Dropping breast milk supply

Feel like your breast milk supply is dropping? It may be normal. The uterus doesn’t tell the breasts how many babies came out. Immediately after birth, hormones cause the breast to go into overdrive to try to figure out how many babies were born…to feed them ALL.

The breast makes milk by being emptied and learns your babies habits and how much milk it needs to make with time and experience. In the early weeks your breasts have extra blood and fluid support to help your breast tissue make milk. This is what makes you aware of the filling and emptying of milk. This extra fluid support goes away around 6-8 weeks and you’ll no longer feel that full/soft feeling. By 10-14 weeks your breasts become more EFFICIENT and only want to make what is routinely emptied. Your breasts will go back to prepregnancy size. You may stop leaking (if you leaked) and not be able to pump as much. That’s NORMAL.

Your body doesn’t want to make milk that isn’t needed. You biological body doesn’t know what a freezer is or that you’re trying to collect that leaking milk for later. Your body wants to be as efficient as possible and make only what is being routinely removed from the breast. It costs your body energy to make milk: about 20 calories per ounce of milk made. Your body doesn’t want to burn calories to make milk that’s not being regularly emptied so it can use those calories for things like your brain function. Because mom brain is real.

So before you reach for formula thinking you don’t have enough milk. Realize that when everything is going normal your milk supply is supposed to regulate and your breast aren’t supposed to stay engorged and full forever. Your body is efficient. As long as baby continues to make good wet and dirty diapers, has a pain free latch where you’re hearing baby swallow, feeding baby in demand and not to the clock, and baby gains weight over time, you body is just doing what it’s supposed to do. You can always increase supply by feeding or pumping more often and decrease supply by feeding or pumping less.

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#normalizebreastfeeding #normalizenormalbodies #postpartumbody #milksupply #milksupplyissues #makingmilk

Low breast milk supply

Whether it’s 3, 5, or 10% of the population, there are people that struggle to or never make a full breast milk supply. From 1 month to 1 year, exclusively breastfed babies average 25oz of breast milk per day. True low milk supply means making less than this when the breasts are stimulated every 1-3 hours day and night. Chronic low milk supply is linked to either a greater health concern or something out of your control which you cannot change or fix with cookies, teas or even sometimes medications and pumping.

🗝Low milk supply that can be increased with time and support:

💡Baby not feeding efficiently from lack of oral motor skill or tongue tie

💡Taking certain prescription medications with a side effect of dropping milk (Sudafed, Benadryl, antibiotics)

💡Not feeding or pumping enough, especially over night

💡Scheduled feedings or over use of a pacifier

💡Birth. Many medications designed to help you labor and deliver actually inhibit baby from latching and feeding effectively for hours to days after birth. Hemorrhage or birth trauma can also cause low supply in the beginning

💡Supplementing, especially in the two weeks after birth

🗝Reasons for chronic low milk supply that may increase even with maximal support:

💡Insufficient glandular tissue (IGT). Breasts never developed during puberty and look tubular or widely spaced. Signs of IGT include breasts did not grow in puberty, or increase in size during pregnancy. No engorgement in the week after birth

💡Uncontrolled or undiagnosed thyroid disorder

💡Uncontrolled diabetes

💡Hormone or endocrine disorders, including severe PCOS

💡Hormonal birth control placed/used too soon after delivery

💡Breast or nipple surgery, augmentation, reduction, trauma

💡Nipple piercing that scars shut instead of staying open

There is a mistaken belief that prescription galactagogues, teas, or herbs can cure ANY chronic low milk supply. Before self-prescribing or taking Domperidone, Reglan, fenugreek, or any other lactation supplement, consider having your serum prolactin levels tested and a full evaluation by a skilled lactation consultant. Continue to follow @lalactation for strategies of breastfeeding with chronic low milk supply.

#lowmilksupplyawarenessday #igtandlowmilksupplysupportgroup #igtandlowmilksupply #igt #lowmilksupply #lowsupply #normalizebf #normalizebreastfeeding #worldbreastfeedingweek #wbfw #chestfeeding #sns #atbreastsupplementation #breastfeeding #bf #ibclc #bottlefeeding #donormilk #mixedfed #pacedbottlefeeding #triplefeeding #breastfeedingproblems #breastfeeding #supplementalnursingsystem #postpartum #breastpump #milkbank #lactationcookie #lactation #galactagogues

Sunflower lethicin and plugged ducts

Lecithin is used in food to provide a smooth, moist texture and to keep ingredients from separating. Lecithin can naturally be found in green vegetables, red meat, and eggs. Commercial preparations are often made from soybeans, egg yolks, or animal products. It is also commonly used in eye drops, skin moisturizers, and food emulsifiers (agents that keep ingredients from separating).

Sunflower lethicin, a specific kind of lethicin, is often taken during breastfeeding to reduce plugged ducts or to help increase milk flow. Sunflower lethicin is thought to reduce the “stickiness” of breast milk by thinning out the fats in the milk and keeping them from clumping together. There are no known contraindications for breast-feeding, and lecithin is “generally recognized as safe” by the FDA. However, people with a preexisting tendency to depression may become depressed if taking high doses of lecithin. While very rare, if you begin to have a fish-like odor while taking high doses of lethicin, stop taking it immediately and notify your physician, as this is a serious sign of liver damage. As there is no recommended daily allowance for lecithin, there is no established dosing for lecithin supplements. Different brands might have different amounts of lecithin in each pill or capsule, so be sure to read labels very carefully before taking lecithin or any other dietary supplement. Per Kellymom.com, the maximum dosage recommended for recurrent plugged ducts is 4,800mg/day. As always, consult with your doctor before trying any dietary supplements while pregnant or breast-feeding.

Sabotaging your milk supply: working mothers who pump

The number one method to sabotage your milk supply when you go back to work is a caregiver who over feeds your baby. 

Scenario one: Baby is given a full bottle and takes 5 ounces in five minutes. Baby then spits up half the feeding and caregiver tries to give more to “keep it down”. Caregiver tells mom baby is fussy and has reflux. Baby gets put on Zantac and rice cereal.

Reality: there are several factors going on in that scenario that will sabotage a working mother’s milk supply. First, babies are not supposed to take five ounces in a feeding. Their stomach is the size of their fist and should only be taking 1-3 ounces per feeding through the first year of life. Their stomach can only hold so much and if it’s past capacity, the only place for it to go is up. I can eat a whole cake, but I shouldn’t. As an adult, if I overeat I get uncomfortable, too. I either take peptobismol or put on my stretchy pants to wait for the pain to subside. Then I don’t eat that much again.  Babies fuss and spit up for the same reason. We’re over diagnosing babies with reflux that are being fed too much or too fast.

Scenario two: Caregiver gives a baby six ounces every feeding, 3 times while mom is gone, every time the baby cries or wants to suck. Baby appears fussy and wants to suck all the time.

Exclusively breastfed babies should consume 25-35 ounces across each 24 hour day and approximately 20% of their calories should be taken over night. If you do the math, that’s a little over an ounce an hour, or 1-3 ounces every two to three hours. And in accordance to what the baby needs, mom will make that volume. So if caregiver is feeding 6 ounces three times in an 8 hour shift, you’re expecting mom to pump 18+ ounces. In reality, her body will most likely make 6-10 ounces which would be the amount she would make if she were home with her baby. In a few days of over feeding the baby, mom becomes discouraged that she’s not making enough and pretty soon she’ll start supplementing with formula

Babies also want to suck for a variety of reasons: comfort, pain, bonding, nutrition, pleasure, etc. Babies use mom as a pacifier without actually drinking. When babies are away from their mommies is very stressful, so their way to soothe is to suck.

Scenario three: Baby is given 4 ounces and chugs it down in five minutes. Baby is happy to chug down high volume and the caregiver thinks baby is just a piggy and really hungry. Baby occasionally coughs and chokes and milk comes out her mouth.

Reason: Babies have a swallow reflex that is with them at birth. When liquid reaches the back of the throat it triggers the swallow reflex. Babies are obligated to swallow otherwise they will choke or let the milk pool out of their mouths. When you see a baby chugging down milk really fast, it’s not usually because they are starving, but because they are trying to keep up with the flow of the bottle. As I said in an earlier post, there’s really no such thing as nipple confusion, but flow confusion. At the breast, other than during active let down in the first few minutes of active feeding, the baby controls the flow of milk by how they suck. In bottle feeding, the bottle will flow because gravity always wins. Caregivers need to be taught paced bottle feeding. Using a slow flow nipple, feeding baby in side lying, and frequently tilting the fluid away from the nipple to slow the baby from drinking so fast gives the baby more oral control and time to appropriately eat.

There are two kinds of receptors in the stomach: stretch and density. It should take a baby 10-20 minutes to eat from a bottle. This is also how long it takes the stretch receptors to tell the brain that the stomach is full. I can eat a whole pizza really fast, but I shouldn’t. Babies can eat a large volume really quickly, but they shouldn’t. Not only is it not developmentally appropriate, but pretty quickly the high volume needs will sabotage mom’s opinion of her perfectly healthy milk volume. She’ll turn to all kinds of milk makers: cookies, teas, herbs, etc and eventually if she’s discouraged enough she’ll turn to formula, when in reality if the caregiver would slow down feedings and give the rigjt volume, every one would be happy.

Happy pumping!!

 

Pumping Log : Boosting Supply

Every working mother I know it’s concerned about her milk supply. We are terrified that if we don’t make enough milk while at work our babies will starve to death. I’ve had my moments of discouragement where I, too, feel like a failure as a mother because I had a low pumping day. Of course this stress only causes a further decrease in supply which becomes a vicious cycle of stress and poor pumping. While I can’t turn my boobs on line a faucet to pump specific amounts of milk each pump session, there are several things I do to promote the best possible milk supply.

1. Hydration. The best hydration is to drink to thirst. Since times in the busyness of my day, though, I forget to stay well watered. I keep a water bottle in my pumping bag and try to drink while pumping. I also work feeding patients. So each time I go into the kitchen at work I try to grab a cup of water.

2. Nutrition. Eating the right kinds of foods also help with adequate milk supplies. Fresh fruits, vegetables and plenty of protein help keep my body working at its best. Oatmeal is also a staple in my diet. Oatmeal contains a protein that may increase prolactin, the hormone that facilitates milk production in mammals. Other whole grains such as quinoa and sesame also contain this same protein.

3. Supplements. Fenugreek, mothers milk tea, and fennel are all known galactogogues, a fancy word for milk makers. I try to drink a cup of tea every night. I’ll admit I’m not the best at taking the fenugreek, but I definitely notice a boost in my supply when I do. Another supplement known to help breast milk production is brewers yeast. Brewer’s yeast comes from a single-celled fungus and is a byproduct of beer making, though it can also be grown as a nutritional supplement. A good source of iron, chromium and selenium, brewer’s yeast also contains several B vitamins, though not B-12. Brewer’s yeast has a history of use as a galactagogue, which is a food, herb or medication that increases milk supply in nursing mothers. Some mothers find drinking a single beer can immediately increase milk supply (although drinking beer is best left to evenings or weekends). You can also buy a powdered brewers yeast from the store or Amazon. It can be added to smoothies, cookies, or other recipes. Here’s one of my favorites!!