Milk supply: “What will my breasts think?

One of the biggest reasons reported for stopping breastfeeding is low supply. This is where parents feel the amount of milk their baby receives from breastfeeding is not enough to meet their needs.

However, it’s actually very rare that a mother is unable to make enough breastmilk for her baby.

Have a read to learn more!

When parents suspect their milk supply is not enough for their baby, what is often happening is one of two things:

1. Their milk supply is actually sufficient, but the parents believe their baby is not receiving enough because they may be misinterpreting their baby’s normal behaviour and cues as hunger.
2. A woman’s supply is low, but may be so due to a variety of reasons, most of which are also able to be overcome with support and education.

Perceived low supply

To begin, let’s look at some normal things in a baby’s behaviour that many parents can misinterpret as signs that they are not getting enough breastmilk.

1. It is normal for babies to cry. For at least 3 hours per day! They will reach their ‘crying peak’ at about 6 weeks of age. It is how they communicate. Yes, crying can be an indication of hunger as well, but you should not expect that your baby will always be content if they are well fed.
2. It’s normal for babies to feed frequently. You can expect at least 8-12 feeds per day. Some will be spaced further apart, some will be closer together. How often your baby feeds and how long they feed for depends on your breast’s capacity, your milk flow, their sucking power, the time of day, how hot it is, whether they’re sick, whether they’re going through a growth spurt, and a bunch of other things! Just because your baby may feed more than another baby does, that doesn’t mean you have less milk.
3. It’s normal for babies to wake overnight. There’s lots that can be said about why this is, but for now, let’s say that they just do! Some may do so more than others, but a baby that doesn’t sleep through the night is not a starving baby, they’re a normal one!

So all of that being said, how are you supposed to know if your baby is getting enough milk?

Adequate milk supply

Here are the signs to look for to make sure your baby is feeding well and getting enough breastmilk.

• They will latch well and you will hear swallowing noises and see gulping once your milk flow begins.
• You will feel your breast empty and get softer as they feed.
• Most of the time (not all of the time) they will be more settled after a feed.
• They will appear well hydrated – at least 5-8 heavy wet nappies per day, clear/pale urine, soft, yellow poos, moist lips and mouth, good muscle tone and normal skin colour.
• They will be gaining weight and growing normally.

If your baby has all of these things, your milk supply is enough for them!

If your baby isn’t meeting these indicators, however, your milk supply may be low.

Let’s talk about milk supply and the factors that control it.

Milk supply

If you are making or changing your feeding plan, always ask,

“What will my breasts think?”

This sounds crazy, but it is vital to understand that your milk supply is determined by what your body believes is the right amount to make. This is determined by nipple stimulation and breast emptying. The more your baby feeds, the more milk you will make.

Demand = supply.

Causes of low milk supply

If you notice signs that your milk supply is not meeting your baby’s needs, think about whether you have changed anything with your feeding, and ask “What do my breasts think?”.

Certain feeding strategies and tools that parents implement can inadvertently have an impact on your milk supply.

Let’s go through some of the most common ones.

Restricted feeding

It used to be common practice (and recommended!) to schedule a baby’s feeds, and restrict the time they were allowed to feed for. This advice is still floating around in places, but it is not evidence based and is no longer recommended.

Current recommendations, supported by evidence, is to allow your baby to feed when they’re hungry (groundbreaking, yes?), which is known as feeding on demand.

If your baby feeds on demand, then your breasts and brain will be aware of the demand, and will produce milk accordingly. Certain situations may call for encouraging your baby to feed more often, but not to make them wait because it ‘isn’t their feed time’ yet.

Poor attachment

If your baby is not latched well at the breast, then they will not be removing milk from the breast in the most efficient way. It will mean less milk for them, more nipple pain for you, and a lower milk supply. Nobody is winning there!

A good attachment at the breast will not be painful, and your nipple will be drawn out symmetrically after a feed (not pinched or ridged).

It is important to seek support if you believe your baby is not attaching well. Small tweaks to your feeding position are often all that is needed, but a good feeding assessment will look at the whole picture, including your baby’s mouth and tongue function when feeding, and check for a tongue tie.

Nipple shields

When using a nipple shield, your baby needs to put in more work to draw milk from your breast and through the shield, meaning they may receive less milk with the same amount of effort each feed, causing less supply overall.

This is not to say they should be avoided completely – nipple shields can be a crucial tool for many women in their breastfeeding journey. However, it is important to have some support when you first begin using them to make sure that your supply is not impacted, and to give you helpful strategies to work towards possibly transitioning off the nipple shield eventually.

Supplementing

If you begin to supplement even one feed per day with formula or expressed breast milk (either because you want to or feel you need to), you will see a reduction in your milk supply.

If you ask “What will my breasts think?”, you will realise that this is because as far as they are concerned, your baby no longer needs that feed, so your body will drop your supply accordingly.

This is not a failure of your body to make enough milk, but actually its way of protecting you from oversupply! In this example, if you are hoping to maintain your milk supply, you will need to indicate this to your breasts by expressing to simulate the feeds that your baby is receiving elsewhere.

Other factors

There may be factors outside of your control that can reduce your milk supply. These might be things like:

• A large blood loss at birth. Your body may not have the resources to help replenish your own body while making sufficient milk to feed your baby. You may see a delay in your milk coming in or just smaller volumes for a while.
• Hormonal imbalances such as thyroid conditions or polycystic ovarian syndrome (PCOS). Some (not all) women may see their milk supply impacted due to the disruption in normal hormonal processes.

If this is you, engaging support early on can be really helpful in giving you the kickstart you need. The assistance you may require will be individual to you and your circumstances.

Increasing milk supply

With this in mind, if you need/want to increase your milk supply, apply the “What will my breasts think?” strategy.

• Make sure your baby is attached well and encourage them to empty your breasts when they feed.
• Encourage your baby to feed more often.
• Add in some expressing to your routine to increase the stimulation your breasts receive.
• Seek some support. If you need to increase your milk supply to meet your baby’s needs, it is a good idea to arrange an appointment with a lactation consultant for support. They will be able to give you personalised advice around feeding, expressing and supplementing (if needed).

Hope that helps!

Chloe xx