 You may have landed here because you think your milk supply is low. And it might be. But there is also a chance your milk supply is normal, and you don’t know it! I'm an IBCLC and passionate about bringing you answers and support. International Board-Certified Lactation Consultants (IBCLCs) are the experts in all thing's lactation, breastfeeding and infant feeding. We are the Gold Standard in lactation care. Let's dive in. If you are evaluating your milk supply based on what you can pump, stop and check your equipment. Is your pump good quality and working for your breast tissue? Has your flange size been optimized? Both factors greatly affect milk supply. *Don’t expect a hands-free wearable pump to create a full milk supply. If you are evaluating your milk supply based on your baby’s weight gain…stop again. If your baby is doing a great job, weight gain can tell us a lot about breast milk supply. But if your baby has a challenge removing milk, you can have a normal or even a robust milk supply and have a baby who is not gaining weight adequately. Now let's get into how the milk is made! Lactation or breast milk production is maintained by regular removal of milk and stimulation of the nipple, which triggers prolactin and oxytocin release. This means Effective removal of breast milk. We need our babies to be latching deeply, comfortably and frequently to build our supply. If we cannot breastfeed, then a high-quality pump can take the place of the baby to build supply. How much milk expression is needed? A newborn usually nurses 8-12X every 24hr. If we are pumping, aiming for a similar regimen is a good idea especially in the early weeks after birth. You can pump every 2hr during your waking hours and every 3h-4hr at night to reach 10X every 24hr. Pumping for 15-20 minutes per session is sufficient. If you have more questions or are struggling with supply issues, schedule an appointment with me to discuss your situation.  Factors that can lower milk supply: 1. Not pumping or nursing at least 8-12 times every 24hr 2. A stretch of longer than 6hr between nursing or pumping in the early weeks 3. Pain while pumping or nursing. 4. Incorrect flange fitting. (Not everyone has pain with the wrong size) 5. Poor quality pump. There are a lot of pumps out there that are just not very good at removing milk. Fortunately, there are also some excellent choices that do a great job for most people. Reach out to your IBCLC for advice. 6. An extra stressor in your life (big life change, death in family, natural disaster) 7. Significant lack of sleep (you can't sleep when the baby is sleeping are run down) 7. Physical illness 9. Retained placenta (usually this will cause vaginal bleeding beyond what is expected or heavy bleeding and possibly clots. Call your OB/GYN right away if you experience this). 10. There are also some medical conditions associated with lowered milk supply. Discussing these is outside the scope of this blog. Work with your IBCLC to determine if there is a medical reason contributing. A one-on-one appointment with me can help you figure all this out and arrive at a workable plan for your family.  What is a normal milk supply? If you are nursing 8-12 X every 24hr and your baby is gaining just over an ounce a day or just over 2lb a month in the first 4 months of life, then you have a normal milk supply, and your baby is getting it! If you are only pumping (not nursing), then you should expect to pump enough milk to meet your baby’s needs by 10-14 days after birth. Pumps are not as good at removing milk from our breasts as babies, so it takes a bit of time. If you are nursing 8+ every 24hr and pumping in-between feedings a normal amount of milk to express would generally be 15.-2oz per pump session (yes, both breasts). Those crazy Instagram posts full of packed freezers are not normal. If you pump instead of nursing your baby, expect to express about an average feeding for your baby. A 2-month-old baby often would take between 2.5-4oz per feeding. A 1-month-old baby usually eats between 2-3 oz every 2-3 hours in week 2-4 of life.  Tips to improve milk supply:
For most people, regular Effective expression will be enough to build a healthy milk supply. If you have tried all these strategies and still are struggling, there is still a lot to be done to improve your supply. You will need the expert assessment of an IBCLC to identify the cause(s) and recommend a care plan for you to see more change. Don't struggle alone. With all the factors involved, having an IBCLC be your detective is the fastest way to the answers. Cathy Walker, MA, RN, IBCLC April 1, 2023
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 Parent looking for Answers No! Breastfeeding should not hurt! Myths regarding nipple pain: “Breastfeeding hurts in the beginning.” “Your nipples will toughen up.” “Just grin and bear it.” “Your baby is gaining weight so nursing must be going great!” If you experienced several poor latches in the first week after birth and sustained some minor nipple damage, this can be normal. If it heals and does not recur, then it likely was just everybody learning where things go. Today, I’m discussing continuing nipple pain during the feeding, or after the feeding with and without visible nipple damage. Chronic pain leads to breastfeeding cessation. Don’t suffer! Reach out for skilled support. Schedule an appointment below. Why is a deep and comfortable latch important?
What should I do right now? One option is to pump, bottle feed and allow your nipples to fully heal. This may take up to a week. At the same time, Book a consultation with an IBCLC to determine the cause of your pain and move the needle in the right direction.  Painful Latch What is happening?
An International Board Certified Lactation Consultant (IBCLC) is trained to assess for the cause and recommend actionable steps to get you pain free.  Statue of parent nursing * In the setting of high milk supply, a baby who is not latched correctly can still sometimes transfer enough milk to gain weight adequately. This may continue for up to 6-12 weeks. At this point, the milk supply regulates to a slightly lower level (still plenty for your baby). When this occurs, this baby who was gaining weight normally may begin to falter. They no longer have a waterfall of extra milk just falling in. When you meet with me, I can assess whether or not the feeding and latch are functional. Is your baby efficient and are you comfortable? We consider this along with weight gain for the full picture. Pain is a signal to your body that something is wrong. This is very true when breastfeeding. Reach out for the support and knowledge you deserve and start feeling better! Happy Nursing! Cathy Walker, IBCLC April 1, 2023
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Photo by Dahlak Tarekegn from Pexels
I’m going to share my favorite simple tips for a great start!
I understand that looking for straightforward answers can drag you down the ‘google’ rabbit hole. Speaking to friends and family can be dizzying with varying advice. And even professionals will sometimes offer different approaches.
I often hear, “I keep hearing different answers to my questions!”. Yup! It’s not you! There can be more than one ‘right’ answer. Finding the best answer for you requires an individualized approach. If it’s a breastfeeding question of any complexity, ask an IBCLC! Others are well meaning and may or may not have the right answer. And what worked for their baby may not be right for yours.
International Board Certified Lactation Consultants (IBCLC’s) are trained in current evidence based information in Lactation and take continuing education regularly. I happen to always be in the midst of a webinar or headed to a conference (Pre-covid). We also happen to be a tight knit group of practitioners. We pool our collective wisdom and bring it to you.
The other reality of lactating (and parenting) is that the ‘right’ answer or advice for a one day old baby is different for a three day old baby and certainly different for a one week old and so on. Then there are specific details unique to your situation that may alter these answers. When seeking your answers, an IBCLC can support you in areas of basic education and complex situations.
My personal motto is “Knowledge is Power”. (credit-Thomas Jefferson)
I have noticed that the more I know, the less I worry. I can also act sooner to prevent a real problem. This is absolutely essential in breastfeeding. Basic education on the normal expectations for the first few weeks (and beyond) helps us immensely as parents. We show more resilience during those middle of the night cluster feeding sessions when we have learned about them ahead of time. We can reach out for skilled support at the first sign of an issue. This can prevent problems from compounding and worsening and brings us to a resolution much faster. If you are familiar with some basic warning signs, you can reach out and prevent such issues as slow weight gain and low milk supply. See my blogs on “What’s all this about Tongue Tie?” and “How do I know if my baby is getting enough milk” https://www.lactationconsultantathome.com/blog/previous/2.
So how do I start off strong in my journey??
I highly recommend a breastfeeding class prenatally or a prenatal consultation with an IBCLC to prepare for birth.
Ask for help often in those early days when you may have access to help. Hit the call button and ask for the nurse or lactation consultant especially if nursing is challenging or painful. Don’t let anyone tell you that nursing is supposed to hurt in the beginning. It’s not!!
Keep your baby in your room at the hospital and at home. You will see and hear their early feeding cues and be able to respond to them faster. Breastfeeding more often will result in a higher milk supply sooner assuming other factors are normal. This strategy also results in easier latches when your baby is less frantic
Limit those visitors! You can end up ‘entertaining’ them when you are exhausted, uncomfortable and really wanting to bond and nurse your baby.
Sleep anytime you can fall asleep between feedings!
Stock your pantry with high protein, higher fat healthy snacks to munch on during nursing sessions.
Remember your baby will often need to be held by you or your partner/family between feedings. They crave closeness and this is normal! Skin to skin contact is best.
Schedule an in-person or virtual consultation with an IBCLC postpartum if you are still having challenges. IBCLC’s are specialists in Human lactation. We are trained specifically to work with the lactating parent and baby as a couplet and assess and create a care plan. If you are concerned about your journey and not getting answers from your providers, seek guidance from the experts.
Get off Google!!!! Most of the answers you will get are wrong and upsetting! Most of the time, when I do this myself, I come away thinking I’m dying of some terrible disease. Here are two reliable resources for basic information: www.kellymom.com and https://www.llli.org/
I can’t overstate how helpful a breastfeeding class is for expectant parents. I always observe that those who have taken one are more relaxed and flexible facing their nursing journey no matter what the circumstances. They feel empowered and more able to accept the truly unpredictable nature of having a new human being in their lives. A prenatal consultation with an IBCLC will cover all of these basics plus individual concerns.
Knowledge is power!!
Congratulations on your new journey!
I understand that looking for straightforward answers can drag you down the ‘google’ rabbit hole. Speaking to friends and family can be dizzying with varying advice. And even professionals will sometimes offer different approaches.
I often hear, “I keep hearing different answers to my questions!”. Yup! It’s not you! There can be more than one ‘right’ answer. Finding the best answer for you requires an individualized approach. If it’s a breastfeeding question of any complexity, ask an IBCLC! Others are well meaning and may or may not have the right answer. And what worked for their baby may not be right for yours.
International Board Certified Lactation Consultants (IBCLC’s) are trained in current evidence based information in Lactation and take continuing education regularly. I happen to always be in the midst of a webinar or headed to a conference (Pre-covid). We also happen to be a tight knit group of practitioners. We pool our collective wisdom and bring it to you.
The other reality of lactating (and parenting) is that the ‘right’ answer or advice for a one day old baby is different for a three day old baby and certainly different for a one week old and so on. Then there are specific details unique to your situation that may alter these answers. When seeking your answers, an IBCLC can support you in areas of basic education and complex situations.
My personal motto is “Knowledge is Power”. (credit-Thomas Jefferson)
I have noticed that the more I know, the less I worry. I can also act sooner to prevent a real problem. This is absolutely essential in breastfeeding. Basic education on the normal expectations for the first few weeks (and beyond) helps us immensely as parents. We show more resilience during those middle of the night cluster feeding sessions when we have learned about them ahead of time. We can reach out for skilled support at the first sign of an issue. This can prevent problems from compounding and worsening and brings us to a resolution much faster. If you are familiar with some basic warning signs, you can reach out and prevent such issues as slow weight gain and low milk supply. See my blogs on “What’s all this about Tongue Tie?” and “How do I know if my baby is getting enough milk” https://www.lactationconsultantathome.com/blog/previous/2.
So how do I start off strong in my journey??
I highly recommend a breastfeeding class prenatally or a prenatal consultation with an IBCLC to prepare for birth.
Ask for help often in those early days when you may have access to help. Hit the call button and ask for the nurse or lactation consultant especially if nursing is challenging or painful. Don’t let anyone tell you that nursing is supposed to hurt in the beginning. It’s not!!
Keep your baby in your room at the hospital and at home. You will see and hear their early feeding cues and be able to respond to them faster. Breastfeeding more often will result in a higher milk supply sooner assuming other factors are normal. This strategy also results in easier latches when your baby is less frantic
Limit those visitors! You can end up ‘entertaining’ them when you are exhausted, uncomfortable and really wanting to bond and nurse your baby.
Sleep anytime you can fall asleep between feedings!
Stock your pantry with high protein, higher fat healthy snacks to munch on during nursing sessions.
Remember your baby will often need to be held by you or your partner/family between feedings. They crave closeness and this is normal! Skin to skin contact is best.
Schedule an in-person or virtual consultation with an IBCLC postpartum if you are still having challenges. IBCLC’s are specialists in Human lactation. We are trained specifically to work with the lactating parent and baby as a couplet and assess and create a care plan. If you are concerned about your journey and not getting answers from your providers, seek guidance from the experts.
Get off Google!!!! Most of the answers you will get are wrong and upsetting! Most of the time, when I do this myself, I come away thinking I’m dying of some terrible disease. Here are two reliable resources for basic information: www.kellymom.com and https://www.llli.org/
I can’t overstate how helpful a breastfeeding class is for expectant parents. I always observe that those who have taken one are more relaxed and flexible facing their nursing journey no matter what the circumstances. They feel empowered and more able to accept the truly unpredictable nature of having a new human being in their lives. A prenatal consultation with an IBCLC will cover all of these basics plus individual concerns.
Knowledge is power!!
Congratulations on your new journey!
Photo by Nicole De Khors from Burst
Author
Cathleen Walker
Breastfeeding Advocate, RN, IBCLC
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