“Breastfeeding is a gift that lasts a lifetime!” – Unknown
Breast milk is considered as the wholesome first food for nourishment and development of newborn babies! Breast milk is known to protect a newborn from many preventable diseases. WHO highly recommends to exclusively breastfeed an infant for the first 6 months of his life.
Though breast milk is a natural source of nutrition, quite a few mothers struggle with breastfeeding, especially in the initial days after childbirth. Breastfeeding may become challenging due to different reasons like the baby not latching well, poor lactation, postpartum complication, sore/flat/inverted nipples, lumps or blocked ducts in breasts, emotional or physical stress, etc.. Many times these issues can affect the breast milk supply (but it is important to note that with the guidance of qualified professionals and sometimes with the support and encouragement from caregivers, most of these challenges can be successfully overcome).
Is my milk supply *really* insufficient for my baby?
Many parents who face difficulty with breastfeeding, switch to formula/top feed for supplementation. One of the common reason to start formula is also the perceived inadequate breast milk supply (when the milk supply may be sufficient for the baby but is assumed otherwise). Unfortunately, many mothers who may be keen to breastfeed but suspect low milk supply, do not even verify the sufficiency of their breast milk through a qualified medical professional. They end up giving top feed to the baby thus depriving their infant of the essential nutrition and (disease-fighting) antibodies delivered via breastmilk.
As a lactating mother, do you find yourself doubting low milk supply due to one or more of the following reasons/conditions:
- Your breasts do not feel “full or firm enough” just before a feed
- Small breast size
- Your breasts do not leak before or during feed
- You do not feel the ‘let down reflex’ (that tingly feeling in breasts when milk ejects)
- Expressed milk quantity *seems* lower
- Other moms express more milk than you can in the same duration
- Baby is feeding for a longer time than usual
- Baby is feeding for lesser time than usual
- Baby looks do not look chubby
- Baby demands feed frequently
- Baby is cranky after breastfeed
- Baby does not sleep after breastfeeding or wakes up often at night
If you (or people around you) are worried about your breast milk supply due to one or more of the above reasons, you should stop fretting over it :-). Please note that these are NOT the valid ways to determine the sufficiency of your breast milk for your baby:
- Size, softness or non-leakiness of breasts
- The size of the breast mostly depends on the fatty tissue, which does not affect milk production. Till milk supply is established, breasts may feel firmer or engorged. But as the body adjusts the milk supply as per the baby’s nursing routine, the feeling of fullness or engorgement reduces/stops. Neither size nor softness of breast indicates non-adequacy of milk supply.
- Some lactating mothers have leaky breasts for first few weeks (or months) especially when lactation initiates, but leaking reduces and eventually stops (especially when milk supply establishes). If your breast does not leak, you are saving money on breast pads and also additional laundry efforts :-).
- Absence of milk ejection signal
- Some females feel the tingly electric signal in breasts when milk ejects; some do not feel it. Not feeling the ejection signal, does not indicate any milk supply issue.
- Quantity of expressed milk
- Expressing milk (with a pump or manually with hands) is not as efficient as your baby (with a regular sucking action) is at sucking it from the breast. Also as your little one grows and your supply gets established, the quantity of expressed milk (or milk consumed directly from the breast) will keep changing.
The amount of milk expressed or time required to express it depend on the efficiency of your pump and its accessories, time of the day when you pump, the time gap between last feed and expressing, your baby’s age, etc.. Expressing milk is rightly called an ‘acquired skill’ by many. The expressed milk quantity does not reliably indicate the actual amount of milk produced.
- Expressing milk (with a pump or manually with hands) is not as efficient as your baby (with a regular sucking action) is at sucking it from the breast. Also as your little one grows and your supply gets established, the quantity of expressed milk (or milk consumed directly from the breast) will keep changing.
- Length/duration or frequency of breastfeeding
- Baby can demand feed more frequently or feed for a longer duration per session due to multiple reasons: hunger, to feel secure by the mother’s touch, growth spurt, cluster feeding, etc..
- As babies grow older and stronger, they keep getting more and more efficient at sucking which reduces the time of nursing per session. Time per feeding session or frequency of breastfeeding is just a number, not to be equated with the sufficiency of breast milk.
- Appearance of baby
- Baby’s physical appearance has a lot to do with genetics! A leaner physical appearance or lack of plumpness does not imply insufficient milk for baby’s growth.
- Crankiness/fussiness in baby
- Some babies are fussy at a particular time of day e.g. at evenings. Some babies are cranky even after a feed; they may want to be held longer. Fussiness can also be due to hunger, change in weather, presence of unknown people, colic, sleepiness, growth spurt or reasons unknown. Crankiness is not necessarily a hunger cue and should not be assumed to imply that mother’s milk is insufficient for the baby.
- The sleeping pattern of baby
- Although many babies feed to sleep at night or at nap time, babies do not sleep after every feed especially after 4-6 weeks of birth, when they become more active.
- Each baby has a different sleep pattern. Infants can wake up at night due to various reasons like hunger, development milestones, change of sleep cycle, dirty diapers, infection, light sleep, etc..
Signs of sufficient milk supply
Following are the appropriate indicators that your breast milk is sufficient for your baby:
- Baby gains weight at a healthy rate
- Please let a paediatrician /lactation consultant decide what the right rate of weight for your infant is … do not fuss over numbers.
- Baby pees around six times in 24 hours (or once every 4 hours)
If your baby is gaining weight at an acceptable rate, is peeing regularly and is active and cheerful, you have nothing to worry about your milk supply :-)!
Seeking help in case of low supply
In case you are concerned about low milk supply, consult your paediatrician or a lactation consultant. If there is an issue affecting your milk supply, in most cases, it can be resolved with diagnosis and guidance of qualified medical professionals (and some patience, and/or help and motivation from your caregivers 🙂 ). Rarely medical intervention may be necessary.
If supply is low, your doctor may prescribe supplementation to breast milk. While the formula is considered probably the best alternative to breast milk, switch to formula only when advised by your paediatrician/lactation consultant…..especially during the first 4-6 months of baby’s life.
Also, remember that breast milk production works on demand and supply. The more you feed or express, your supply will increase. When you supplement breast milk with the formula (especially when supply is sufficient but perceived otherwise), your supply may reduce since the formula is partly fulfilling the demand.
If your baby is on formula, but you are keen to continue breastfeeding, consult your paediatrician/lactation consultant who can guide you on how to maintain or improve your milk supply.
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