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Low milk supply

The good news is that there are quite a few things that you can try to increase your milk supply, and there’s a lot of success with the methods that I'm about to talk you through.

Having a low milk supply can be a very stressful and time-consuming ordeal. Although it’s often completely out of your control, you may feel like a failure. I wish that I knew the magic words to help change those feelings and take that burden off your shoulders. All I can say is it’s not your fault. Set yourself a realistic time frame to try these methods and then reassess where you’re at and how you’re feeling. If you’re exhausted and if it’s robbing you from enjoying your baby and sleep, please move on to stage two.

Stage two is accepting what cannot be changed or maintained, to achieve the milk required for your baby and your mental health.

So, let’s get this milk flowing!

Feed your baby every three hours from the start of each feed. Feed from one side till you feel like your baby has drained it as much as possible. Make sure that your baby is effective at feeding and not just comfort sucking. You should see long sucks, with their jawline moving all the way through to their ear. It should be suck, suck, suck, suck, swallow. As I mentioned before, babies are allowed to pause, swallow and breathe, 30 seconds to one minute pause is long enough, and it’s often a lot less than that. If they’re pausing for too long, encourage them to suck by lifting their jawline with your finger. It’s a lift and encouragement, not a lovely stroke that will soothe them to sleep. Work, work, work, reward.

The following advice is for term babies. (Always check with your own health professional, to ensure that the suggestions made here are right for you and your baby)

  • Have a cold, wet face washer to wipe over their face.

  • Make sure that your baby isn’t wrapped up or they will just fall asleep; you want to encourage them to stay awake.

  • Skin-to-skin in the right environment is very beneficial, both for bonding and to release the hormones that increase milk. So, unwrap your baby and take their gear off.

  • While you’re trying to increase your milk, swapping from one breast to the other will encourage a second let-down of milk, by offering each breast twice in one feed. This can be done every five to ten minutes, if your breasts feel like they’ve been drained and your baby isn’t swallowing or really fussing at the breast, like “Hey Mum! There’s nothing in here!” and is pulling on and off.

  • If your baby is happily sucking and feeding, don’t stop the flow. This technique can be done later through expressing.

  • Gently massage your breast towards the nipple throughout breastfeeding and expressing.

  • Once you have finished a breastfeed, you’ll need to give your baby a top-up of expressed milk or formula, depending on your supply and your baby’s needs. Some mothers can avoid formula while increasing their supply, while others need it to sustain their baby’s needs and reduce further weight loss. It’s very time consuming to top up with both breastmilk and formula. You may prefer to store your breastmilk till you have sufficient for a full top-up. You can combine breastmilk from different express times as long as they are both at the same temperature – either both at room temperature or both at fridge temperature.

  • It is important that a whole feed doesn’t take longer than one hour. Your baby needs to rest, as do you.

  • Once your baby’s feed is completed, you’ll need to express.

  • Make sure that you are comfortable while breastfeeding and expressing.

  • If you have a low milk supply, it’s very important to have a good breast pump. I recommend an electric pump with two let-down features. These pumps are designed to mimic a baby’s feeding patterns. When a baby starts a feed, they do short and quick sucks to aid the milk let-down, followed by longer slower stronger sucks and swallows. It is often best to hire a hospital-grade breast pump until your milk has increased.

Express after a feed to increase your supply. It’s important to finish feeding your baby first, so that they are not waiting for milk while you express and missing out on valuable sleep for growth and development time. As mentioned before, their feed should not take longer than one hour – less if your baby is under three kilograms or premature. Always follow your paediatrician’s advice on the maximum time their feeds should take.

It can also be beneficial to give your breast a little break between breastfeeding and expressing, to aid a second let-down. This break can range anywhere from ten minutes to half an hour, but no longer than that or you’ll be getting too close to your next feed. You want your breasts to have refilled for your baby.

Start your pump on the breast you finished feeding from. Increase the pump pressure to feel like your baby’s sucking technique, a little stronger if your baby is premature or if they’re not great on the breast. Having the pump on too high will not give you extra milk; keep it comfortable. The last thing you want is to do more damage to your nipples.

If your breast pump has two settings, start on the first setting with short and fast suctions and once you see a few drops of milk flowing, you can press the second phase button, which will be longer and stronger suctions. You may need to turn the pump down if the next stage is too strong or painful.

While you’re trying to increase your milk supply, you swap the pump from breast to breast every five or so minutes, using five minutes as a rough guide. So now, at the risk of sounding repetitious, I’ll talk you through a full example for clarity and just in case you fell asleep along the way:

Start the pump on your left breast on the first setting. When you see the milk flow starting, as the milk let-down commences, press the second-phase button. Leave it on till your milk flow stops or slows down dramatically –this usually happens at around four to seven minutes. Stop the pump and go to your right breast and do the same thing. Then stop and repeat the cycle again. So, you do left, right, left, right for a total of 20 minutes or so. While you are trying to increase your supply, do not swap sides while milk is flowing well.

When your milk increases, you stop alternating sides and do 10 minutes on each side, less if your milk is exceeding your baby’s top-up requirement. You can express a little more than they require but remember that eventually you want to stop expressing and have your body be in tune to your baby’s needs.

An example of a full feed is as follows:

  • Breastfeed for 15–20 minutes on each side.

  • Give your baby its required top-up according to their weight and age requirements, completing their feed within one hour.

  • Express and keep that milk for the next top-up.

This is a rough guide, based on a healthy, full-term baby. Breastfeeding length times and the quantity of milk top-up will vary according to the baby’s age and birthweight, as well as their weight loss.

It is important to be guided by your healthcare professional in terms of feed lengths and top-up quantities.

Midwives and lactation consultants, will often advise that while you’re trying to increase your milk supply - you feed your baby every three hours, followed by expressing and topping-up with expressed breast milk. That equates to feeding eight times in 24 hours, as well as expressing eight times a day and giving eight bottles. That’s 32 feeds in 24 hours! Quite often by the time you finish a full feed, there’s only just over an hour’s break before it’s time to start again. You may wonder if this is even possible. It is, but only for a period of time and you’ll need support to get through it. If breastfeeding is something that’s important to you and you really want to, the best thing you can do is give it a go. Stay positive and get as much rest as you can between feeds. Be kind to yourself and abide by these mantras as well as adding your own to the list:

  • Your health and your baby’s health are the most important thing, both mentally and physically. If there’s not enough breastmilk, formula will provide the nutrition your baby needs.

  • Allow yourself to skip a phase of expressing, if you’re exhausted and need sleep. Use formula, when you need to.

  • In order to feed your baby, you must nourish yourself and stay well hydrated. A car doesn’t run on an empty tank; nor does your body.

  • Nourish yourself first and have treats as a dessert - not as a meal.

  • In an ideal world, you’ll do it all and have great hair while doing so. Wake up and smell the coffee – we don’t live in an ideal world and that’s okay.

  • Have convenient and nourishing snacks available.

  • Include healthy fats and oils as part of your diet. Refer to healthy breastfeeding foods- Blog coming soon. (If you need it now, there’s plenty of information available through the breastfeeding association)

Before you start this process, make a pact with yourself and a support person to stop or pause when you:

  • A

  • B

  • C

(Make your own list of reasons to stop or take a break.)

Don’t torture yourself. It’s more important to be mentally, physically and spiritually healthy than to solely breastfeed your child.

Mothers often ask how long they should breastfeed for, or how do you know if your child is getting enough from just the breast? Weight gain and growth in both their length and head circumference is the easiest way to tell if a baby is getting sufficient milk. But since you cannot weigh and measure your baby every day, there are other very reassuring things to look out for.

  • Five to six good wet disposable nappies a day.

  • Runny yellow poos.

  • During awake times - your baby will be alert and active.

  • Your baby is feeding well and with energy, while demanding for feeds every three to four hours or a minimum of six times in a 24-hour period. (Refer to age-appropriate feeding routines.)

Signs that your baby isn’t getting enough milk:

  • Poor growth and weight gain.

  • Lethargic and mostly sleepy, without energy to feed for long.

  • Less than five wet nappies a day.

You can also chat to your doctor, to see if a prescribed medication to increase your milk supply, is right for you.

Always consult with your own health professional and stay in contact with your Maternal and Child Health nurse for further weight checks and review.

Refer to the Australian Breastfeeding association for more information and support.

Breastfeeding Helpline: 1800 mum 2 mum – 1800 686 268. There are over 400 counsellors that can provide reassurance and or helpful knowledge and advice. They can also help you with instructions on how to hire a breast pump or connect you with lactation consultants.

The Royal Women’s Hospital – is also a great resource. Checkout their fact sheets for further information – by simply searching low supply. They also translate into many languages.

Remember to choose what’s right for both you and your baby and throw-out other people’s judgements – out of your bucket – like a toddler would. Refer to my blog on the truth about breastfeeding and real-life stories.

All the best. From Your takeaway midwife.

Always check with your own Doctor, midwife or healthcare professional prior to following any information here - to ensure it's safe and adequate for you and your situation. This is not a midwife - patient - client relationship.

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