Do I have enough milk?

This is a common concern about breastfeeding. In fact, it is one of the most common reasons for a mom to stop breastfeeding because she is worried that she doesn’t have enough milk.

If you are asking yourself if you have enough milk, or you are worried that you don’t and are thinking you should switch to formula, please contact a lactation consultant. She can help you determine if you do have enough milk or truly do have a low supply.

There are several different reasons a woman might have a low milk supply, and she can help you determine what the reason might be. This, in turn, can affect the recommendations for treatment.

There is not one intervention that will help everyone.

Common Reasons a Mom Doubts her Milk Supply

• Your baby wants to breastfeed frequently.
• Your baby eats frequently and someone comments on it being too often.
  • My mother-in-law did this with all three of my babies, no matter how chubby they were. The ironic thing about this was, the two who ate the most frequently were the chubbiest, the one who ate less frequently was the one who had weight gain issues.
  • I was one of those moms who had plenty of milk, but I needed to feed my babies frequently
• You have read a book that recommends scheduled feedings, and the intervals are longer than your baby wants to go between feedings
• When your baby goes to daycare, the daycare provider says she needs more milk than what you are providing
• Your baby eats a greater amount from a bottle than what you can pump
• Your friends can pump large amounts of milk than you can, even after feeding.
• Your baby isn’t as chubby as some of the other breastfed babies that you see

There are ways to see if your milk supply is enough to meet your baby’s needs.

The most effective way is to see if he is gaining a normal amount of weight for his age. That is always the bottom line.

If you are exclusively breastfeeding and your baby is gaining enough weight, then you have enough milk.

Some moms still might be concerned. The might try ineffective ways to check their milk supply, such as:

• Breastfeeding and then offering their baby a bottle of their pumped milk, or formula. If he takes it, they think that means they don’t have enough milk to satisfy him
• Pumping instead of feeding to see how much milk they have
• Giving their baby a bottle and seeing how much he takes and comparing it to how much they can pump

There are some things that can increase your milk supply.

I will share the most effective ways, in my experience, to increase milk supply.

I always stress that you should work with a lactation consultant if you are not seeing the kind of weight gain that is expected, or if you just want the reassurance to know that everything is normal.

If you do meet with a lactation consultant, and she has confirmed that you have a low milk supply, she has also probably told you about ways to increase your milk supply. I may say the same things.

These may be additional things you can try.

Let your lactation consultant know about other things you want to do. She can help you determine if they make sense in your situation.

The Basics of Ensuring a Good Milk Supply

Some moms will never have a good milk supply, no matter what they do.

Other moms can do everything wrong and still have a great milk supply or even too much milk.

The vast majority of moms make enough milk for their babies if they are covering the basics to ensure a good milk supply.

• Frequency: the baby needs to eat, or you need to be pumping, enough times, especially in the early days of your baby’s life. This will be at least 8 times every 24 hours.
  • Keep in mind though that a baby who eats 10-12 times in a 24 hour period is still perfectly normal.
  • You should be feeding your baby whenever he shows feeding cues.
    • These are: opening and closing his mouth, sticking out his tongue, smacking his lips, rooting, sucking on his hands. Crying is a late feeding cue.
• Thorough draining of the breasts.
  • Every time milk is taken out of your breasts it sends a message to your body.
    • If you leave a little bit of milk in your breasts, it tells your breasts to make about the same amount as what was taken out.
    • If your drain your breasts as much as possible, then they will usually make more, over time.
    • If you leave a lot of milk in your breasts, it tells your body to make less milk.
    • It might take some time for your body to start to make more or less milk.
    • Remember that your breasts are always making milk, even when you are feeding, so you will probably always be able to express some drops, even when your baby has done a really good job of draining them.
• Good Latch: It is very important for effective draining that you have a good latch.
  • Usually, you will know if your latch is good if it doesn’t hurt when you breastfeed, and your nipple is round when your baby comes off.
  • Some discomfort in the early days can be ok but check with a lactation consultant just to be sure if you are having any discomfort.

Additional Stimulation Can Help Increase Milk Supply

• Getting your baby to eat more frequently
• Pumping after your baby breastfeeds
• Hands-on pumping is also very effective to help your breasts make more milk.

Herbs that can Increase Milk Supply

I live in a community where alternative medicine is very common. It is common for the moms I see to have heard about herbs that can increase milk supply and use them. There are many herbs that can help increase milk supply.

The most common herbs that increase milk supply are:

• Fenugreek – seems to be more effective when taken as a tincture. It should make you smell like maple syrup. If it causes GI upset, try decreasing how much you are taking. If you don’t take enough, it won’t be effective. If you take too much, you’ll probably have GI upset.
• Goat’s Rue – most commonly found as a tincture.
• Shatavari – not as common, but can be very effective. Most commonly found as capsules.

There are also some tinctures that are combinations of these herbs.

I think it is best to start with one single herb and see how your body reacts to it. If you take a combination and you have a bad reaction, you won’t know which herb caused it, especially if the herbs are not something you have ever consumed before.

If you have taken all the herbs in the combinations then they are good options for some.

A really great resource for low milk supply in general and specifically different herbs and dosages is the book,“Making More Milk” by Diane West and Lisa Marasco. They also have a website with thorough information on herbs, www.lowmilksupply.org.

Additional Things to Increase Milk Supply

• Another very effective treatment for increasing milk supply is acupuncture. The moms I have worked with have found it really helps
• Lactogenic foods. These are foods that are believed to help milk production.
• Medications
  • Reglan/Metoclopramide – this is a drug that has a black box warning due to the potential side effects and one of the side effects is depression, and being postpartum already puts you at risk for depression
  • Domperidone – while this drug is designated an orphan drug by the FDA, it is not currently FDA approved. Some moms can still get it, either at a compounding pharmacy, or online from countries where it is legal, and available without a prescription. I suggest you do research to understand the pros and cons of this drug, and you should definitely not take it without professional advice and supervision

Things that Probably Won’t Hurt, or Help Much

When Trying to Increase Milk Supply

• Teas, unless herbs are fresh and high quality. Get from a store that specializes in herbs
• Cookies
• Beer
• Brewer’s Yeast

Remember, the bottom line is always weight gain.

The older your baby gets, weight gain slows down, and weight gain can vary from week to week.

If you are concerned about, or are documented to have, low milk supply, it is always best to work with a lactation consultant to verify the issue, try to figure out why it is occurring and come up with a plan, and then assess whether the plan is working.

One Final Thought

Breastfeeding is not an all or nothing deal. If your milk supply is low, every bit of it that you can give to your baby is valuable.