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:
Address any latch/feeding issues. Your baby is great at improving your milk supply if they are doing well.
Use a high-quality pump.
Seek out a flange fitting from an IBCLC who has been trained in the most up to date guidelines (They should watch you pump)
Avoid long stretches between nursing and pumping sessions.
Use Hands-On pumping. Hands-On pumping Video.
Use hand expression at the start or the end of your pump session. (ex. pump for 10 minutes, hand express for 5 minutes) (Pumps are using suction but a hands-on approach can almost always yield more milk per session). Hand expression Video.
Cover the bottles/flange set up with a blanket so you can’t watch the milk come out.
Use meditation apps, music, and pictures or videos of your baby to help with letdown. Smelling your baby’s clothes is great too!
If you change something in your pumping or nursing regimen, it will take 3-5 days to see an increase in supply. If you don’t see a gradual improvement by then, reach out to your IBCLC.
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
Registered Nurse and Lactation Consultant
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