This has got to be the most commonly raised topic when I visit clients’ homes.
Women are not sure if baby is getting enough milk and it is, in a lot of cases, simply due to a lack of information and a widespread lack of support. That is; consistent, accurate information about breastfeeding and support that does not place the individual at fault for being ‘broken’. So let me go through the basics. If you are finding breastfeeding confusing then read ahead.
How does breastfeeding work?
Put very simply, various breast tissue types, hormones and the removal of milk from the breast are the basis of milk production. It is very rare that a woman will lack the breast tissue required for this milk production.
In fact, a very simple principle of supply and demand tells us that the more baby feeds, the more milk is produced. It is also reliant on a good latch, which ensures the nipples do not become unbearable sore, and baby can efficiently remove the milk.
Finally, support; moral support from friends and family, breastfeeding education during pregnancy, physical support during postpartum. I can’t stress enough that the more supported a woman feels in her breastfeeding journey, the greater her chance of reaching her breastfeeding goals.
Understanding how breastfeeding works and being prepared for it are key to succeeding. Simply being told ‘it’s natural and your body knows what to do’ is not going to help when you are crying at the pain of feeding your one week old in the middle of the night.
Beginning during pregnancy, it is a great idea to become familiar with your breasts and an option to begin expressing colostrum. This antibody rich substance is baby’s first food and also provides immunity, prevents low blood sugar and clears baby’s system of meconium among other things. Hand expressing and collecting colostrum in small syringes (eg 3ml) is a great way to become familiar with your breasts, helps stimulate milk supply to start flowing, and is fantastic as an extra store or if mother and baby are separated. It can be safely done from around 37 weeks onwards in most cases (history of premature labour being an exception).
Also falling into the category of education is knowing about the breast crawl. Google it! If you haven’t already seen a visual of this fascinating sequence of events that babies follow to find the breast and begin breastfeeding all on their own, then do so! Know that this process is hard work for newborn babies and takes up to 60 minutes to achieve and after that first feed they will often sleep for a number of hours.
Breastfeeding is a learned skill for both mother and baby, and as such takes up to 6 weeks to fully establish. During this time it is important to offer unlimited access to the breast, know that feeds can be very lengthy (also cluster feeds..argghh), skin to skin contact is helpful and to look at the baby for feeding cues, rather then the clock, charts, or a phone app.
So IS my baby getting enough milk?
A couple of easy questions can help to answer this question, as I do when visiting client’s homes. First of all, what goes in must come out! Look at how many wet nappies are produced in a 24 hour period. In those first few days it can be quite small as the amount of colostrum produced for each feed is just a few mls. By one week old babies will be doing around 6-8 wet nappies in a 24 hour period. Have a look how alert baby is when awake, and are they coming off the breast content? Do they have good colour/ skin tone? All these things can be answered easily and at a glance. Of course, there should also be some weight gain AND growth (such as length and head circumference). This is often taken as the first and only measure, however the full picture should be considered if there is concern about milk supply. If there is genuine concern then contact a good IBCLC (International Board Certified Lactation Consultant) to talk to about your concerns. They can help you develop a breastfeeding plan and identify any potential red flags that may be the cause for breastfeeding obstacles.