Busting the Booby Traps of Low Milk Supply

Pinky McKay

It can seem as though every time your baby whimpers somebody will suggest, ‘he’s hungry,’ or they may even ask, ‘are you sure you have enough milk?’ Then there is the anxiety about having your baby weighed. It feels like a ‘pass’ or ‘fail’ for your mothering, depending how much weight your baby has gained.

Is it any wonder the leading cause of early weaning from breastfeeding is cited as ‘low milk supply’?

There are some medical and health conditions that may cause challenges with milk supply, such as thyroid disorders, diabetes, low iron levels, retained placenta, polycystic ovarian syndrome and less common, insufficient glandular tissue (IGT) or breast hypoplasia – signs include little or no breast development during puberty or pregnancy and widely spaced tubular breasts.

Then there is the lack of information or support and unhelpful information that can undermine you and have you doubting your body and your boobs. This creates stress hormones that work against your lactation hormones.

There are no reliable statistics about how many women may have challenges with milk supply – it’s often quoted that, “less than 5% of women physiologically can’t produce enough milk.” However, there is no research around this figure. In fact, this 5% figure was traced back to a remark in an opening presentation given by JC Spence, MD, FRCP, at the Annual Meeting of the British Medical Association in Plymouth, in 1938.

Just a comment by a Dr, no research whatsoever! Since then, it seems, everyone has been quoting everyone else who had used this figure. Regardless, percentages don’t matter – individual women matter. It is devastating if you are a mum desperately wanting to breastfeed, but things don’t seem to be working for you and your baby.

Often, anxiety around milk supply can be more of a factor in reaching for the bottle than actual low milk supply and even if you have a medical condition that means you are having a hard time, you don’t need to ditch your nursing bra just yet. Try to remember, every drop of breastmilk is liquid gold and even a small amount will boost your baby’s immunity. Calling in an expert such as an IBCLC (International Board Certified Lactation Consultant) could make a world of difference to your confidence and your breastfeeding experience.

Meanwhile, let’s bust some ‘booby traps:

My Baby Feeds ‘all the time’

Your newborn’s stomach is tiny and breast milk is easily digested so your newborn will need at least 8 to 12 feeds in 24 hours and in the early weeks your baby is mastering the art of coordinating sucking, swallowing and breathing, so he needs lots of practice to become an efficient feeder. Individual women also have different breast milk storage capacities so although most women produce enough milk, a woman with a smaller storage capacity (this isn’t necessarily related to breast size), will need to feed her baby more often than a woman with a larger storage capacity.

Tip: Get an IBCLC lactation consultant to check your baby is latched, sucking and transferring milk effectively. In the early weeks, there is still some breast development going on and by feeding according to your baby’s hunger cues (not the clock), you are setting your breasts’ capacity for milk production. This means that the more milk your baby removes, the more milk your breasts will be signalled to make and the higher you will ‘set’ your ongoing milk production. But if you space out feeds (by implementing a feeding schedule) or you top your baby up with formula unnecessarily (first rule is always ‘feed the baby’ so be advised by your health carer), she naturally eats less at the breast and your breasts will respond by making less milk.

My breasts feel soft

At first your breasts will feel firm or even hard and swollen as your milk comes in but a lot of this swelling (engorgement) is extra blood circulation and tissue fluid as your body gets used to this new experience. As your baby and your breasts become synchronized so you are making the amount of milk your baby needs, your breasts will naturally soften and feel less swollen. As long as your baby is feeding effectively and you respond to his hunger signals, you will usually make exactly the amount of milk your baby needs.

Tip: If your baby is only drinking breast milk and having at least one soft yellow bowel motion and 6 to 8 very wet cloth or 5 wet disposable nappies a day, he is getting enough milk (what comes out must be going in!).

My baby has suddenly started feeding more frequently

Your baby may be having a growth spurt and a corresponding appetite increase or he may be coming down with a bug and need an immune boost: the transfer of saliva from your baby’s mouth to your breasts signals you to produce antibodies to any bugs your baby is exposed to and he will receive these antibodies as he drinks your milk.

Tip: Take your baby to bed or ‘netflix and chill’, keeping up your fluids and nourishing snacks, snuggling skin to skin with your baby (this will boost your milk making hormones) and allow him to feed whenever he shows early hunger signals. This will help your body catch up with your baby’s increased need to feed.

My baby only has short feeds

Although in the early days, feeds seem to take forever, often at around 10 to 12 weeks, many babies seem to quite suddenly feed more quickly. As long as your baby is having wet nappies (see above) and gaining weight, they have most likely become an efficient feeder so don’t need to suck as long. However, if your baby seems to be having short feeds and isn’t gaining weight steadily, consider, is he latching and sucking well, has he been checked for an issue such as tongue tie, is he distracted during feeds?

Tip: Any time you are concerned about your baby’s feeding patterns, get a professional such as a lactation consultant to observe a feed to make sure your baby is attaching, sucking and transferring milk effectively.

My baby grunts and squirms and seems frustrated when he feeds:

Although some babies become impatient as they wait for the milk to start flowing, others can feel uncomfortable for various reasons. For example, your baby may be affected by tummy discomfort because as he starts sucking, this also starts peristalsis (food or wind moving around the gut) so he is struggling a bit to coordinate feeding and farting at the same time. Tired babies or babies who have been crying (crying is a LATE hunger signal), will often squirm at the breast because they are having difficulty organizing feeding behavior. This often happens in the evening, leading mums to believe they don’t have enough milk.

Tip: Observe your baby’s feeding cues (rooting towards the breast, moving his hand to mouth and making little noises) and respond quickly. If you have been giving your baby bottles, he may be developing a preference for the fast flow from a bottle so if you do need to supplement, start at the breast then ‘finish at the breast’ so that he associates a full tummy and comfort with Mummy and breastfeeding.

My baby gulped down a full bottle of formula after a breastfeed

Sucking is an involuntary newborn reflex. It’s particularly strong in babies under three months. This means that when you pop a bottle teat into your baby’s mouth, it will automatically stimulate a sucking reflex. As the baby sucks, his mouth fills with milk, which he then has to swallow. The swallowing triggers the suck reflex again so your baby keeps on sucking and swallowing.

It looks as though your baby is ‘hungrily’ gulping the bottle of formula when, in actual fact, he simply couldn’t control his natural sucking reflex. Of course, after drinking a full bottle of formula, your baby will fall asleep for hours because he is ‘full’ and also because formula takes longer to digest than breast milk, so it’s only natural that you will start to doubt your ability to produce enough breast milk.

Tip: It’s never early or too late to get help – watch your baby, not the clock, eat nutritious foods, drink to your thirst, surround yourself with supportive people and seek help if you have any concerns about your milk supply. If anyone asks, ‘are you sure you have enough milk?’ tell them, ‘my nurse/doctor/pediatrician’ says we are doing fine, thankyou,’ then quickly change the subject.

For tips to boost your milk supply, download this FREE ebook ‘Making More Mummy Milk, Naturally’ by Pinky McKay IBCLC.