Worrying about low milk supply is a common breastfeeding concern. Without being able to see how much milk your baby is drinking, feeling confident in amounts can be difficult. Luckily there are many ways to ensure that your milk supply is what your baby needs and when it is time to reach out for additional support.
Do I have a low milk supply?
The amount of advice given to new parents can be seemingly endless. Advice that is given from well meaning friends and loved ones can be confusing and inaccurate, with little scientific or logical basis. Infant feeding, and more specifically breastfeeding can be a particularly hot topic. "Old Wives Tales" and personal experiences can often shadow, real evidenced based information. Our experts have the truth behind these common low milk supply myths.
I do not pump a lot, or my pump output has changed? Breast pumps can be awesome tools and allow us to continue breastfeeding even if we need to be separated from our babies. But what you can express with a breast pump does not always tell the whole story. It is also important to be mindful of what is realistic to expect when pumping. When your baby is taking pumped milk from a bottle, they will need 1-1.5 oz per hour. If your baby eats every 3 hours, they could take anywhere from 3-4.5 oz each feeding. It is likely what you are going to see when pumping, is close to what your baby is eating, as our bodies regulate to our baby’s needs (aren’t they amazing?!). There are instances of oversupply, where a mom may produce a lot more than her baby needs, but that is more the exception than the rule. In the age of social media, it can be hard not to compare, but if you are pumping what your baby needs, then you are doing great!! There’s no reason to stress over trying to make our bodies do something that’s not biologically normal. If you feel you are not getting what your baby needs when pumping, you may need to adjust your pump settings, flange size, or do some massaging while pumping.
My breasts are always soft. Did you know that soft, “empty” breasts make more milk than full or engorged breasts? Our breasts work like factories, so when they are super full, they send “shut off” signals to our bodies telling them we do not need any more milk. Breast milk contains something called FIL (Feedback Inhibitor of Lactation) which controls your milk production. When the breast is full, FIL will signal the body to make less milk. When the breast is empty, the body speeds up milk production with less FIL present. It is very normal to have engorgement and fullness in the early weeks of breastfeeding and then for the breasts to start to soften as milk supply regulates. I know it is hard to believe, but some breastfeeding moms never experience engorgement! It is important to remember that breast softening alone doesn’t indicate a low milk supply.
My baby wants to nurse frequently or for long periods of time. In the first 8-12 weeks postpartum, your baby will cluster feed (nurse frequently, sometimes in bursts or for long periods at a time) a lot. This is a good thing! Remember how breasts are like factories? This cluster feeding helps tell our bodies that we need to keep the storage capacity open. Every time your newborn nurses, you can think of it like ordering a feeding for the future. And once your baby is out of the “4th trimester”, as it is commonly referred to, cluster feeding is still common during times of developmental spurts, teething, illness, or if your baby is needing extra comfort. Can frequent nursing also be a sign of low milk supply? Yes, it can. If a baby is nursing constantly or for long periods of time, and never seems satisfied, is not producing appropriate diapers, or not gaining weight appropriately, it’s time to seek help from a lactation professional.
My breasts never leak. Leaking breasts is one of those things we do not completely understand. We know why breasts leak, but we do not always know why some moms leak and some do not. But leaking milk really is not an indicator of how much milk you are making. For moms, that leak, milk catching, or saving products can be an easy way to store some extra milk up for work or other times away from your baby
My baby will take a bottle after nursing. Sucking is very comforting for babies. They even practice soothing, by sucking on their hands in utero. So, there is a good chance that hungry or not, they will suck on a bottle nipple. And once that milk starts flowing, they only have one choice, which is to drink. Infants are still coordinating their “suck, swallow, breathe” reflex, so a bottle dripping down their throat causes them to swallow, so they can breathe. So, a baby being willing to take a bottle after nursing does not always mean their belly isn’t already full. As mentioned above, there are times when a baby is not getting what they need at the breast, and supplementation is required. That is something that a lactation professional can help you determine, so you feel empowered and comfortable with your plan. Supplementation is not bad, nor does it have to mean the end of breastfeeding. But it is also not something that every baby needs.
I do not feel my milk let down. A lot like leaking, this is another thing we do not fully understand. Some moms feel it and others do not. Some describe it as a heavy, true let down feeling, some tingly or itchy, others a tightening, and some do not feel it at all. Or you may find that you felt it strongly in the early days of breastfeeding, but as your baby gets older, you no longer feel it. All of those are variations of normal and not feeling a letdown sensation does not mean you have a low milk supply or your baby isn't removing the milk they need.
Is my baby getting enough milk? How will I know?
Baby’s growth and weight gain. One of the surest ways to know is that your baby is growing appropriately. You can talk to your pediatrician about what they expect, but generally, if your baby is growing consistently on its own curve, you are doing well. Breastfed babies tend to grow more rapidly in the first 6 months of life and then slow down. If you have concerns about your baby’s growth, please reach out for help from your pediatrician and a lactation professional. If you are concerned your pediatrician is not supportive or does not understand how breastfed babies grow, don’t be afraid to ask questions and use a lactation professional to help you make a plan where you feel empowered to meet your feeding goals.
Diaper output. If milk is going in, it is going to be coming out! Watching your baby’s wet and dirty diapers is a great way to see that they are getting enough. Your baby should have 1 wet diaper and 1 dirty diaper, per day of life, for the first week. After 7 days you can expect to see at least 6-8 wet and 1-2 dirty diapers. It is common for babies to have a dirty diaper with each feeding, 1-2 is a minimum.
Watch your baby, not the clock Your baby has many ways of showing you that they are satisfied. While your baby is nursing, you can hear them swallowing, and see their jaw moving in a slower, rocker motion. That tells you they are actively nursing. You can also see their little bodies relax, as they go from showing hunger cues to showing signs of satisfaction. Their hands will relax from fists, to open. They will often close their eyes, or sometimes even fall asleep. And they will end the feeding, or break the latch happily, and on their own. Sometimes babies will be fussy or frustrated, for various reasons. There is a lot going on in their little worlds and processing all that can be difficult for them. There may be days when it takes some extra patience or soothing to get them to latch, or they may want to nurse more frequently than normal. This is expected and okay, occasionally.
If you feel your baby is constantly upset at the breast or they never show signs of satisfaction, it is a good time to ask for some extra support. A lactation professional can do a feeding assessment with you, to make sure everything is going well and give you tips and tricks to make nursing feel more comfortable for both you and your baby.
If there is something wrong, like a low milk supply or baby not transferring enough milk, they can help you with that too! We understand the anxiety that can come with not being able to “see” what your baby is taking in. It’s hard to trust your body to do something that maybe it’s never done before.