There is a significant number of women who genuinely struggle with a low breastmilk supply.
Low milk supply is an issue that many health professionals do not acknowledge even now. You will hear that it is just a’ perceived poor milk supply’ and ‘you really just have to relax, you will have enough breast milk to feed your baby’.
This used to be the case. Sadly with the rise of adult onset diabetes (Type two) and Polycystic Ovarian Syndrome (PCOS) in mothers, low milk supply is a real, honest problem.
Polycycstic Ovarian Syndrome affects up to 20% of the US population, and the number is growing.
Of these women, approximately one third will struggle with an over supply of breast milk. One third will have no issues what so ever with milk supply, and the final third will struggle with some form of low breastmilk supply issues.
Of this final third about 10% of these women will seriously struggle to naturally make any milk at all – I am one of these women.
Diabetes has a similar affect on a woman’s ability to produce milk, and women with either type one or type two diabetes may struggle to make enough milk to fully breastfeed their babies.
Do I have low breastmilk supply issues?
It is entirely probable that you are actually making enough milk for your baby. If you have gotten to about 6 weeks postpartum (after baby is born) and you are noticing that your breasts no longer feel full like they used to and baby is more fussy, and feeding more often.
THIS IS NORMAL
At 4-6 weeks your body settles in to a more ‘normal’ milk producing cycle. Your hormones start to settle down and you will no longer feel engorged all the time.
At this time, your baby is also becoming more aware of the world, and is more likely to fuss more, and want to feed more often.
Also, as your breasts are no longer spraying the baby like a fire hose at each feed, your baby actually has to work to get the milk, they will feed more often until they work out how to feed faster.
If your baby is having settled times between feeds and is having 6 or more wet diapers per day, and is gaining weight. He is fine. Your milk supply is doing exactly what it should be.
At about 6 weeks of age, your baby may start going 1-7 days without pooping, and as long as when they do poop it is soft and not small marbles, that is normal for a breastfed baby. He is not constipated, it is just what breastfed babies do.
How to know a baby is getting milk
When a baby is getting milk, he will have an open mouth wide – pause – close mouth type of suck. He is not getting milk just because he has the breast in his mouth and is making sucking movements.
When he is sucking and not getting milk his chin moves down and up rapidly with no pausing of the chin at the maximum opening—this means “I am not getting milk flow into my mouth”.
To demonstrate this to yourself, put your index finger into your mouth and suck as if you were sucking on a straw. As you draw in, your chin drops and stays down as long as you are drawing in. When you stop drawing in, your chin will come back up.
This pause that is visible at the baby’s chin represents a mouthful of milk when the baby does it at the breast. The longer the pause, the more milk the baby got, so it is obvious that the frequently advised “feed the baby 20 minutes on each side” makes no sense.
A baby who drinks very well (as opposed to sucking without drinking) for say, 20 minutes straight, will likely not take the other side. A baby who nibbles (doesn’t drink) for 20 hours will still come off the breast hungry.
Symptoms of not making enough breastmilk
If you are at risk of not making enough breastmilk, these are the things you should be watching out for:
1 – A crying restless baby that won’t settle between feeds
There are many causes for an unsettled baby, but if yours never seems happy unless it is latched on, you should consider working with a lactation consultant to get to the bottom of this.
2 – 5 or less wet diapers in 24 hours
After 5 days of age your baby should be soaking 6 or more diapers per day. It is more difficult to check this with modern disposable diapers, but they should feel heavy when they are taken off.
3 – Poor weight gains, or weight loss
Ideally you will be seeing your midwife or doctor regularly in the first 2 months of your baby’s life, and they will weigh baby for you. Be aware that breastfed babies can gain weight more slowly than formula fed babies. If slow gains are the only symptom, don’t be bullied in to supplemental feeding, it may not be necessary.
Ask for another week and try these effective methods for boosting your milk supply first, and re-weigh after a week to 10 days.
4 – Baby is not swallowing when feeding or falls asleep feeding
A newborn that is not swallowing when sucking will eventually tire and just fall asleep hungry.
A baby who is obtaining good amounts of milk at the breast sucks in a very characteristic way. When a baby is getting milk you will see a pause at the point of his chin after he opens to the maximum and before he closes his mouth, so that one suck is (open mouth wide > pause > close mouth type of sucking)
Just because a baby is sucking does not mean he is getting milk.
An older baby – 5 weeks or more – may start to fuss at the breast rather than fall asleep. Your milk supply hasn’t changed in this case, your baby has!
5 – Early onset jaundice or jaundice that isn’t clearing as expected
A dehydrated baby may experience jaundice before the typical 3 day “breastfeeding jaundice” and the results may be far more drastic than typical jaundice as well. Normal “breastfeeding jaundice” will not clear as quickly or as well as expected in a baby that is not receiving enough fluids.
If your baby is looking yellow to you, especially if they are also drowsy and are seldom awake, you need to get a blood test done on them! A badly jaundiced baby that is also dehydrated can die rapidly. Don’t muck around if you are concerned.
Symptoms of Low Breast Milk Supply
If you are experiencing any of these 5 symptoms then you should work on increasing your milk supply ASAP. And if you are concerned you should contact your doctor, midwife or lactation consultant.
If your baby is ever lethargic, floppy or hard to wake, take them to the emergency department or call an ambulance immediately.