For the first six months after birth, baby is supposed to be on an exclusive breast milk diet. At six months and beyond your breast milk goes through a major change. The volume of milk slowly drops because baby is eating and drinking other foods. They may also be sleeping longer at night and are more active during the day. Your milk is super smart and shifts with this drop to have more antibodies and a higher fat content. The breast makes milk based on how it is emptied and what your hormones are doing based on how old baby is. Your hormones are also shifting and you may start your monthly cycle again. Many experience a further dip in supply around the time with their period. If you’re exclusively breastfeeding, you may notice baby pulling or tugging on your nipple or using their hands to beat your chest while feeding. If you’re pumping, you may slowly start to see less milk each pump session. Usually months 5-7 are the hardest from a baby behavior perspective and it settles out again as baby eats more table food and your hormones adjust. If breastfeeding is your goal, just keep offering the breast and pumping often.
Good bye pumpkin, hello peppermint. Tis the season for peppermint bark, candy canes, peppermint lattes, and holiday cookies with crushed red and white striped mints. While you may binge on all things peppermint this December, be warned: it may drop your milk supply.
Peppermint is a soothing herb best known for treating stomach and digestive problems. Popular products like toothpaste, chewing gum and tea are often flavored with peppermint. The calming and numbing effect of peppermint treats headaches, menstrual cramps, diarrhea, anxiety, nausea, and skin irritation. Peppermint oil has even been used to treat cracked nipples!! It is also used as an active ingredient in vaporizers and chest rubs. Menthol and methyl salicylate, the active ingredient of peppermint, possess antibacterial, antifungal, and antiviral properties.
It’s been commonly reported that peppermint and spearmint decrease milk supply, especially when taken in large amounts such as during the holidays. Drinking an occasional peppermint latte shouldn’t be a problem. But if you start to notice your supply taking a dip this holiday season, check your peppermint intake.
Paced bottle feeding (meaning you’re setting the pace for how fast/slow baby drinks) helps prevent over feeding baby: it takes 20 minutes for the stomach to tell the brain that it’s full. If a baby takes a bottle too quickly, the mouth can still be “hungry” and wanting to suck when the stomach is actually full. Like going to an all you can eat buffet and eating a lot of food quickly and then realizing half hour later you ate way too much. A baby that happily sucks down too much milk from a bottle can make you think you don’t have enough breast milk even if you make a normal amount. It can also make baby frustrated by the flow of milk from the breast and inadvertently sabotage breastfeeding
These pictures are the same baby in two different positions for paced feeding: semi upright and side lying. Side lying is my favorite position to use as it puts baby in the same position as breastfeeding. Many parents feel baby is more supported in this position. Baby is supported by your leg or breastfeeding pillow.
🍼Never feed baby on their back
🍼Keep the bottle parallel with the floor with about half the nipple filled with milk
🍼Use the slowest flow nipple baby will tolerate
🍼Rub the nipple gently on baby’s lips, allow baby to latch at their own pace, don’t force it into their mouth
🍼It should take 15-20 minutes to finish the bottle
🍼Watch the baby and not the bottle, stop when they show signs of being full
🍼Resist the urge to finish the bottle, even if there is only a little left, when baby is showing signs their tummy is full
🍼Take short breaks to burp and give the tummy time to fill naturally
🍼If baby is gulping or chugging, slow down
🍼If baby has taken a good volume of milk (2-4oz) in a short amount of time and is still acting hungry, offer a pacifier for a few minutes to help them digest and give the tummy to to tell the brain it’s full. If they’re still hungry, slowly offer more in 1/2oz increments
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.
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
💡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.
How many ounces should I leave if I’m exclusively breastfeeding but need to leave my baby a bottle?
The answer is: that depends. Some babies are grazers. They like smaller, more frequent feedings to keep their tummy from being too full or uncomfortable. Their feedings can range from 1-3 ounces and they may feed 10 or more times a day. Other babies are bingers. They like a big, full tummy and may take 3-5 or even occasionally 6 ounces but not as often. They may feed only 6-8 times a day and have longer sleep stretches. Their tummy doesn’t mind being stretched fuller and their bodies tell them it’s ok to go longer between feedings.
The question is: how many feedings do they get in 24 hours? From one month to one year, babies take between 19-32 ounces of breast milk a day. The average is 25 ounces in 24 hours. There’s a range because babies eat more or less depending on the activities of the day, growth spurts, teething, and even babies emotionally eat sometimes. In general, take 25 and divide it by the number of feedings they average in any given day. Also take into account that growth slows between 6-12 months and baby should be eating table foods, so you don’t need to increase the ounces in the bottle during that time. If your baby took 4 Oz bottles at 4 months, 4 Oz bottles are still appropriate at 9 months because they’re also begging for the food right off your plate in addition to what you’re putting on their tray.
The best way to lose weight is to be in a calorie deficit. Choosing the right foods, protein, fruits and vegetables with moderation of carbs, sugars and starches is guaranteed for most to lose extra pounds. Sure, exercise helps. It helps burn calories, again contributing to calorie deficit. But exercise alone won’t help you lose weight if you’re still eating a high calorie diet. Sure, going vegetarian or vegan or doing Weight Watchers or Atkins or any other “diet” helps. It helps you monitor intake to be in a calorie deficit. But even on any diet plan, if you’re not following it correctly and still eating high amounts of foods you won’t lose weight. Certain people do better on certain diets or with specific exercise programs because of how their specific body handles and processes food, vitamins, stress, movement, and all of the other factors like environment and genetics. Finding a nutritionist, weight loss coach, or personal trainer helps you look at your specific body and goals and helps you reach them. You can absolutely get there in your own, having someone counsel you through often gets you quicker results from their experience and wisdom. But the principle remains: calorie deficit is the number one way to lose weight.
The best way to make breast milk is to empty breast milk. Whether that’s your baby or a high quality breast pump, moving milk multiple times a day tells the body to make more milk. The more often milk is removed, the faster it is made. Sure, supplements help. They support your thyroid and blood with the extra nutrients and hormones needed to produce milk. But supplements alone is no replacement for moving milk. You can take the best lactation bars and drink all the tea you want, but without emptying the breast every few hours routinely I wouldn’t expect the majority of us to make enough milk to feed baby. Sure, hydration and nutrition are important. It takes calories to make calories and hydration help with that process. But even the research shows women who are malnourished in famine torn countries make plenty of milk for their babies when baby is allowed unrestricted access to the breast. Yes, adding in chia seed, flax seed, oats, nuts and nut butters, and coconut water helps make milk. Certain people do better on certain herbs and foods because of how their specific body handles and processes food, vitamins, stress, hormones, and all of the other factors like anatomy and genetics. Finding a lactation consultant, peer counselor, or trained doula helps you look at your specific body and goals and helps you reach them. You can absolutely get there in your own, having someone counsel you through often gets you quicker results from their experience and wisdom. But the principle remains: emptying milk from the breast is the number one way to make breast milk.
CLUSTER FEEDING. Two words when paired together that drive fear and trembling to parents. Cluster feeding is NORMAL for ALL breastfed babies. It has nothing to do with your supply. It has nothing to do with the clock. It has nothing to do with what you’re eating or drinking or those supplements you just took. It may not even have anything to even do with being hungry. Babies typically cluster feed in the afternoon/evening. When your milk supply naturally and appropriately dips. When your milk is a smaller water concentration with a higher fat content. As long as baby is happy to feed the rest of the day, is making plenty of wet and dirty diapers, is content and sleeping routinely between feedings, and gaining weight over time, DON’T BLAME THE BOOB!! Even if baby seems like they want to feed constantly. Cluster feeding is normal. It typically happens MORE when baby is going through a growth spurt (body growing), developmental leap (mind/skills growing), or teething/illness. Why does baby want the breast more?
• Preparing for a longer sleep: Some babies just prefer to fill up on milk for a few hours before a longer sleep.
• Milk flow is slower at night: Some babies nurse longer to fill up due to the slower flow.
• A growth spurt: they usually occur around 3, 6, and 8weeks of age.
• They need of comfort. Breast milk has hormones to develop baby’s circadian rhythm. At nighttime baby may just seek comfort to help them sleep.
• Developmental leap: Mental and emotional growth spurts when they acquire new skills.
• Baby is sick, thirsty, or teething: breast feeding is a pain reliever, medicine and hydration all in one
Know that it’s normal. Be patient through the process. Be prepared with snacks and water for yourself, a comfy spot, a good pillow for support and the remote and your phone charger close by to get you through. You’re not alone and it doesn’t last forever!!
Too often we look around to see what everyone else is doing and it makes us feel incomplete, incompetent, like we’re doing something wrong or not doing enough. We see the success of others in parenting, sleep training, their milk supply, pumping, whatever, and it makes us feel like we’ve failed. Comparison is the number one way to have your joy and peace stolen. Stop looking at Becky over there with her oversupply and thinking your normal supply is inadequate for your content and growing baby. Stop looking at Gina over there whose baby has slept through the night since two months and thinking there’s something wrong with your happy child. Stop comparing your tiny but mighty that looks like the rest of your flock to my giant giraffe babies that look like the rest of my herd. You’re not getting a grade. Breastfeeding is not a pass/fail activity. Trust your baby. Trust your body. You’ve got this.
I’ve never been a super pumper. I’ve diligently pumped three times a day at work for the last 8 months. I’ve almost always made just enough for the next day of feedings. Sometimes I’ve even had a conservative stash in the freezer for low pump days or when my husband and I want to go out. There are definitely times when I have to work on my supply to keep it up enough to feed my daughter. Oatmeal for breakfast, teas at lunch, a Guinness with dinner, more tea before bed. Pump. Breast massage. Pump. Repeat. It’s exhausting. Especially since my uninvited monthly visitor has me with a low supply. As I come up on my daughters first birthday, I’m torn. Continue the schedule I’m on with the highs and lows of constant pumping? Drop the pumping and only breastfed when I’m home and offer something else while I’m gone? Or gradually wean all together? The professional side of me (the crunchy, granola, die hard side) says, “Stick it out!!! It’s not that bad!! Breast is best!!! Your baby needs your milk!!! Show your boobs who’s boss.” While the personal side of me screams, “Screw it! You’re working so hard! Give yourself a break. You went a whole year. You did the best you could with the support you had. Some other milk won’t kill your kid. She’s eating like a champ and she won’t even notice.” I get it now. I understand why some moms give up breastfeeding, especially working moms. I also get why mom’s push through and keep going. We all just want the best for our babies. I’m still on the fence. We’re T minus 1 month to the big one year birthday. I’ll keep you posted on what I decide. But for now, Happy Pumping!!