cause this type of behaviour, because baby is struggling to stay latched on to the breast.
Sometimes the milk flows too fast, and it causes baby to choke and pull away from the breast. This can be easily remedied by feeding in the laid-back position.
Having said all that, a baby that is fussy on the breast is often a sign that something is not going well – although usually the problem is with the baby, not with the milk supply. If you have a baby that’s always fussy on the breast, keep an eye on his weight gain and see a professional if needed.
False alarm 5: Baby sucks on his hands
Babies love to suck; they will suck on anything that comes near their mouths. For a baby, sucking is their way to calm down and relax. And as they grow older, they learn to bring their hands to their mouth – it’s an important part of how they learn about their world. So while sucking on the hands can be a feeding cue, it doesn’t mean that your milk supply is low! It’s actually very simple: offer the breast. If baby is hungry, he’ll take it, and then you can let him drink.
False alarm 6: I can’t express any milk (or only a little bit)
Let me just say this clearly: expressing (or pumping) is a terrible indicator of how much milk you have. Why? Because it’s not a very efficient process. Firstly, you need to have the correct technique, even with a pump, or you will not get much milk out even if there’s plenty in the breast. And then there are some women who simply cannot express; their breasts just don’t respond to a pump. (There’s even some medical conditions, like hyperthyroidism, that can cause this!) And even if you’re doing everything right, and you’re a pumping maestro, you can never get as much milk out of a breast as a baby can. Let’s all say this together: there’s always more milk in the breast than the pump can get out.
Also keep in mind, if you’re trying to express in-between breastfeeds, you’re getting only the leftovers after baby is finished! So anything you manage to express then is a bonus over and above what your baby actually needs.
False alarm 7: My breasts are soft and floppy
One day you notice that your breasts no longer seem to get full and hard between feeds, and you panic that your milk is disappearing. After all, up until now you’ve been in serious need of a bigger bra! Rest assured, though, that this is normal. Your breasts go back to being soft and squishy eventually – often from around 6 weeks, although if you have oversupply issues it can take a lot longer. As long as baby is still showing the signs of getting enough milk, you don’t have to panic. Enjoy fitting into your Wonderbra again.
False alarm 8: I don’t feel a let-down in my breast; or I used to feel it but I don’t anymore
The let-down is that tingly feeling you get in your breast when baby starts to suck and the milk starts to flow. Some women also describe it as a squeeze or a sensation of heat. But here’s the thing: some women never feel it. Like, never, not even once. And most women stop feeling it eventually, some sooner than others. If you can see your baby swallowing, you can be pretty sure you’re having a let-down, whether you feel it or not.
False alarm 9: I don’t leak milk
Some women are leakers, some aren’t: it depends mostly on the strength of the muscles that surround the nipple openings. And even heavy leakers tend to stop leaking eventually (speaking from experience here…). This is really just a non-issue.
False alarm 10: I gave baby a bottle and he gulped it down
Ah, saving the best for last! While it is true that a hungry baby will gulp down a bottle of milk, it is also very likely that a baby who is not hungry at all will gulp it down. How so? Well, have a look at what happens if you hold a baby bottle upside down: the milk runs out! So for baby, it’s a case of swallow or drown! (Gulping, by the way, is always a sign that the milk is flowing too fast for the baby to handle).
A newborn baby’s strong sucking reflex also confuses the matter. Babies have a built-in tendency to suck: if something presses against their palates, they suck. It’s an automatic reflex; they can’t help it. And equally automatic is the reflex to swallow if there’s liquid in the mouth. So you can see that by sticking a bottle teat in baby’s mouth, you’re virtually guaranteeing that he will suck and swallow the milk.
And finally, just because baby takes the bottle, doesn’t mean he needs it. He would most likely have been just as happy to get the breast. Remember, if you offer me a chocolate, I’ll take it – even though I certainly don’t need it and should probably say no!
Wrapping it up
So remember, if baby is healthy, happy and gaining weight, your milk supply is absolutely fine – nothing else matters. Write this on a card on your wall, say it to yourself a million times, make it your mantra. You will save yourself a lot of unnecessary stress!
Have you ever had a milk supply scare that turned out to be a false alarm? Write a comment below and tell me about it!