The size of your breast has nothing to do with the amount of milk you will make. The size of your breast is determined by the amount of fatty tissue in the breast. The amount of milk you will make is determined by the amount of glandular tissue in the breast that makes milk. This glandular tissue starts growing during puberty. It increases during pregnancy and is part of what accounts for the increase in breast size during pregnancy. Everyone’s storage capacity is different.. just like every breast size is different. However breast size does NOT equal breast storage.
Small capacity: Approx 2-3 ounces per feeding/pump. Baby may need frequent feedings: 10-12 per day. Baby usually takes both breasts and may want each breast twice. Parent feels uncomfortable quickly between feedings and sees a supply drop with more than 3-4 hours between feedings
Medium capacity: Approx 3-4 oz per feeding/pump. Baby may feed 8+ times per day. Baby may take one breast or both breasts each feeding. Parent feels uncomfortable and see a supply drop with more than 4-5 hours between feedings
Large capacity: Approx 4-6 oz per feeding/pump. Baby may feed 6+ times per day. Baby may only take one breast per feeding. Parent may go up to 6 hours without seeing a drop in supply
XLarge capacity: 8+ oz per feeding/pump. Baby may feed 6+ times per day. Baby may only take one breast and parent may still feel full in that breast. Some babies may be gassy from higher foremilk intake as they may not drain the breast fully. Parent may go 6+ hours without seeing a supply drop. Parent may still feel uncomfortable between feedings depending on how quickly the milk fills the breast
All capacities have the same ability to feed baby well as long as the breast is routinely being emptied.
If breastfeeding is going well and you’re planning on being home with your baby or only gone for a few hours at a time there is no need to have a huge freezer stash. Having milk in the freezer is a nice security, especially is your have to work or will be away from your baby. But if you’re always with your baby or are only gone for a short while, there is no need to have a stash.
Having the right stash for your family means having enough stashed for when you’re away from your baby. If you’re gone for one feeding, you only need one feeding worth of milk. If you’re gone 2-3 feedings, you need 2-3 feedings worth of milk. If your baby is being bottle feeding while you’re away, you would pump while you’re gone to tell your body the milk is needed. That milk then becomes the stash for the next time that you’re gone.
If you want to have a big stash, great!!! You can absolutely have that as an option. Just don’t feel pressured from other people’s journeys on social media to have something you may not need or use. I’ve had several moms who spent countless hours pumping and stashing only to have to donate or throw out the milk stash because they never used it and it was going to expire. I’ve also had several moms who thought you had to have a stash and were relieved to know they didn’t! Do what is best for you and your baby and not based off of anyone else.
You’ve got this. Trust your body. Trust your baby.
While your young baby is supposed to gain on average an ounce a day (30gm), weight gain slows as baby ages. From 4-6 months babies should only gain 3-4 ounces per week (90-120gm) and from 6-12 months babies should only gain 1-2 ounces per week (30-60gm). If you have been tracking baby’s weight gain and see the scale slowing down, don’t be alarmed if your baby is older. Continue to watch for lots of wet diapers and consistent pooping. Trust your baby and trust your body.
Some times we can sabotage our own milk supply from little things that we don’t understand will make a difference. Here are the top ways to accidentally drop your milk supply:
😳Putting baby on a feeding schedule in the first 3-4 months
😳Watching the clock instead of feeding baby on demand
😳Sleep training in the first 3-4 months after birth
😳Waiting for your breasts/chest to feel full to pump or feed
😳Not pumping when baby is getting a bottle
😳Letting partner feed a bottle in the middle of the night to get more sleep (and not getting up to pump)
😳”Topping off baby” after feeding, especially during the witching hour phase. (I’m not talking about when supplementing is necessary or if you’re on a triple feeding plan because of true low supply or baby weight gain. Supplementing after breastfeeding can be needed, but you would also be pumping at that time)
😳 Not pumping enough when returning to work
😳Using the wrong size pump flanges
😳Using a poor quality pump (insurance companies have to provide you with one, but that doesn’t mean they’ll give you one of quality)
😳Going back on hormonal birth control at your 6 week postpartum checkup
😳Taking nasal decongestants or allergy medications
While these seem like normal recommendations from many parent groups or even your health care providers, these subtle things can sabotage milk supply. Your body works on a demand and supply basis. The more you empty or demand from the breast/chest, the more milk it will make. Want to increase supply? Increase the number of milk removals, give young infants free access to feed on demand, and watch out for medications, hormones, of pumping traps that can sabotage your success.
Were you told by your pediatrician to give your baby vitamin D drops? Vitamin D is absolutely critical strong bones, because it helps the body use calcium from the diet. Traditionally, vitamin D deficiency has been associated with rickets, a disease where the bone tissue doesn’t mineralize properly, leading to soft bones and skeletal deformities. Recent research also tells us that vitamin D is key in maintaining our immune systems for regulating both infection and inflammatory pathways. If you shun the sun, have a milk allergy, or follow a strict vegan diet, you may be at risk for vitamin D deficiency. Known as the sunshine vitamin, vitamin D is produced by the body in response to skin being exposed to sunlight. It is also occurs naturally in a few foods like certain fish, fish liver oils, egg yolks, and fortified dairy and grain products.
Our bodies are designed to make very large amounts of vitamin D through exposure to the sun (10,000—20,000 IU in 24 hours, after 15—20 minutes of summer-sun exposure in a bathing suit/45—60 minutes of exposure for those with darker skin tones). However, in an effort to decrease our risk of skin cancer from over exposure to the sun, we’ve limited our ability to keep our vitamin D status at a normal level from absorbing it directly from the best source. That said, those living where clouds often cover the sky or in cities with polluted air quality will have a hard time getting sun exposure for natural vitamin D. People with darker skin tones are more likely to have low levels of vitamin D, as well, due to the increased pigment in their skin. They require nearly four times the length of sun exposure in order to penetrate the skin to manufacture vitamin D.
Vitamin D is essential for babies. Your pediatrician cannot tell you to put your baby in the sun, even though that is the best source of vitamin D, because of the risks of skin cancer. So they should have advised you to give your baby 400 IU of vitamin D each day, usually given by drops in the mouth.
All formulas sold in the United States have at least 400 IU/L of vitamin D; so if your baby is drinking 32 ounces of formula, vitamin D supplementation is not needed.
But what about from breast milk? Human milk is a very poor source of vitamin D, usually containing less than 50 IU per quart. This is why the AAP recommends all breastfed infants be supplemented. This does not mean there is anything wrong with the milk, but an issue in the recommended amount of vitamin D the lactating parent should be taking. This goes back to the sunlight recommendation. If you were getting 15-45 minutes of sunlight (depending on how dark your skin tone is) 3-4 times per week, your body would have plenty of natural vitamin D to pass through your milk to your baby. Many who live in the US either don’t live in a location where that’s possible year round (hi, Chicago in January) or maybe can’t get out in the sun because of needing to work. The Academy of Breastfeeding Medicine (a global organisation) recommends that “The breastfeeding infant should receive vitamin D supplementation for a year, beginning shortly after birth in doses of 10–20 lg/day (400–800 IU/day) (LOE IB). This supplement should be cholecalciferol, vitamin D3, because of superior absorption unless a vegetable source such as ergocaliferol vitamin D2, is desired. … Vitamin D also may be delivered adequately through human milk.” Research has shown that as long as you as the lactating parent is taking 6,400 IU of vitamin D daily, there is no need to supplement the baby as your milk will have adequate amounts.
An IUD is a form of birth control that’s put into your uterus to prevent pregnancy. One of the most common forms of birth control, it’s long-term, reversible, and considered one of the most effective birth control methods. Many doctors will encourage new mothers to have them placed between 4-6 weeks postpartum checkup to prevent pregnancies too close together. The Paragard IUD is wrapped in copper and doesn’t have hormones. The Mirena, Kyleena, Liletta, and Skyla IUDs use the hormone progestin to prevent pregnancy. Be aware that each IUD has a different amount of progestin. They are not created equal. Progestin is also the hormone found in the mini pill.
Hormonal IUDs and the mini pill are often recommended by doctors as the best form of birth control for breastfeeding mothers because most of the research that is available says that they don’t impact breast milk supply. And many who use these methods don’t experience any drop in supply. For some, though, both the mini pill and the hormonal IUDs will drop breast milk supply, some times drastically. Every body is sensitive to different levels of hormones. If you have an IUD placed and notice a drop in supply, the only way to increase supply again is to remove the IUD. Increased pumping or herbal supplements will usually not be enough to increase supply again because you’re working against hormones. The only way to rebound supply would be to remove the IUD. If you’re considering a hormonal based IUD and aren’t sure if your supply will drop, consider taking a few rounds of the mini pill (progestin only) which is the same hormone as the IUD. If your supply drops, you only have to stop taking the pill and your supply will rebound much quicker.
Did you use a hormone based birth control? Did you notice a change in your breast milk supply?
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.
It is normal for let-down not to feel as strong as baby gets older. Some of us never feel let-down, and some stop feeling the let-down sensation as time goes by. This does not necessarily indicate that let-down is not taking place. Remember, just because you don’t feel it or it feels different over time, or any mean it’s not happening.
Signs of let-down include:
• Uterine cramping during letdown in the first week postpartum
• Baby’s sucking pattern changes from a quick suck-suck to a rhythmic suck-swallow pattern as milk begins to flow
• Feeling of calm, relaxation, sleepiness or drowsiness.
• Sudden thirst
• Leaking from the other breast
• Tingling, pins and needles sensation, itching, nausea, headaches, or negative emotions
Things that can be the cause of a slow or inhibited let-down:
• History of breast surgery where nerve damage that can interfere with let-down.
• In extreme situations of stress or crisis, the release of extra adrenaline in can reduce or block the hormones which affect let-down from a fight or flight response
• Sometimes a cycle is created, where baby fusses and pulls off because the let-down is slow, which makes mom tense up, which makes the let-down even slower, etc.
• It’s normal to have a harder time letting down for the pump than baby.
Later into your breastfeeding journey, you may notice it takes longer to trigger a let-down. This is common and what works early on may change over time.
Check for possible causes:
• Worn pump parts that need replaced. Replace the valves and membranes often. Check for worn tubing.
• Make sure you’re pumping with the correct flange size. Nipples may become more elastic over time and a different size may be used.
• Starting your period or are you possibly pregnant? Both can decrease milk production and impact let-downs.
• New hormonal birth control or medication? These may impact supply.
• Check your body. Tension, pain, cold, fatigued or anxiety may block the neurochemical pathways required for milk let-downs.
Tips to trigger let down:
• Try a different pump or flange size
• Use heat, breast massage/compressions, or vibrations to prompt milk flow
• Orgasm. The same hormone released during orgasm also causes let down. Studies show having an orgasm can help let down
• Relax. Use slow, deep breaths and meditation
• Singing or humming can also speed let-down
• Gently massage your breasts. Stroke your breast towards the nipple with the flat of your hand or edge of a finger. Gently roll your nipple between your fingers
• Watch videos of your baby. Smell their clothing. Remember the feeling of let down
• Use all of your senses to facilitate let-down. Concentrate on the sight, sound, smell and feel of your baby.
• Take a warm shower or bath prior to nursing
• If you are in any pain, consider taking a pain reliever about 30 minutes before you feeding. Pain can cause stress and inhibit let-down.
• Choose a calm, less distracting setting
• Turn on music or a tv show that you enjoy
• Skin to skin contact with your baby: Undress baby to their diaper and yourself from the waist up. Stay like this for 1-2 hours prior to a feeding
• Eat a favorite snack and drink a comforting beverage like warm tea
• Get comfortable. Sit in a comfy chair or lay in bed. You should be in a comfortable position
• Switch nurse: move baby back and forth frequently between breasts until let-down occurs
• Visualization. Take several deep breaths and close your eyes as you begin. Try to visualize and “feel” what the let-down response feels like for you (if you normally feel anything). Imagine milk flowing or use images of waterfalls. An excellent book on visualization techniques is Mind Over Labor by Carl Jones.
• Distraction: watch TV, read, talk to a friend, don’t watch the pump bottles.
• One study has shown that the moms of hospitalized babies who listened to guided relaxation or soothing music while pumping had an increased pumping output. When mom listened to a recording that included both music and guided relaxation while pumping, in addition to looking at photos of her baby, pumping output was increased even more. In this study, the interventions led to moms producing 2-3 times their normal pumping output. Milk fat content also increased for these moms in the early days of the study. (Reference: Keith DR, Weaver BS, Vogel RL. The effect of music-based listening interventions on the volume, fat content, and caloric content of breast milk-produced by mothers of premature and critically ill infants. Adv Neonatal Care. 2012 Apr;12(2):112-9.)
Humans by design are predisposed to be lactose intolerant. The only reasons Westerners (mostly) lost this intolerance was due to centuries of eating cheese and having their bodies evolve to adapt to consuming it. Lactose is the number one sugar in breast milk. It’s broken down by an enzyme called lactase which is supposed to disappear in early childhood, right around the time we would naturally wean. Asian cultures are predominantly lactose intolerant because their cultures have had cuisine sans cheese and cow’s milk for millennia (think traditional Japanese, Chinese, and Korean dishes. No cheese. No cow’s milk.) Yet in Western cultures it’s occasionally encouraged to drink milk to make milk. There is no scientific evidence to back this up. You do not need to drink cow’s milk or eat dairy in large quantities to make breast milk. You do need to stay hydrated, eat quality foods, and routinely empty the breast.
Caffeine is safe to take while breastfeeding in moderation (up to 300mg per day). Only about 1.5% actually enters breast milk. Caffeine enters your bloodstream about 15 minutes. It peaks in your blood within 60 minutes and has a half-life of 3-5 hours. The half-life is the time it takes for your body to eliminate half of the drug. The remaining caffeine can stay in your body for a long time. The half-life of caffeine is about 97.5 hours in a newborn, 14 hours in a 3-5 month old baby and 3-5 hours in a baby older than 6 months. Because caffeine takes much longer to clear out of a young baby’s system it is possible that high caffeine intake can make a baby irritable. If baby is sensitive to the caffeine now, they may not be when they’re older. Cut caffeine now and try again in a few months.
So if you drink a cup of coffee with 100mg of caffeine at 7am, you’ll have 50mg of caffeine in your bloodstream at 10am. Your baby would get 1.5mg of caffeine.
Every baby is different in how they react to caffeine. If you drank coffee while pregnant, your baby had an IV of caffeine (called the umbilical cord) and is already used to having it in their blood stream. If you didn’t drink coffee or switched to decaf, your baby may have a more noticeable reaction when you drink coffee. When drinking coffee after birth, go low and slow. There’s nothing you can do to decrease caffeine in your system except time. Start with a very small cup first thing in the morning and see how your baby reacts. Drinking your morning cup of coffee while your breastfeeding gives you the most time for the caffeine to peak and start decreasing before your next feeding.
