If you’ve ever worried that your baby isn’t getting enough breast milk, you’re not alone. Concern about low milk supply is common among breastfeeding mothers, especially in the early days and weeks after your baby’s birth. Sometimes mamas do have breast milk supply issues, but most mothers make enough milk to feed their babies. So what should you do if you’re worried you have low milk supply?
We asked Kate Marchant, Registered Nurse, Midwife, International Board Certified Lactation Consultant and Mum, to help us figure it out. Kate is the founder of The Milk Midwife, a parent education, breastfeeding and lactation support service in Inverell, NSW.
Kate reassures us that it is more common for a mama to think she has low milk supply than to actually have supply issues and gives us some advice about what you can do if you’re worried about your milk supply.
I don’t think I have enough breast milk
“My baby is always hungry. She wants to feed all the time.”
If your baby seems constantly hungry, you might start worrying that perhaps you have low breast milk supply. After all, if your baby were getting enough milk, he wouldn’t want to feed all the time – right? Not necessarily, says Kate. A baby wanting to feed frequently is, in fact, usually not a sign of low milk supply. It just might mean that today you baby is demanding a little more milk than what they asked for yesterday. Or they are possibly seeking the breast for comfort, familiarity and warmth.
What is ‘normal’ baby breastfeeding behaviour?
How can you tell if your baby’s seemingly constant feeding is normal or a sign of low milk supply?
It is normal for babies to go through periods when they want to feed constantly, this is called cluster feeding. As exhausting as it can be, this is normal. It's also normal for them to wake up and demand the breast overnight. Kate says that it is developmentally age appropriate for all babies up to 12 months of age to wake overnight, and younger babies will wake more frequently as their tummies are only small and breastmilk is so easily digested. Waking overnight and demanding breastfeeds is a baby's way of ensuring enough milk is being made for their feeds the following day. None of these behaviours, on their own, are a sure sign of low milk supply.
It’s also important to note that just because your baby wants to be at the breast and sucking it doesn’t always mean they’re hungry. Not only do breastfed babies go to the breast when they’re ready for their main meals, but they also want to feed when they feel like a snack, when they’re thirsty and for comfort, too. “The breast is their safe space, its warmth and reassurance - you may also find when your baby is unwell, teething, experiencing a developmental leap or just wanting to go off to sleep they will want to be close to their Mum, to have skin to skin time and be sucking at the breast” Kate says.
How can I tell whether my baby is getting enough breast milk?
Rather than focusing on how often your baby is feeding, Kate says it’s important to look at the clinical signs that show whether or not a baby is receiving enough breast milk. Understanding these signs can positively change a mothers perception of her milk supply
Start with your baby’s nappies. Are they wet? Kate says newborn babies should produce one wet nappy on their first day, two on day two, three on day three, and so on. From day five onwards, you should get five or six wet nappies in a 24-hour period. Look for wee that is odourless, clear or pale yellow, indicating your baby is sufficiently hydrated.
And don’t forget about poo! Exclusively breastfed babies (who don’t have formula or any other supplemental feeds) will usually have three or more very soft poos every day for the first few weeks. As they get older, they might do fewer poos. It’s perfectly normal for an exclusively breastfed baby to go up to 10 without having a bowel motion. Be prepared for when it does though.
Is my baby growing in length, head circumference and gaining weight?
Every baby is an individual and will grow in their own unique way. But a baby who is growing in length, whose head circumference is increasing, who is plumping up, outgrowing clothes and has good skin and muscle tone is likely to be getting enough milk.
Is my baby alert, meeting developmental milestones and reasonably contented?
Remember it is normal for babies to have times when they want to feed more frequently and have fussy periods! The Australian Breastfeeding Association has wonderful information on cluster feeding and fussy periods.
What should I do if I think I have low milk supply?
If your baby isn’t alert, isn’t looking at and engaging with you, isn’t meeting developmental milestones or isn’t reasonably content between feeds, it might be because they’re dehydrated. There might be a milk supply issue, they may need to feed more often, or it may be something else entirely. Kate says that’s why it’s important to have your milk supply assessed by a doctor, midwife or lactation consultant. They can check all the clinical signs like your baby’s output (wees and poos), growth and behaviours. They can also look at your baby’s attachment at the breast. A deep attachment means your baby will drain your breast, which stimulates your breast to make more milk. “Some women might have a drop in supply because their baby isn't attaching to the breast correctly and isn't draining that milk effectively,” Kate explains.
Your GP, midwife or lactation consultant can also assess factors that might contribute to low milk supply, like your breasts’ milk-producing tissue and storage capacity. It’s important to remember that empty-feeling breasts are usually not a sign of low milk supply. “Breasts that feel empty can be normal especially after the first 6-12 weeks. A Mothers breasts may begin to feel softer and less full, as your breasts have adjusted to making the amount of milk your baby is demanding. It's important to remember that your breasts are never completely empty - once your baby is removing milk from the breast more milk is being produced for the next feed.
Kate’s top breastfeeding tips for mamas worried about their milk supply
- Keep feeding! The more you breastfeed, the more milk your body will produce. Our bodies are incredible - when a baby or pump is stimulating and draining the breast there is a feedback system that signals our breasts to refill. Kate explains. So if your baby is demanding the breast more frequently then you're never going to get that feeling or being ‘over full’ or engorged because your baby is effectively draining them. She says that a study carried out in Western Australia a few years ago showed that the main reason mamas were weaning early or introducing top-up formula feeds was because they felt that their breast milk supply was low. “It’s a self-affirming loop,” Kate says. “If you start introducing those top-up feeds, then baby is going to skip a breastfeed, which means you’re not stimulating the breast, which is then going to reduce your milk supply.” That’s how the perception of low milk supply can end up actually creating low milk supply. Of course, sometimes supplemental feeding is required. Your healthcare professional can provide advice about what is right for you and your baby.
- Lean on your support people. “Breastfeeding a newborn baby is more hours than a full-time job,” says Kate. “You need that support network around you to get you through.” She suggests a breastfeeding-friendly way dads and other support people can help with night feeds is to do everything but feed the baby. They can change the nappies, help you position the baby at the breast while you’re lying on your side in bed, watch the baby to make sure they’re safe (in case you drift off) and then settle the baby and put them back to bed while you go back to sleep.
- Be comfortable and relaxed when Breastfeeding. This can be easier said than done when you’re worried about whether your baby is getting enough milk or if you have nipple pain or trauma from a baby with attachment difficulties. But, Kate says, “if you’re not relaxed throughout a feed, your milk isn’t going to flow. If you’re shoulders are up, and your feeling really tense and tight, your breasts are doing the same thing.” Create a calm feeding environment, avoid distraction, play your favourite music, have a drink and snacks close by, and set yourself up in a comfortable position. “You could use your Lactamo, massaging your breasts throughout a feed to aid relaxation and stimulation to get your milk to flow.”
- Seek advice from a professional. If you’re worried about low milk supply, talk to your GP, midwife or lactation consultant. They can assess your baby and help with everything from attachment, to breastfeeding positions, to medication to improve your milk supply, if necessary.
Breastfeeding can be challenging, and you’re not alone in your worries about your milk supply. The good news is that most mamas make enough milk for their babies, and if you need it, help is always available.
If you need breastfeeding support, don’t hesitate to consult your healthcare professional.