I Don't Have Enough Milk

“I Don’t Have Enough Milk”

By Samantha Crompton BNURS SACLC

New mothers are often overwhelmed with the insecurity that they will not be a good mother, that they will not do everything right. Over the years our confidence in the ability of our bodies to grow, birth and nourish our babies has been stripped from us. I often hear mothers say that they don’t have enough milk, and I always try and find out why they are saying this.

“The first milk is not enough, I need to top up until my milk comes in”, the milk coming in is an unfortunate term as it implies that there was no milk to begin with which is untrue. Despite mothers knowing the many benefits of colostrum, when they hear that it is measured in teaspoons and not tens of mls, they often think that can’t be enough for my baby, surely I must top up.

 A newborn with a stomach capacity of around 20ml translates into a feeding interval of around 1 hour. This is in line with gastric emptying of human milk and neonatal sleep cycles. Larger feeding volumes at longer intervals may therefore be stressful and the cause of spitting up, reflux and hypoglycaemia. (Bergman 2013)

 

Colostrum is low in fat, and high in carbohydrates, proteins and antibodies. Natures first vaccine. It is easily digestable, and has a laxative effect on baby helping to pass early stools, which aids in the excretion of excess bilirubin and helps prevent jaundice. Colostrum has an important role to play in babies gastrointestinal tract. A newborns intestines are very permeable. Colostrum seals or paints the GI tract mostly preventing foreign objects from penetrating. Small frequent feeds are all your baby needs, and your breasts will begin to produce mature milk increasing in volume as your baby grows. It is often not that our baby is feeding too often and not getting enough in these early days, but more that our expectations of how often baby needs to be fed are misdirected.

“My baby feeds all the time, my milk must be low or not strong enough”

Firstly it is good to know that frequent nursing is normal and expected in the early months. Most newborns need to nurse 8-12 times a day. It is needed to reduce engorgement in early days, nourish growing baby with a small stomach capacity but needs to double weight by 5-6 months, and to establish a good milk supply.

 SUPPLY = DEMAND. (Every formula bottle decreases demand therefore supply leads to vicious cycle).

Nursing is not only about nutrition, safety & security are basic needs. They just need mom, lots of kangaroo care in the first 6 weeks.

Managing expectations, it helps when the parents understand growth spurts or frequency days. I usually get the crying phone call at 2 weeks old. This is good baby suddenly turned on you and the lack of sleep caught up. Nature designed these frequency days to increase our milk supply to keep up with the growing demands of our baby. Your baby can feed every hour for 2-3 days and then usually returns to normal feeding patterns. They are difficult but if you are prepared for it mentally and physically. Adjusting expectations is the best way to cope. Once you consider frequent nursing in this time to be the norm and not a problem it will make life easier. Prioritise your to do list – List things that have to be done in the week and list things that can wait.

“When I pump, I am only getting ..ml’s”

Pumping is a good way to see how much milk you can pump. A baby that breastfeeds well can get much more milk out than you could ever pump. How much milk you can pump out depends on many factors. It is not unusual to have to pump 2-3 sessions to get enough milk for 1 feed. Pumped milk while breastfeeding full time is extra milk. It is normal for output to vary from session to session and day to day. Other things to consider:

-          Are you using the appropriate pump for the stage of nursing and the amount of pumping that you are doing. It is extremely difficult to pump colostrum with an electric pump. In early days hand expression is much better than any pump on the market. If you are pumping for a full day away, you may need a double electric pump to keep up.

-          Is the flange on the pump the correct size. Sometimes switching to a larger flange or getting the correct sizing makes all the difference.

-          How old is your pump?

There is also the lost art of Hand Expression. It is extremely important to  learn how to hand express. No need for electricity or batteries, hands are always with you. A number of my mom’s that battle to express using pumps get much better results when using hand expression or manual pumps.

How do I know that I really have a low supply?

As moms we tend to stress ourselves more than we need to. We obsess about knowing how much milk baby is getting. Let baby tell you how much milk he is getting.

-          The number of wet nappies your baby produces.

-          Weight gain problems such as a flat or dipping growth trajectory.

-          Consult with qualified SACLC or IBCLC lactation consultant

There are many factors that can cause a low supply, but it is not all doom and gloom, and the answer is not always come in a tin or a pill / supplement. We need to find the cause of your low supply and address the problem. Discuss these technicalities with a skilled lactation consultant and together you can find the right solution for you.

Samantha Crompton

BNURS RN RM community psych

South African Certified Lactation Consultant

Certified Preggi Bellies Instructor