Low Milk Supply

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Milky

Is your milk supply really low?

First of all, is your milk supply really low? Often, mothers think that their milk supply is low when it really isn’t. If your baby is gaining weight well on breastmilk alone, then you do not have a problem with milk supply.

It’s important to note that the feel of the breast, the behavior of your baby, the frequency of nursing, the sensation of let-down, or the amount you pump are not valid ways to determine if you have enough milk for your baby.

What if you’re not quite sure about baby’s current weight gain (perhaps baby hasn’t had a weight check lately)? If baby is having an adequate number of wet and dirty diapers then the following things do NOT mean that you have a low milk supply:

• Your baby nurses frequently. Breastmilk is digested quickly (usually in 1.5-2 hours), so breastfed babies need to eat more often than formula-fed babies. Many babies have a strong need to suck. Also, babies often need continuous contact with mom in order to feel secure. All these things are normal, and you cannot spoil your baby by meeting these needs.
• Your baby suddenly increases the frequency and/or length of nursings. This is often a growth spurt. The baby nurses more (this usually lasts a few days to a week), which increases your milk supply. Don’t offer baby supplements when this happens: supplementing will inform your body that the baby doesn’t need the extra milk, and your supply will drop.
• Your baby nurses more often and is fussy in the evening.
• Your baby doesn’t nurse as long as she did previously. As babies get older and better at nursing, they become more efficient at extracting milk.
• Your baby is fussy. Many babies have a fussy time of day – often in the evening. Some babies are fussy much of the time. This can have many reasons, and sometimes the fussiness goes away before you find the reason.
• Your baby guzzles down a bottle of formula or expressed milk after nursing. Many babies will willingly take a bottle even after they have a full feeding at the breast. Read more here from board-certified lactation consultant Kathy Kuhn about why baby may do this and how this can affect milk supply. Of course, if you regularly supplement baby after nursing, your milk supply will drop (see below).
• Your breasts don’t leak milk, or only leak a little, or stop leaking. Leaking has nothing to do with your milk supply. It often stops after your milk supply has adjusted to your baby’s needs.
• Your breasts suddenly seem softer. Again, this normally happens after your milk supply has adjusted to your baby’s needs.
• You never feel a let-down sensation, or it doesn’t seem as strong as before. Some women never feel a let-down. This has nothing to do with milk supply.
• You get very little or no milk when you pump. The amount of milk that you can pump is not an accurate measure of your milk supply. A baby with a healthy suck milks your breast much more efficiently than any pump. Also, pumping is an acquired skill (different than nursing), and can be very dependent on the type of pump. Some women who have abundant milk supplies are unable to get any milk when they pump. In addition, it is very common and normal for pumping output to decrease over time.

See also Is my baby getting enough milk?

Who to contact if you suspect low milk supply

If you’re concerned about your milk supply, it will be very helpful to get in touch with a La Leche League Leader or a board certified lactation consultant. If your baby is not gaining weight or is losing weight, you need to keep in close contact with her doctor, since it’s possible that a medical condition can cause this. Supplementing may be medically necessary for babies who are losing weight until your milk supply increases. If supplementing is medically necessary, the best thing to supplement your baby with is your own pumped milk.

Potential causes of low milk supply

These things can cause or contribute to a low milk supply:

• Supplementing. Nursing is a supply & demand process. Milk is produced as your baby nurses, and the amount that she nurses lets your body know how much milk is required. Every bottle (of formula, juice or water) that your baby gets means that your body gets the signal to produce that much less milk.
• Nipple confusion. A bottle requires a different type of sucking than nursing, and it is easier for your baby to extract milk from a bottle. As a result, giving a bottle can either cause your baby to have problems sucking properly at the breast, or can result in baby preferring the constant faster flow of the bottle.
• Pacifiers. Pacifiers can cause nipple confusion. They can also significantly reduce the amount of time your baby spends at the breast, which may cause your milk supply to drop.
• Nipple shields can lead to nipple confusion. They can also reduce the stimulation to your nipple or interfere with milk transfer, which can interfere with the supply-demand cycle.
• Scheduled feedings interfere with the supply & demand cycle of milk production and can lead to a reduced supply, sometimes several months later rather than immediately. Nurse your baby whenever she is hungry.
• Sleepy baby. For the first few weeks, some babies are very sleepy and only demand to nurse infrequently and for short periods. Until baby wakes up and begins to demand regular nursing, nurse baby at least every two hours during the day and at least every 4 hours at night to establish your milk supply.
• Cutting short the length of nursings. Stopping a feeding before your baby ends the feeding herself can interfere with the supply-demand cycle. Also, your milk increases in fat content later into a feeding, which helps baby gain weight and last longer between feedings.
• Offering only one breast per feeding. This is fine if your milk supply is well-established and your baby is gaining weight well. If you’re trying to increase your milk supply, let baby finish the first side, then offer the second side.
• Health or anatomical problems with baby can prevent baby from removing milk adequately from the breast, thus decreasing milk supply.
• Mom’s health (uncontrolled anemia or hypothyroidism, retained placenta, postpartum hemorrhage…), previous breast surgery/injury, hormonal problems (e.g. PCOS), anatomical problems, medications she is taking (hormonal birth control, sudafed…), or smoking also have the potential to affect milk supply.

See Hidden Hindrances to a Healthy Milk Supply from more information on things that can decrease milk supply.

Increasing your milk supply

Milk production is a demand & supply process. If you need to increase milk supply, it’s important to understand how milk is made – understanding this will help you to do the right things to increase production.
To speed milk production and increase overall milk supply, the key is to remove more milk from the breast and to do this frequently, so that less milk accumulates in the breast between feedings.
OK, now on to things that can help increase your milk supply:

• Make sure that baby is nursing efficiently. This is the “remove more milk” part of increasing milk production. If milk is not effectively removed from the breast, then mom’s milk supply decreases. If positioning and latch are “off” then baby is probably not transferring milk efficiently. A sleepy baby, use of nipple shields or various health or anatomical problems in baby can also interfere with baby’s ability to transfer milk. For a baby who is not nursing efficiently, trying to adequately empty milk from the breast is like trying to empty a swimming pool through a drinking straw – it can take forever. Inefficient milk transfer can lead to baby not getting enough milk or needing to nurse almost constantly to get enough milk. If baby is not transferring milk well, then it is important for mom to express milk after and/or between nursings to maintain milk supply while the breastfeeding problems are being addressed.
• Nurse frequently, and for as long as your baby is actively nursing. Remember – you want to remove more milk from the breasts and do this frequently. If baby is having weight gain problems, aim to nurse at least every 1.5-2 hours during the day and at least every 3 hours at night.
• Take a nursing vacation. Take baby to bed with you for 2-3 days, and do nothing but nurse (frequently!) and rest (well, you can eat too!).
• Offer both sides at each feeding. Let baby finish the first side, then offer the second side.
• Switch nurse. Switch sides 3 or more times during each feeding, every time that baby falls asleep, switches to “comfort” sucking, or loses interest. Use each side at least twice per feeding. Use breast compression to keep baby feeding longer. For good instructions on how to do this, see Dr. Jack Newman’s Protocol to manage breastmilk intake. This can be particularly helpful for sleepy or distractible babies.
• Avoid pacifiers and bottles. All of baby’s sucking needs should be met at the breast (see above). If a temporary supplement is medically required, it can be given with a nursing supplementer or by spoon, cup or dropper (see Alternative Feeding Methods).
• Give baby only breastmilk. Avoid all solids, water, and formula if baby is younger than six months, and consider decreasing solids if baby is older. If you are using more than a few ounces of formula per day, wean from the supplements gradually to “challenge” your breasts to produce more milk.
• Take care of mom. Rest. Sleep when baby sleeps. Relax. Drink liquids to thirst (don’t force liquids – drinking extra water does not increase supply), and eat a reasonably well-balanced diet.
• Consider pumping. Adding pumping sessions after or between nursing sessions can be very helpful – pumping is very important when baby is not nursing efficiently or frequently enough, and can speed things up in all situations. Your aim in pumping is to remove more milk from the breasts and/or to increase frequency of breast emptying. When pumping to increase milk supply, to ensure that the pump removes an optimum amount of milk from the breast, keep pumping for 2-5 minutes after the last drops of milk. However, adding even a short pumping session (increasing frequency but perhaps not removing milk thoroughly) is helpful.
• Consider a galactagogue. A substance (herb, prescription medication, etc.) that increases milk supply is called a galactagogue. See What is a galactagogue? Do I need one? for more information.

http://pregnant.thebump.com/new-mom-new-dad/breastfeeding/articles/tia-tamera-mowry-breastfeeding-interview.aspx?MsdVisit=1

Night Weaning

Breastfeeding is not an all-or-nothing process. Night weaning is a workable alternative for many moms, and baby continues to receive the many nutritional and immunilogical benefits of breastmilk.
Remember that sleeping through the night is a developmental milestone (like walking or toilet training) that different babies will reach at different times. At some point, your child will sleep through the night – even if you do nothing to encourage it.
If night weaning is not going well, then consider backing off and trying again a little later. The closer your child is to reaching this milestone on his own, the easier it will be for both child and parents.
Getting your baby to sleep is not a battle to be won, as it is so often portrayed in books and the media. The real goal should be for your family to get the sleep they need, while respecting the needs of the youngest family member(s).

• Gentle methods for encouraging less night nursing

• Eliminate discomfort
• Maximize baby’s nursing during the day and during any night wakings
• Maximize sleep for the entire family

Gentle methods of night weaning for toddlers

Is night weaning necessary to get baby to sleep through the night?

Additional information

Gentle methods for encouraging less night nursing

Following are suggestions for easing your baby into less night nursing…

Eliminate discomfort

• Teething.If you suspect teething at all, it may help to give baby a pain reliever before bedtime (check with baby’s doctor for suggestions). Some babies nurse more often to try to relieve gum pain. Teething pain is often worse at night.
• Room temperature.Find your baby’s temperature comfort level: some babies will wake if they get too hot or too cold.
• Solid foods.Has baby recently started solids? Many babies (particularly those under six months) start or increase night waking after the introduction of solids, due to problems digesting the food. Try avoiding solids in the evening, or consider decreasing or eliminating the solids until baby’s digestive system matures more. Several studies have shown that adding solids to a baby’s diet does not help baby to sleep more at night.
• Allergy.Babies with food allergies, environmental allergies or eczema may wake more at night due to discomfort.
• Reflux.Discomfort from reflux may also keep baby up at night.
• Illness.Illnesses like ear infections and colds can interrupt baby’s sleep, and result in increased night nursing. A bad diaper rash or other rash might also affect baby’s sleep. Anytime baby suddenly increases night waking, keep an eye out for illness.

Maximize baby’s nursing during the day and during any night wakings

• Nurse more during the day.Encourage baby to nurse more often during the day (perhaps every 2 hours instead of every 3), so that she takes in more milk during the daytime hours.
• Minimize distractions.During the day, nurse in a room that is as free of distractions as possible. Turn off the light, close the door, pull the blinds, etc. Get your older children busy doing something before you start nursing. Try nursing while lying down. Sometimes babies can become so distracted during daytime feedings that they don’t take in enough milk and then have to make up for it with more frequent night feedings. One study showed that older babies can consume as much as 25% of their total daily intake of mother’s milk during the night, probably partly because of daytime distractibility.
• Tank up before bedtime.Nurse often in the hours leading up to bedtime (at least every 1-2 hours). Some moms nurse on one breast only during this time period so that baby gets more of the higher fat milk available at the end of a feeding (this helps baby go longer between feedings). When baby wakes at night, try nursing on the other breast for all or most of the night, again so that baby gets more of the higher-fat milk.
• Listen to your child.Only your child knows if she’s really hungry – don’t automatically assume that your child is not hungry or thirsty. Many adults wake at night for a drink of water or even to get a snack.

Maximize sleep for the entire family

• Dream feed.Nurse baby right before you go to bed (even if baby has already gone to bed), so that you get a longer period of sleep before she wakes again. Many babies barely wake at this time, even though they may get a good nursing in.
• Try to begin settling baby before he’s overtired.Some babies have a hard time going to sleep when they’re overtired, so keep an eye out for signs of sleepiness.
• Try different sleep arrangements.Find out what sleeping arrangement work best for the entire family while continuing to meet baby’s needs.

• Full-time co-sleeping.Many babies sleep better when they are close to mom. Consider sleeping with your baby – many families have found that baby and the rest of the family gets more sleep this way. Sleeping with your baby and nursing baby to sleep will not teach bad sleep habits. All the co-sleeping babies/toddlers who I know have begun to sleep through the night at some point without any type of training or encouragement or change in sleep location.
• Part-time co-sleeping.Part-time co-sleeping works for many families, where baby sleeps in her crib until the first night waking and then joins mom and dad for the rest of the night.
• Separate beds.If you’re not comfortable with baby in your bed or if you are currently sleeping with baby and no one is getting any sleep, then try other options. Consider placing baby on a pallet on the floor beside the bed, or place baby’s crib with the rail down beside your bed. That way, baby will be close enough that nursing won’t interrupt sleep quite so much (such as when you get up each time and go to baby’s room). Another option that works for some families is putting a bed for just mom and baby in baby’s room for awhile, or Dad might instead choose to sleep in another location himself.

Gentle methods of night weaning for toddlers

• Limit Access.After you nurse, place the baby back in her area, or slide her away from you so that close proximity doesn’t encourage more frequent nursing. Wear clothing that makes it harder for baby to access your breast at night.
• Get Dad in on the nighttime routine!If your baby appears to be waking only for comfort during the night, she may accept Dad as the comforter (and won’t expect Dad to nurse her). Dad can comfort baby in other ways, such as offering a drink, just lying next to her, holding her, etc. Dad may even be able to sleep with baby in another room or on the couch with less interruption than if baby were sleeping near mom. The links below to articles by Bill & Martha Sears have many great suggestions along these lines.
• Increase daytime contact.Allow baby unlimited nursing and cuddling during the day. Sometimes toddlers will seek out the breast more at night when they aren’t getting enough close cuddling during the day. Sometimes we as busy mothers, especially if we have other children, forget to pick these little ones up often during the day and just sit and cuddle with them. If you can increase this close contact during the day, she may need it less at night. If you work, night nursing may be her way of trying to reconnect with you.
• Talk to your child.With an older child, you may be able to explain something like this, “When the sun goes down, or when we go night-night, num nums (or whatever she calls them) go night-night, too. She probably won’t accept or understand this completely at first, but if you say it before bed each night and repeat it each time she awakens, in time she’ll “get it”.
• Just say “no”… or “later.”With an older child (over 18 months), feel secure enough to say “no” (at least some of the time) while staying sensitive to your child’s needs. At night, you might say, “not now, but we will later.” She may – or may not – awaken again to nurse later.
• Substitute other comfort measures.You also may try other things to settle her, such as a back rub, just holding and cuddling, getting her a drink of water, humming softly, etc.

Is night weaning necessary to get baby to sleep through the night?

People may tell you something to the effect of “If you nurse your child at night (or sleep near your child, or a zillion other things), you won’t be able to discontinue it in the future.” This sells books, but it isn’t true at all!
Remember that night waking in babies and young children is temporary!
Children grow out of night waking, even when we do nothing to discourage it. This period of time will be a very tiny part of your child’s years with you.
A child’s internal timetable for sleeping through the night can vary greatly. Some parents are comfortable with letting the child lead when it comes to night weaning, but for others night nursing truly interferes with their quality of life. If night nursing is not working for you, then encourage changes while taking into account the needs of your child.
Your goal is to maximize sleep for everyone, and if what you’re doing works, then you’ve met your goal. If it’s not working (or stops working) then you can always do things differently. All parents find that they change the way they do things as their child grows older and reaches different developmental stages – sleep is just another thing that changes as your child grows.\
From: http://kellymom.com/parenting/nighttime/weaning-night/

Sleep and breastfeeding

In the first few months, breastfeeding your baby to sleep is a lovely way for you both to wind down at the end of each day.

This can be a time for you to get a bit of rest, too (DH 2009a). Many mums enjoy this quiet time with their baby, especially if they have older children (Healthonline 2008).

As the first few months pass, your baby will start to learn the difference between day and night. By about three or four months, you may wish to ease your baby out of the habit of feeding to sleep. Then you won't become tied to breastfeeding your baby back to sleep every time he wakes.

When your baby is young he'll need to feed often during the day and night, but as he gets older he'll be able to last longer between feeds.

By three to six months, some, but not all, babies can sleep for longer stretches at night (DH 2009). Between the ages of six months and 12 months, your baby will probably start to manage without night feeds (DH 2009).

Every baby is different, though. You may find your baby actually starts to wake more often, even if he was previously a good sleeper. This doesn't necessarily mean he is hungry. It has more to do with him learning new physical skills and his increasing awareness of the world around him (DH 2009).

Will my baby sleep longer if I give him top-up feeds before bed?

It may be worth trying to see if it works for you. It's possible that breastfed babies wake more often at night than babies who are formula fed (NICE 2005).

Breastmilk is easier to digest than formula milk, so it could be that babies get hungry more quickly and wake more often. Not everyone agrees with the idea that breastfed babies are hungrier during the night, though (Montgomery-Downs et al 2010).

You could try the following to see if they help your baby to sleep longer:

• Cluster feeds: giving your baby extra breastfeeds during the early evening before bed.
• Dream feeds or top-up feeds: semi-waking your baby for a breastfeed between 10pm and midnight.

There's no guarantee cluster or dreamfeeding will help your baby to sleep longer (Semple 2008, NCT 2009). Some mums find it helps, others don't. If you decide to try dream feeding, allow three or four hours to go by since your baby’s last feed. Otherwise, you could find you are waking a baby who already has a full tummy.

You can read our article on helping your baby to sleep through the night for more ideas.

How can I make breastfeeding at night easier?

You may find it easier to cope with night-time wakings if you have your baby right next to your bed in his cot. You won't need to get out of bed to feed and may be able to stay half asleep yourself (Healthonline2008).

Another way to make night-time feeds easier is to co-sleep with your baby. Co-sleeping may also help you to continue breastfeeding for longer (NCT 2009, Blair et al 2010).

However, don't share a bed with your baby if you or your partner:

• are smokers
• have drunk alcohol
• have taken medicine that makes you sleep more heavily
• feel extremely tired
(DH 2009)

There are other important precautions you'll need to take to keep your baby safe in your bed. Read our article about co-sleeping safely to find out more.

How can I help my baby fall asleep without feeds?

Once your baby has had his first check with your health visitor, at about six to eight weeks, you can try easing him into a bedtime routine (NHS 2009b.

As they grow, children thrive on consistency. A reassuring and predictable routine will help your baby to feel relaxed. A warm bath followed by a story or a song at around the same time every evening is all it takes.

By about three months, your baby may be ready to learn how to fall asleep on his own. Try to get into the habit of putting him down to sleep when he is sleepy, but not actually asleep (NHS 2009a).

You can help your baby tell the difference between daytime and night-time breastfeeds by keeping the lights low during his last feed of the evening (Healthonline 2008, NHS 2009a, NCT 2009).

If you separate breastfeeding from the act of falling asleep, even by a few minutes, your baby won't need to feed to fall asleep. So try feeding him before his bedtime story or song.

Your baby may cry when you put him down, but this is normal and won’t do him any harm for a few minutes. Try not to talk to your baby. Instead, just gently stroke his head to comfort him.

One or two minutes can seem an awfully long time when your baby is crying, but he needs time to allow him to settle himself.

Once your baby can fall asleep on his own at bedtime, hopefully, he should find it easier to soothe himself back to sleep during the night.

My baby still wakes for a feed at night. What can I do?

To help you get the rest you need, you could ask your partner or a relative to help during the night-time feeds or wakenings. Here are some ways they could help:

• Wind and settle your baby after you have fed him at night so that you can go back to sleep.
• Get your baby dressed and changed in the morning after you've fed him so that you can go back to sleep, particularly at weekends.
• Give your baby a bottle of expressed milk (NHS 2009a).

You could ask your partner or relative to do the night-time feed, even if you have to get up as well in order to express milk. Expressing milk may take only 10 minutes, after which you can go back to bed. Your partner can then feed, change, and lull your baby back to sleep.

If you're still struggling to get enough sleep, talk to your health visitor for further advice.

from: http://www.babycentre.co.uk/a553835/sleep-and-breastfeeding#ixzz32Zg0L5FY

Choosing a bottle to breastfeed with

I knew I wanted to breastfeed as long as possible and that some bottles make it hard for baby to go back and forth. So after some research I came up with Phillips Advent and Mimijumi. The cheaper being Advent for about $8-$10 a bottle and the more expensive being the Mimijumi at $17 a bottle. I knew that at baby shower some people might might get the cheaper option so I went on the hunt for Mimijumi!

They only sale these online and in specific baby stores, however i could not find it anywhere! I went to the Mimijumi website and and literally went through almost every store they had listed.

They have two options

4oz (not so hungry)

8oz (very hungry)

I finally found them in stock at 

pamperdot.com

and 

kidslandusa.com

Hopefully she likes them!!

1st post!

I am currently 23 weeks and 4 days due September 5th, 2014! Schools out and I am bored!!! this is my first baby so I thought id start a blog about the many decisions new moms have to make!! ENJOY :)