If you are questioning if your baby is getting enough breast milk, it’s important to keep track of their wet and dirty diapers. As long as your baby is steadily gaining weight, and has at least 6 wet diapers per day then you should rest easy. If you are questioning how much your baby is getting, you can always pump and then bottle feed just to see the quantity. Another method is weighing your baby before and after breastfeeding to see if they have gained a few ounces. Most babies get all they need from breast feeding alone but if you truly have low milk supply it can be upsetting, frustrating, and defeating. I know personally I felt all of those feelings.
It is considered a low milk supply when you are not producing enough to meet yours baby’s nutritional and growth needs. Some people confuse low milk supply with poor latch. If your baby is having difficulty latching and therefore not getting enough milk, you may try to express milk with a breast pump and then give it to your baby through a bottle. Many women elect to do this without ever trying to breastfeed for varied reasons. Poor latch doesn’t mean low supply, you can still produce enough, just giving it to your baby in a different way.
Causes of low milk supply are widespread, in some cases feeding your baby formula can decrease supply because you are emptying your breasts less, which causes decreased hormones that signal your body needs to produce more milk. Similarly if your baby has a poor latch, the basic concept is the more your baby feeds and the more your breasts empty, the more your body will produce. It doesn’t happen instantaneously, but your body works on a supply and demand basis. That is why if you want to increase supply it’s recommended to pump more consistently and frequently, as well as “power pump” once a day.
Other causes of low milk supply are due to mastitis, breast surgery, estrogen containing birth control, smoking cigarettes, and caffeine. Alternatively if you had a traumatic birth, have low hemoglobin or hematocrit levels, being on magnesium pre and post labor.
Most circumstances, there is nothing you can do to change it but know that just because your not producing enough breast milk, does not mean what you do make is not beneficial to your baby. Breast milk contains tons of antibodies that help build up baby’s immune system, as well as stem cells, and nutrients your baby needs. Breast feeding also helps with your baby’s temperature regulation. So even if you only produce small amounts of breast milk, you can still breast feed and then supplement with formula.
There are many ways you can supplement, as they always say a fed baby is a happy baby regardless of the method. Some people will say you should bottle feed first so baby isn’t ravenous while you’re trying to breastfeed, in which circumstance you will give less in the bottle than you would if you were exclusively bottle feeding. I personally don’t like this method because what babies take at any given time varies. If the baby only wants 2 ounces, but normally takes 4, then they will be full before ever going to breast. I personally prefer breastfeeding first, then giving the bottle afterward and baby can take however much until full. This ensures I am breastfeeding with every bottle, which helps empty the breast more often than with pumping alone in most circumstances. As well as fully emptying the breast which signals your body to continue to produce breast milk.
Alternatively you can also pump and add it to the formula bottle. I suggest preparing the formula first and then adding the breast milk in this case. If you start adding formula to breastmilk without the correct water amount it can concentrate the milk, and most babies have delicate little kidneys that can become damaged. If you are directed to concentrate or fortify breastmilk by your pediatrician, which can be the case for premature babies or if babies are underweight, it is important to follow the directions provided by the pediatrician.
This may be emotionally challenging as a new mother. I was on the phone with my mom when I was describing how the baby was just very fussy and kept crying but was fussy when latched, and she suggested giving him a bottle. I was upset because I felt as though my body should be able to support my child like women have done for hundreds of years. Unfortunately it was the realization that my body wasn’t producing enough that was heartbreaking for me. My baby and I had already been through so much, this was something that we really got the hang of while in the NICU and coming home. However when I started breastfeeding my baby was only taking about 1 oz each feeding with a bottle, so when I would breastfeed he was probably only taking around 1 oz. And this was during those crucial weeks where my breast milk was starting to regulate. In hindsight I should have pumped after every single feed to ensure my body didn’t settle into only producing 1 oz. I can’t say that this is the only reason I had low milk supply, I also had preeclampsia with severe features and HELLP syndrome, which led me to bleeding after the c section and a low hemoglobin, as well as being on magnesium for 3 days. When my milk supply started to drop off, I had tried everything to get it back up, drinks, supplements, lactation baked goods, oatmeal with flax and brewer’s yeast every morning, drinking tons of water, pumping every 2 hours, and power pumping once a day. Nothing worked.
If you are in the same circumstance, know you aren’t alone. Unfortunately in the US there is no FDA approved prescribed medication they can give you to help. But if breastfeeding is still what you want to do. Don’t give up. Every ounce you can give your baby of what you do produce is so beneficial! Or if you need to preserve your sanity and just switch to formula, know you are doing what’s best for you and your family. You are a strong mama!
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