MILK SUPPLY CHALLENGES

Generally if your baby is nursing often, has lots of wet and dirty diapers and is gaining weight adequately, you are giving your baby enough milk. A baby that cues to feed frequently, or cluster feeds is not always an indication that there is a milk supply concern. This can be your baby’s natural feeding pattern or a growth spurt.

If your baby has latching issues, has trouble staying awake for feeds, always has to be woken up to feed, is feeding less than 8 times a day and isn’t producing wet and dirty diapers you should seek help.

Not enough milk

The following factors can decrease your milk production:

  • If a baby is not correctly latched at the breast and removing milk (as there will be a decrease in the messages the body receives to produce more milk)
  • Medical conditions such as thyroid problems or infections
  • Previous breast surgery (some breast reduction surgeries)
  • Heavy blood loss, during or after the birth
  • Stress, pain or feeling very tired
  • Infrequent feedings, reduced night feedings and limiting lengths of feeds (as there will be a decrease in the messages the body receives to produce more milk)
  • Breast/chestfeeding only on one side at each feeding
  • Use of soothers or bottles, especially in the early weeks, leading to less frequent feeds and latching problems
  • Smoking
  • Alcohol use
  • Some medications including birth control pills, antihistamines and some herbal teas
  • Incorrect use of a nipple shield
  • Severe engorgement
  • Painful nipples or breasts
  • Retained placenta fragments
  • Pregnancy

Talk to your doctor, public health nurse or a lactation consultant if you think any of these may be affecting your milk supply.

Increasing your milk supply

 The following strategies can help increase your milk supply:
  • Make sure your baby is latching and feeding well at the breast
  • Increase time spent skin-to-skin with your baby
  • Increase the number of feeds in 24 hours (at least 8 – 12 times a day), night feeds are especially important for increasing a milk supply
  • Offer both breasts at every feeding, allowing your baby to finish the first breast before moving to the next side
  • Compress your breast (with the thumb on top and fingers underneath) when your baby’s sucking slows down, to increase the amount of milk your baby swallows at each feeding
  • Try switching your baby back and forth between sides, offering each breast twice more during a feeding
  • Express milk after feedings by hand or use an efficient pump
  • If your baby is not breast/chestfeeding, use an effective pump set at a comfortable setting, at least 6 to 8 times a day (including once at night)
  • The use of a double pump attachment will reduce time spent pumping and allow more rest time between pumping sessions
  • Put warm compresses on your breast or massage your breasts before, and while using the pump to increase milk flow
  • Ask your doctor about medications that may increase milk supply
  • Get more rest. Ask for help with household tasks
  • Eat a well-balanced diet (see Canada’s Food Guide) and drink to satisfy thirst
  • Get help from a lactation specialist

Too much milk

Some people have a large milk supply or the milk comes out very fast from the breast. In many cases, this is temporary, and gets better once your milk supply adjusts to your baby’s needs. You and your baby may benefit from some help if:

  • Your baby nurses often, but is gulping at the breast
  • Your baby frequently pulls back off the breast
  • Your baby spits up milk often and has a lot of gas discomfort
  • You find that your breasts feel overfull and uncomfortable
  • You leak a lot of milk between and during feeds

Some strategies to try if you have too much milk or have a fast milk flow:

  • Try different feeding positions such as laid back or keeping baby more vertical
  • Burp your baby often
  • Temporarily feed your baby on only one breast per feed
  • Avoid pumping excess milk after a feed as this will stimulate your body to make even more milk
  • Wait until the milk has let-down, then take baby off the breast, wait until the leaking has slowed, and then latch baby again
  • Hand express a little milk before latching the baby to reduce the speed of the flow