This week we are going to continue with our FAQs and talk about the mom who asks the question: I am struggling to make enough milk for my baby. What can I do about it?

The first thing that we need to do is to determine that mom is actually struggling to make enough milk. Is this a real low supply or a perceived low supply. Really, I know it may be hard to believe, but ask any IBCLC and I am sure she will tell you that she has worked with many moms who are making enough milk, they just don’t think they are.

Sometimes they base it on their previous breastfeeding experience and are so fearful the next time around, that they are always questioning their supply, even when it is clear that their baby is packing on the weight and peeing and pooping up a storm.

Sometimes they base it on how much milk they can pump after a feeding or instead of a feeding.

Another common way for them to base it on is whether or not their baby is gaining well

For the moms who come see me and their baby is obviously gaining well, I want to find out – is there baby’s weight gain primarily from exclusive breastfeeding OR is her baby breastfeeding and getting supplemental milk. When they are exclusively breastfed and are gaining well, I ask the mom a few other questions to satisfy myself that breastfeeding is going quite well. Once I determine that she does have enough milk at breast, it is then my job to explain to mom all the reasons why i think she is making plenty of milk. We go over it point by point until I am sure she understands it all and I do whatever I can to help build her confidence in her ability to provide for her baby.

For the moms who are struggling, once I get their individual story, I work hard towards helping them resolve this issue. For some moms, it is just a matter of adjusting the position and latch to allow for better overall milk production. She has been letting baby just hang on to the nipple. A young baby will have difficulty getting a nice flow milk when held in this position. It does not matter what the volume of milk is, if your baby cannot get to it, they will not gain well.

When I had my first baby, I could not seem to get comfortable on the couch or any chair that I had in my small apartment. Initially, I never thought to feed while laying down in bed. My intuition was blinded by pictures I would see in the books of mothers sitting up in a chair breastfeeding. They would just hold their baby, in what I now know to be called a cradle hold and as far as I was concerned, the baby was feeding well and the mother was comfortable and all was well with the world.

When it came to me actually breastfeeding my baby, she was not feeding well, she pushed away from the breast half the time, when she did latch on, she sqwiggled and wiggled most of the feeding and my head and neck ached from leaning over and working hard to get her to stay put.

After a few weeks, I settled into a pattern of sitting on the floor Indian Style as this way I could use my legs and knees for support that I could not achieve while sitting on the couch. I did have to put a pillow under my tush as this was still sore, but overall this seemed to work better than anything else. Knowing what I know now, this was far from optimal and more than likely the reason I spent the first few months of her life with cracked and bleeding nipples. Oh, what I wish I knew then that I know now!!

Whenever I see moms in awkward positions, I totally know where this is coming from. We either have been shown something really wacky from someone who has helped us. Perhaps you were shown positions that may have been helpful, but you have knots in your shoulder and you have made some interesting adjustments, Or we are going by some pictures that we have seen of older babies nursing ( those older nursing babies can be held upside down and a few feet away from their mom and still get a great latch)! Sometimes it is what the mom figured out on her own in order to cope with the early days of her bottom hurting her, or her sore belly with stitches from the c/sec or the back ache that she has had since the birth.

You can begin to see why, that as an IBCLC, I am always interested to see how a mom is latching her baby on. Where she is sitting, any support she is using, or not using, her posture, and once baby does latch on, how she is supporting her baby, her breast, her upper body.

It would be fair to say that a majority of moms I work with, can use some gentle adjustments, some tweaking, in how they are latching their babies on. It would also be fair to say that many times, this can make the difference between her healing and breastfeeding pain free, or not being able to continue. It would also be fair to say, that this can often make a huge difference in the volume of milk her baby is able to transfer, therefore increasing milk to the baby, weight gain for the baby and an increase in her supply.

Is that not crazy or what? Just by making adjustments to position and latch – we have the potential to make a big change for the better in her breastfeeding situation. Another reason I love this work that I do. To be that middle person and to be able to make a difference and help a mom enjoy breastfeeding. Now that is the best thing ever!

Regarding her milk supply, in addition to actually educating a mom that she does have enough milk and she and her baby are doing great and all they needed was to understand and build confidence, the next change we can make is position and latch. What else might we do to help her increase her supply?

The next most common change we can make is in feeding frequency. As an IBCLC, I find that when moms do not feed their baby frequently or efficiently enough, it does not matter if they have enough milk for twins and they only have one baby, their baby just will not gain what they need to, leading moms to think they don’t make enough milk.

What is this business about not feeding your baby frequently enough. Don’t mothers hear their babies cry and then just pick them up and feed them? Of course, many moms do this instinctively. Some moms start off their breastfeeding relationship doing exactly this and then for various reasons, change how they mother and feed their babies. I typically find that when moms are so exhausted they begin reaching out for help. Moms start to think that other people must have the answers. How often babies feed and how much they sleep are often big topic of conversations.

There are some physicians and some family and friends who feel that because moms need to get more sleep and because they feel babies should get more sleep,, that the way to make this happen is to begin scheduling babies times at the breast. Scheduling how often they feed them, and how long they feed them for. They work towards getting a routine going. Moms read or learn from others that babies do not need to be feeding for such a long time. People tell them things like: 10 minutes on each breast and their baby can get what they need. WRONG! Anything after that, they are just pacifying. WRONG! They also learn that their baby only needs a pre-determined about of feedings per day to get what they need. WRONG again!

For anyone listening to this show, I beg you to ignore that line of thinking! Babies do not read these textbooks people talk about. They do not read the latest best seller in the parenting category. They do not know how to tell time! Our babies are dependent on their moms to READ! Absolutely! Our babies are dependent on their moms learning how to READ their hunger cues. To pay close attention and learn how to READ your babies signs of fullness. Learn how to READ when your baby is full and tired. Learn how to READ your precious babies body language and when your baby is tiring and needs to sleep. And speaking of TIME! Our babies are dependent on their moms moving away from the clock that may have organized their life before their baby was born. They are dependent on you taking the TIME to learn about this beautiful little person in your arms. Our babies don’t care if you say it is time to eat or the clock tells you it is time to eat, or the app on your phone says its time to eat. Our babies are depending on you ignoring the TIME, and paying oh so close attention to what they are trying to tell you.

For moms who are new at this, you might be saying: How do I know what my baby is trying to tell me? How do I learn how to READ them. My answer: You may feel like you know little about your baby in the early days, however, spend lots of time holding, feeding, rocking, singing, cuddling your baby & in a few very short weeks, you will be amazed at what you will learn. You will be more competent at this if you take in info that you learn from me, from books, from classes & combine that with what you see in your arms. Right now, you are holding the best teacher – Your baby! If you are unsure if your baby has had enough milk, well then, just offer him some more. Never hesitate to offer your baby the breast. We have a fun saying that goes like this: “When in doubt, take it out.”

My favorite way of giving back a mother more milk so to speak, is by encouraging her to feed her baby according to her babies cues and ignore the time. And to please not limit your baby to a defined amount of minutes at the breast. This is also another sure way to make sure you don’t make enough milk for your baby.

To wrap up todays show, you can see that we can make significant changes with the mom who feels she is not making enough milk for her baby.

One is to find out that she actually is making enough for her baby. Giving her all the info she needs to understand this, and the confidence she needs and the trust in her body she needs, to carry on and enjoy a healthy breastfeeding relationship with her baby.

Second is – and you all know that I love this one – position and latch. Making adjustments can turn things around in a positive direction, more than anything else I could have done for her. Hooray for the mom that comes in to get help, thinking she has a low supply, only to learn a few simple adjustments that turn it all around for her. I love when this happens.

Third – Let moms know that by limiting feedings at the breast, limiting time on each breast, limiting to only one breast, these are all behaviors that has the potential to severely damage your supply, dangerous behavior that can cause a low milk supply with a mom, who actually has the potential to make more than enough for her baby.

Lisa on The All About Breastfeeding podcast
https://www.allaboutbreastfeeding.biz/lisa_hendrickson/

Lori on Fertility Friday podcast
http://fertilityfriday.com/lori-isenstadt/