Solving the Milk Supply Crisis during Breastfeeding
Yesterday I received a comment on my Korean Seaweed Soup Recipe [A Milk Production Helper] where a mom was not making enough milk for her baby. Come to find out she was supplementing with formula. I don’t have enough background info to know if this was a medical decision; but in most cases; supplementing with formula is not a good way to establish your milk supply.
According to a certified Lactation Consultant, “Frequent unrestricted nursing is best in the early days. Most breastfeeding babies will need and want to nurse every 1 1/2-3 Hours or more often. If your baby is very sleepy, wake him to nurse every three hours during the day. If your baby sleeps a long stretch at night, you will need to wake him for night feedings [until your milk supply is established].” I stuck by this rule and this has helped to maintain my milk supply.
For the first six weeks of breastfeeding; do not let the baby go without feeding for more than four hours. The more the baby sucks, the more breast will start to produce milk. There’s a biology behind this; but I don’t want to go into here; trust me, just put your baby to your boobs if you want to increase your stash. “Anytime you supplement, you decrease your milk supply because your breast won’t be stimulated to make that milk that’s now being guzzled in the form of a supplement.”
There’s also a time when a baby will go through growth spurts and will want to feed CONSTANTLY. This is also not the time to supplement with formulas. In the book, So That’s What They’re For; The Definitive Breastfeeding Guide, Janet Tamaro explains how to deal with the “Perceived Six Week Milk Crisis”
Dr. Jane Heinig, A researcher at the University of California at Davis, says that if there’s one thing she’d like new mothers to know, it’s that they shouldn’t wean or supplement at six weeks just because they suddenly feel like they aren’t making enough milk. “This seems to be the number one time to wean because two things are happening that moms don’t expect: first, your body adjusts to making milk, and your breasts won’t fill anymore. Second, your baby is going through a growth spurt and will be at the breast constantly in order to build up the milk supply”
Dr. Heinig says that mothers start to worry at about six weeks that they aren’t producing enough milk because they can’t really feel stored milk in the breasts anymore and because the baby seems so hungry… This is normal. Expect this, and you won’t have to worry that your child is getting enough to eat. Yes, he is hungrier. That’s why he’s eating all the time, but his increase in demand will cause the milk-producing cells to step up production.
On a personal note, I did notice that my breasts were no longer the size of two Cantaloupes around six weeks. I did question if my milk supply was going down, but on a particular day, I had to pump because little Layla was too upset to latch on; lo and behold, I was able to pump out 4 oz of breast milk in a jiffy. So, just remember, put the baby to your breast and the sucking motion will help increase milk production and your stash. I also recommend a consult with a lactation consultant, the breastfeeding expert, or find a local La Leche League where experienced breastfeeding mothers can help you out. Gotta love your Pediatrician, but in this case, it’s probably better to get help from these two sources first unless they have extensive training in breastfeeding. (either through certification or through personal experience). The lactation consultant can also work with your pediatrician to come up with a workable solution if your baby is losing weight.
(More weigh-ins, in-house consult… ect…) Don’t forget to try the Seaweed Soup too. I swear whenever I make it; I am overflowing with milk.
Sources:
Moses Taylor Hospital Lactation Department
So That’s What They’re For: The Definitive Breastfeeding Guide
Image source: Marja Flick-Buijs stock.xchng
Breastfeeding Experience from A Green Girl and First Time Mom
Initiation of Breastfeeding by the Breast Crawl
Soothe Colicky Babies and Help Infants Sleep Better with Happiest Baby on the Block
Thanks for this post! Posts like this are so important.
In my experience, pediatritians can be the driving force behind supplimentation (a post about how to deal with a very pushy/concerned pediatrition in the supplimentation area would be benificial to many). I can’t even tell you how many mothers I have ran into, in the three years that I’ve been nursing, who have told me their pediatritian noted a weight gain issue and told mom to suppliment. My lactation consultant told me that, most often, this is really bad advice.
I struggled with weight gain my whole life (until I had kids, at least) and my girls are not on the “chart.” I have been asked to come back for weight checks due to “weight-gain problems” several times and I never have and I never supplimented. Instead, I used my instinct as a mother and, as you suggested in this post, I consulted with a lactation consultant and attended La Leche League mtgs. I try to avoid doctors (I’m a military spouse and we don’t often get to see the same doctor each time) who stick strictly to the “charts” and seek out doctors who use common sense (as in: what size are parents, parents weight-gain history, infants developmental milestones, siblings growth history, etc).
Mothers who are not fully educated about breastfeeding and/or know little about the help lactation consultants can provide, mother’s who are first time parents and/or very anxious and nervous moms often are the ones I see following pediatritians strict instructions. Often, it’s a downward spiral from there! These mom’s need to the most help and, hopefully, blogs like this one can help bring light to their situation and guide them to seek out help from the proper people who can then work with their pediatritian as a team!
Hi Natalie, Thanks for adding on additional information about the milk production crisis. I have also heard of many mothers who turn to supplements on the insistence of their pediatrician. According to the Lactation consultants; the growth chart is for formula fed babies, breastfed babies grow differently and that chart needs to be updated accordingly.The better gauge of is your baby getting enough milk is the output. Your baby should be getting 6-8 wet diapers. That’s how you know your little one is getting enough milk.
Pediatricians are the baby experts but I don’t think they get extensive breastfeeding education during their medical training (Of course, peds are welcome to chime in on this) Lactation consultants ARE the breastfeeding experts and should be first people to call. I think if new moms do this; there would be less supplementation and more success with breastfeeding. Other mothers who have breastfed are also excellent support system or people to get advice from. Ironically, my prenatal nurse and my therapist both breastfed their babies for more than a year. Both had a serene smile on their face and said, “there’s really nothing like it.” There really is nothing like it. It’s the perfect symbiosis. If you can get over that first hump, It’s incredibly rewarding. I wish all new mothers knew that.
Thanks for reminding me about output (I’m currently nursing my 19-month-old and forgot that I paid attention to output during the first weeks).
And, thanks for reminding me of the breastfeeding chart. Though, I have yet to find a pediatritian who uses it. Even here in Europe, where I currently live, our pediatritian pulls out his Nestle growth chart. I cringe every time I see it - b/c I know my breastfed infants (and now toddler) shouldn’t be judged off of it and b/c I’ve banned Nestle products.
I do have friends who print out the breastfeeding chart themselves and bring it or ask their doctor to use it instead. They’ve told me they’ve had little issues doing that.
I certainly don’t mean to bash Pediatritians! They are the experts in so many things and we certainly need them. However, many of my friends attend La Leche mtgs and consulted with lactation consultants and followed their advice instead of a pediatrian’s advice to suppliment and their babies all thrived just fine!
I would love peds docs to chime in on their training on breastfeeding. I attended regualar breastfeeding support mtgs with an IBCLC as leader and she so often spoke of her struggle to get local ped docs educated properly on breastfeeding b/c their bad breastfeeding advice made her work with struggling mothers so much harder.
Now that I think about it, I have only found one peds doc who was an expert on breastfeeding and I think that was only b/c she was, herself, a waterbirth and breastfeeding advocate, having had waterbirths and nursed each of her children past the age of one (not an easy task when you’re an Army doctor and deployable). Mother’s privilage to find a doctor like that are blessed, indeed!
The charts I’m referring to are the recently updated (2006) WHO growth charts which uses breastfed infants as the optimum size. Several friends, as per advice of a lactation consultant, have asked their doctor to use those as a guide instead.
I’ll have to ask my girls’ doctor here what he uses (Portu
haha, no wonder i’ve had no supply issues. i don’t know if my son has ever slept more than 4 hours in a row
I never understood the need to wake a baby to nurse. My midwives were very laid back and said nurse on demand no matter what time they last nursed. Waking a baby is not on demand, and I always fed my babes as soon as they awoke (but like littlecindy, my kids never slept long).
This is a very important topic and I thank you for bringing it up here. One year ago, before I gave birth to my son, I would have agreed with all of the comments left here. Now, I have a slightly different perspective on the matter.
I am a firm believer that women should be given way more credit for being able to birth their children on their own, the same goes for feeding them. I do believe that formula supplementation is overdone and should be avoided when possible. I am here to offer the other side of the story however.
When my son was 2 weeks old, he still had not transitioned to yellow colored stool, was still jaundiced and had lost a significant amount of weight. My midwife was doing everything she could think of to remedy these issues, to no avail. Finally we went into a lactation consultant to get my son weighed and that’s when we realized that he was only getting half of the amount of milk that he needed for his weight. We had to make the choice to supplement with formula so that he would not lose anymore weight and so his system could properly flush out the jaundice.
That was not an easy choice for this homebirthing, pro-breastfeeding mama. In fact, I cried my eyes out as my mom and sister went into the store to buy some formula for my little baby. Do I ever wish that things would have turned out differently? Of course. Do I think I should have just kept on as things were to risk something horrible happening? No. Sometimes, you have to put the safety of your baby over your own ideals.
I just wanted to share another perspective with you, as it is hard to relate to other moms in this area if you haven’t had to go through it yourself. I used to roll my eyes at moms who told me their doctor said they needed to supplement. I still think most of the time it’s ridiculous, but sometimes there are legitimate reasons it needs to be done. Just something to think about…
Erin, I really appreciate your comments. When my son was born with a congenital heart defect, I also had to let go of a lot of my previous notions for his health, such as vaccinations. Although I didn’t have to supplement with formula, I can relate to your experience.
Hi Erin, Thank you for sharing your story. In your case, supplementation was necessary and I am glad you chose to listen to your heart and did what was necessary for your baby rather than follow some ideal. I am also glad that you chose to work with a lactation consultant. I am not against supplementing; I just wanted to bring light to the issue of supplementing when it’s not necessary. I should confess that during my stay in the hospital; I was so very close to supplementing with formula because my baby would not stop crying and sucking. The night nurse kept suggesting very strongly that I supplement.
I think the medical community in general are not educated enough about breastfeeding (OK, I am going to get a lot of flack from my Pediatrician friends for saying this) Its best to consult with someone who has the knowledge or first hand experience when it comes to something like breastfeeding. Instead of going by your Pediatricians insistence of supplementing; get a second opinion. If in your heart you know your baby is thriving or healthy despite the what the dreaded chart says, then follow your gut. I, fortunately, have a daughter who is a moose and don’t need a chart to know she’s gaining weight.. but even if she was having minor issues (not like yours Erin, where the health of your baby was at stake) this is the route I would take and hope others mothers will take. and one thing I am learning about motherhood.. ideal or perfection is not your friend.
I am glad that there’s many mothers here who are passionate about this issue.
p.s. I think the best thing to do is to find a pediatrician who are Pro “breastfeeding” and have the knowledge to back it up. Either she breastfed (if it’s a woman) or his wife breastfed with their child (if it’s a man) If you really LOVE your pediatrician but he or she is not breast friendly or knowledgeable; have a lactation consultant as a back-up. They can support you and work with your ped to come to a reasonable solution. Your pediatrician is the baby expert but YOU are your baby’s expert.