Milk supply and sleep are the biggest concerns of new parents. One of the top reasons to wean before one year is perceived low milk supply, whether or not there actually is a true low supply. Our expectations of how much milk we should make may not actually be true of how much baby really needs. When baby wants to feed more often, fusses at the breast, or tugs/pulls on the breast, this gets misinterpreted that milk is not adequate, either in quality or quantity.
Signs of plenty of milk:
💩 6+ wet and 1-2 daily poops
💕Pain free latch
⚖️Consistent weight gain over time

🤱🏽Baby nursing frequently does not equal low milk supply
🤱🏾Baby not settling after a feeding does not mean you have low supply
🤱🏿Occasional long, frequent, endless feeding, especially during growth spurts, are not a sign of low supply
🤱🏼Waking frequently at night and changes in sleep or nap routines are normal
🤱🏻Babies don’t like being put down
🤱🏻 Breasts no longer feeling full between feedings is normal. Your body gets more efficient as time goes on. They go back to pre pregnancy size and still make plenty of milk 🤱🏾Not every one leaks. Some never leak. Leaking stops over time while still maintaining a full supply
🤱🏼 Some never feel their let down. Many stop feeling let down as baby ages
🤱🏽Baby fussing at the breast, pulling away, but still wanting to nurse does not mean you have low supply
🤱🏾 Babies want to nurse for more than just nutrition. It is comforting, pain relieving, soothing, and bonding. Being on you is safety.
🤱🏿Pumping is NEVER a good indication of your true supply as baby is way more efficient at accessing you milk (unless there is a tongue tie or oral motor weakness)
🤦🏽‍♀️It is possible for a baby to refuse the breast and still take a bottle. You can’t force a baby to latch the the breast but you can make a baby latch to a bottle.
💕If breastfeeding has been going well for several weeks/months, don’t blame the boob as the root of your baby’s behavior unless there is a justifiable cause (like taking medications or birth control, starting your period, reducing your number of feedings/pumps)

Sisters, not twins. This milk is from the same pump session. Each breast made different colored milk!!! Did you know your breasts work together and independently? Here’s some fun facts about your girls:
⭐️70% of us make more milk on the right side, often significantly more (up to double for some!!)
⭐️Each breast can have its own flow rate. Some babies prefer the flow from one side over the other
⭐️ Breasts and nipples are not symmetrical. The left is usually slightly larger than the right. Nipples can be different sizes and lengths. For a significant size difference, you may need to pump with different sized flanges
⭐️Milk during the same feeding can taste and be a different color from side to side. The fat content can also be different based on which side baby fed from last. I once had a toddler tell their mom that they preferred milk from one side because it tasted like oatmeal, and the other tasted like tea!!
⭐️When you have a milk let down, your milk will let downs on both sides, which is why many will leak from the opposite breast while feeding. It’s also why we usually recommend pumping both breasts at the same time to take advantage of those let downs.
⭐️ You can successfully breastfeed from only one breast. One side can make enough milk to feed you cold.
⭐️ If you tandem feed and we’re to keep the other child on one side and the younger always on the other, your breasts would make different milk for them based on how often each child feeds.

💤 Prolactin, the major milk making hormone, is rises when we sleep, so it is naturally higher at night. Prolactin rises about 90 minutes after sleep begins and peaks around 4-5 hours later and stays high for about 2 hours after waking up. This helps you make more milk throughout the rest of the day

🛌 For most, milk removal in the middle of the night is essential for maintaining milk supply. If your exclusively breastfed baby under 12 months is waking at night, most likely they want to feed. If your baby is naturally sleeping longer on their own (with no sleep training or sleep devices to help baby sleep longer), they are telling you they are getting enough milk from you at other times to not need milk at night for growth.

Breast storage capacity has a LOT to do with whether or not you need to wake up to pump. If you have a large breast storage capacity you may be able to go longer between pump or feedings without dropping supply or feeling uncomfortable. You may be able to get a 4, 5, or even 6 hour stretch of sleep and not see your supply drop. Baby also has more milk available at other feedings and may take very large, less often feedings.

Those with low supply, small breast storage capacity, or baby struggling to feed efficiently may need to take advantage of higher night time prolactin levels made during REM. Even if you feel like you have a healthy supply in the first 4-6 weeks, a sudden drop in supply can happen if insufficient milk removals start too early into your breastfeeding journey when supply regulates around 3 months.

If you’re not sure what your storage capacity is, if baby is sleeping longer and you’re waking up engorged, or you’re waking up and pumping and then baby wants to feed and you have now pumped that milk, there are Lots of options:

✏️ Dream feed. If you’re waking up engorged and baby is still sleeping, some times you can sneak in a dream feed to relieve the breast and help baby sleep even longer. Bring sleeping baby to the breast to root and usually they will latch and feed while still sleeping. Lay them back down when you’re done. Don’t burp or change diapers as this will wake them up.
✏️ Pump 30-45 minutes after your last breastfeeding ends when you anticipate baby to take a longer sleep stretch. This will help you go a little longer before the next feeding without getting as engorged, seeing as drastic a supply dio, or pumping too close to the next feeding.
✏️ Pump when you feel uncomfortable but only pump enough to feel comfortable and not to empty the breast. If baby wakes up, you can always offer the breast and top off with what you pumped if they’re still hungry
✏️ Do nothing. If your baby is naturally sleeping longer at night on their own with no sleep training, your body will naturally regulate your supply.
✏️ If you are sleep training baby or using something like the Snoo to help baby sleep longer, you may need to still get up every few hours over night to maintain your milk supply.

Breastfeeding issues are medical problems. I wish health care providers would understand this. When a parent wants to breast/chestfeed, but is running into challenges, those challenges need to be taken seriously, just as if they were complaining about any other health or medical issue.

Feeding your baby from your body should not be painful. Our bodies are designed to feed our babies, so when there is pain there is always a reason. Pain tells us that something needs fixed. It may be as simple as the position and latch or as complex as a tongue tie. At no point should healthcare providers accept tissue damage as normal. If they are telling you it’s fine and part of the process, please get a second opinion.

When everything is going well, our bodies are designed to provide plenty of milk for our babies. If you are not making enough milk for your baby while seemingly doing all the right things, we should find the root (IGT? Wrong pump flange? Not pumping enough? Medications? Hemorrhage at birth?).

Baby unable to latch? Popping on and off? Babies are born to feed. All of their reflexes and instincts are designed to get them to latch and feed. If baby is struggling at the breast, there is always a reason. Rarely will we not find the root if we dig deep and long enough.

When there is pain, damage, low milk supply or a non-latching baby, interventions are often needed. These are medical interventions that should be overseen by an IBCLC who has lactation specific training to make sure the correct tool for the correct cause of the issue is being used. And getting the best, most accurate information for that individual family. If a family chooses not to breastfeed because of these issues, that is their choice and should be supported to the fullest. If your health care providers are not taking your concerns seriously, find another health care provider

Milk is a liquid. And it obviously flows like a liquid. Have you ever sprayed your baby in the face from milk that flows too fast during let down? Have you ever been concerned with how fast or slow your milk seems to flow in any given feeding or pump session?

Did you know the breast is like a tree inside? With lots of lobes at the back of the breast that funnel down through milk ducts to fewer nipple pores at the front? The flow of your milk is impacted by multiple things. One of the biggest things to impact how your milk flows is your unique breast anatomy.

🌳Everyone has a different number of milk making lobes, also known as alveoli. These lobes are connected to your blood steam, because milk is made from nutrients in your blood. Oxytocin triggers contractions of the lobes to release milk down your milk ducts

🌴The length and diameter of the ducts play a role in how quickly milk goes from where it is made to the baby.

🌲The viscosity, or thickness, of your milk can slow down or speed up milk flow. This viscosity can change from feeding to feeding depending on many factors. Many will take sunflower lethicin to thin their milk (keep the fat from sticking) to help speed up milk flow and reduce the risk of the milk fat sticking in the ducts and causing plugged ducts

🎄How dense or elastic your breast tissue is contributes to flow rate.

Your body and your anatomy is unique. Milk production or how milk is made in the breast is not the same for every person. If you’re struggling with making or releasing milk to your baby, schedule a consultation to figure out why and develop an individualized plan that works for your anatomy.

Milk production is controlled by how often milk is being emptied from the breast. An empty breast makes milk faster than a full breast. The more you empty, the more you make. This is because milk production is being controlled in the breast by a substance called the feedback inhibitor of lactation, or FIL (a polypeptide), which is present in the milk itself. Sometimes one breast stops making milk while the other breast continues (in some cases of slacker boob), for example if a baby nurses on only one side. This is because of the local control of milk production independently within each breast. If milk is not removed, the FIL builds up in the milk and stops the cells from making any more milk. This protects the breast from things like clogged ducts and mastitis. If breast milk is emptied from the breast, the inhibitor is also removed, and making milk resumes. Milk removal can be done by the baby or a pump
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The amount of milk that is produced is determined by the amount of FIL in the milk, which is driven by how much and how often the baby or a pump removes milk from the breast. Emptier breasts have less FIL and make milk faster. Full breasts have more FIL and make milk slower. This mechanism is especially important for continuing to make milk after 11-14 weeks when hormones shift and milk making is completely determined by how much milk is being emptied from the breast.

🍀Doctors have long known that infants who are breast-fed get fewer infections because babies gain extra protection from antibodies and live immune cells found in human milk.
🍀Research shows every tsp of breastmilk has 3,000,000 germ killing cells in it. Even one teaspoon a day is giving baby some immune protection!
🍀Once ingested, live molecules and cells in the milk help to prevent microorganisms from penetrating the baby’s body tissues.
🍀Some of the immune molecules bind to viruses/bacteria/germs in the digestive tract, preventing them from getting into the rest of the body.
🍀Certain immune cells in human milk attack viruses and bacteria directly. Another set produces chemicals that stimulate baby’s own immune response.
🍀The most impressive amount of immune cells are found in colostrum.
🍀Several studies suggest human milk may induce an infant’s immune system to mature more quickly than with formula
🍀Some of the immune factors in breastmilk increase in concentration as baby gets older and nurses less, so older babies continue to benefit from breast milk
🍀Remember, freezing kills some of the live immune factors of breastmilk even though the nutrition (vitamins, protein, fat) is maintained. Offer fresh breast milk whenever possible.
🍀Research is showing that if you’ve had COVID or the COVID vaccine, your milk will pass antibodies to your baby to protect them from getting it!

Having the right pump flange size can make all the difference in your pumping journey. Most pumps come standard with a 24mm and possibly a 27/28mm flange(s). Did you know I’ve only recommended the 28mm flange twice in the last 3 years? And the 24mm only maybe a dozen times out of hundreds of moms? The majority of the people I woke with need a 17, 19, or 21mm flange and often need a cushion to make it a half size. Too much areola in the tunnel can cause swelling that doesn’t let your milk empty efficiently, leading to plugged ducts and a drop in milk supply. (Ever pump but still feel like there’s milk in the breast? Most likely your flange is too big) Measuring your nipples can give you an idea of what size flange you’ll need. Use a ruler at the base of your nipple (not the areola!) and find the diameter. Add ~3mm and that’s a good place to start. Pumping should feel comfortable with no pain or rubbing of your nipples in the tunnel. It’s like trying to find the perfect shoe. It may take trying a few sizes to get the right fit, but trust me, it’s worth it!! Have you measured your nipples yet? Did you know there are still too many lactation consultants (especially in the hospital) who don’t know there are other sized flanges? There are lots of products (inserts, cushions, different shapes and sizes) to help make your pumping experience so much better.

So why wasn’t this considered when pump companies were making flanges? I read some where the original reason they made 24 and 28mm was for the size of baby’s mouth, not nipple size!

Do you nipples stretch a lot and swell into the tunnel? We call those elastic nipples. You may do really well with something like the Beaugen Mom Cushions which help hold the areola back. Or the Pumpin Pal flanges which have a different shape to help with the stretch.

What size flange do you use?

Oxytocin is the hormone responsible for making milk eject or “let down” during feeding and pumping. Milk is constantly being made and collected in little sacs (alveoli) at the back of the breast. When the breast and nipple are stimulated during feeding, oxytocin makes the cells around the alveoli contract in what’s called the milk ejection reflex (MER). This makes the milk that is already in the breast flow for baby.

You can train yourself to have MER through your senses and feelings, such as when you touch, smell or see your baby, hear baby cry, or think lovingly about them. If you are in severe pain, anxious, or emotionally upset, the oxytocin reflex may become inhibited, and milk may suddenly stop flowing well. With support, and recognition, once you feel comfortable and baby continues to breastfeed, the milk will flow again.

Signs that the oxytocin reflex is active:

• Tingling sensation in the breast before or during a feed

• Milk starts to drop when you think of baby or hear crying

• Milk flowing from the other breast when baby is sucking

• Milk sprays from the breast if baby unlatches

• Slow deep sucks and swallowing by the baby, indicating milk is flowing

• Uterine cramping in the first week after delivery

• Thirst during a feed.

If one or more of these signs are present, the reflex is working. However, if they are not present, it does not mean that the reflex is not active. Not every one feels or is aware of these sensations.

Breastfeeding isn’t the only way to get a dose of oxytocin. If you can feel milk in your breasts but are having trouble letting the milk down, try this:

◦ Keep baby in skin to skin contact for 1-2 hours prior to feeding or pumping

◦ Do yoga. A small 2013 study found after 1 month of yoga, people had higher oxytocin levels

◦ Listen to music. Multiple studies have found that listening to music naturally boosts oxytocin. This can be especially helpful when pumping at work

◦ Meditate. This helps reduce stress which increases oxytocin

◦ Touch. Physical touch releases oxytocin. This can be from cuddling, hugging or touching another person you love or getting a massage

◦ Laugh! Laughter really is the best medicine

◦ Sex. This is a hard one depending on where you’re at in your postpartum journey, but orgasm is a key way to boost oxytocin

◦ Pet you pet! Animal touch can release oxytocin just like human touch can

◦ Oxytocin nasal spray. Struggling with severe anxiety and nothing else is working? A prescription for an oxytocin nasal spray can help trigger let downs

👉🏼Pumping is NEVER an indication of supply

👉🏼Chances are you will need a pump flange size that didn’t come with your pump (We don’t all wear a 36C, why would pump companies expect us all to have the same nipple size?)

👉🏼You can NEVER empty the breast. It constantly makes milk. It takes at least 40 days of no stimulation for the breast to stop making milk

👉🏼Nipple damage is not normal. It is always a sign of something: Shallow latch. Tongue tie. Wrong size flange.

👉🏼Breasts/chest are NOT supposed to stay engorged

👉🏼That full feeling between feedings goes away around 6-8 weeks

👉🏼Babies become efficient feeders, so a 3 month old may get a full feeding in 5 minutes even if they fed for 30 as a newborn

👉🏼Some times they’ll want one side. Sometimes they’ll want both. Sometimes they want both sides multiple times 🤷🏽‍♀️

👉🏼This is eating. We may want a snack, a buffet, a meal, a treat, dessert or a thirst quencher. Same goes at the breast

👉🏼Some leak, some don’t. Leaking is not an indication of supply. Leaking may slow or stop at any point and is NOT an indication that you’re losing supply

👉🏼Not everyone feels their let down. Many stop feeling their let down with time.

👉🏼The longer you go between feedings the higher the water content of your milk. The shorter you go between feeding the smaller the volume but the higher the fat concentration

👉🏼Every baby feeds differently

👉🏼Your body is amazing!!!!

👉🏼Trust your body. Trust your baby

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