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