SingaporeMotherhood | Baby & Toddler

October 2012

Understanding Your (Breast) Milk Supply

“I have often wondered whether I have enough milk. My son has always been small-built compared to other babies his age. Family members and friends have also commented that I may not have enough milk, adding to my worry,” shares Tania Ho, a stay-at-home-mum to eight-month-old Jayden.

Like Tania, many breastfeeding mothers are concerned about producing enough milk to keep up with their babies’ growing needs. Working mothers who pump milk for their babies also experience uncertainty about their milk supply.

Rest assured that the majority of women is able to produce sufficient milk for their nurslings. Many women are able to produce milk to meet the needs of more than one baby or for siblings of different ages. Here’s why.

How Milk Is Made

Let’s start at the beginning, with milk production. In a female, the development of breasts begins at foetal stage, continuing throughout childhood. After puberty and before pregnancy, more structures develop in the breasts during each ovulatory cycle, until a woman is about 35 years of age.

During pregnancy, your milk-producing glandular tissue grows significantly. Milk production begins in mid-pregnancy and takes off three to five days after the birth of your child.

During pregnancy, and in the first days after delivery, the production of milk is largely controlled by hormones. At about nine days after delivery, breastmilk production is controlled to a lesser extent by hormones. It now works on a system of supply and demand – the greater the amount and frequency of milk removed, the greater the amount of milk produced.

Breastfeeding experts Diana West and Lisa Marasco, authors of The Breastfeeding Mother’s Guide to Making More Milk, say in their book that the components needed for good milk production are:

  • Adequate glandular tissue
  • Intact milk channels and nerves
  • Sufficient hormonal influence and
  • Effective, frequent removal of milk

They also say that how often and effectively your baby feeds during the early days after birth helps your body create its blueprint for later milk production. Simply put, this means that more feeding early on leads to more milk later!

Your Mind’s Influence on Milk Supply

When it comes to milking it, mind does work over matter. Think positive! These feel-good thoughts and emotions, plus nurturing mothering behaviour towards your baby, can influence hormonal levels and boost milk supply.

Sherrie See, a mother of three breastfed babies, believes that communicating, spending time with your baby and being attuned to his needs all help to get the milk supply up. “I think emotional attachment and the physical ability to nurse your baby are somehow intertwined!” the 38-year-old executive shares.

Low Milk Supply?

Many new breastfeeding mothers suspect that they have low milk supply. There are a variety of reasons for this. Firstly, it is easy to mis-read common baby behaviour and think that your baby is reacting in a certain manner because you do not have enough milk.

While you are in the process of learning to decipher your baby’s behaviour, it is easy to misread common behaviours as signs of a low milk supply. The following are some commonly misinterpreted baby behaviours and the reasons why they do not necessarily indicate low milk supply:

iFrequent feedings

  • Newborns have small stomachs that require frequent fill-ups.
  • Babies nurse for food as well as for comfort; your baby may want to breastfeed more frequently when he needs more comforting. Your baby may also nurse more frequently than another baby his age because of different temperament or needs.
  • Your breasts’ storage capacity also affects feeding frequency. A larger storage capacity means there is more milk available for your baby to consume at one feed, allowing for a greater feed interval.

Cluster feeds

  • Cluster feeding is when babies space many feeds close together at certain times, keeping feeds at other times spaced farther apart. Your baby may nurse for a few minutes, pull off, cry, nurse more, and pull off again. This behaviour is normal.

Frequency days

  • When your baby is going through a growth spurt, frequent feeding signals your body to produce more milk to meet his increasing needs.

Arching, choking, clamping down or tugging at the nipple

  • Your baby’s behaviour at the breast often indicates how comfortable he is with the rate of breastmilk flow. Arching, clamping down or turning away from the breast may mean that you have an oversupply or a flow that is too fast for your baby!

Frequent night feeding

  • Some babies breastfeed more often at night. Nightwaking is part of how babies sleep. If you are separated from your baby during the day, he may breastfeed frequently at night to make up.

Some mothers may feel insecure about their ability to provide enough breast milk for their babies because of what they are going through. They are confused by their breastfeeding experiences:

Inability to feel letdown

  • Many mothers do not feel letdown; even if you felt letdown early on, the sensation may fade as your baby grows older.

Breasts feel less full or leak less

  • Feelings of breast fullness decrease as your milk supply starts to sync with your baby’s needs, usually six to 12 weeks after birth. Some mothers continue leaking for many months, others never leak from day one!

Decrease in the volume of expressed breastmilk

  • If you are expressing breastmilk for your baby routinely, you may feel under pressure to produce ‘adequate’ output each time! However, the amount of milk you express is not a clear measure of your milk supply. It is normal for the amount of pumped breastmilk to vary on different days and at different times. The volume of milk expressed also depends on the quality of the breastpump, the fit of the shield, and your response to the pump.

Investigating Your Milk Supply

You can figure out if you have milk supply issues by looking at the various signs that make up the whole picture. Ask yourself: Is my baby getting enough? You can find out if your baby is getting enough milk by checking his weight gain, diaper output and sucking patterns.

Your newborn’s stools should resemble this:

Days 1 & 2
1 bowel movement, black, tar-like

Day 3
1 bowel movement, green

Day 4
2-3 bowel movements, green or mustard

Until 6 weeks
Frequent, at least 2-3 mustard bowel movements daily

After 6 weeks
Varies, 3-5 times daily or one bowel movement every few days

Is the problem my supply or my baby’s intake?
You may be able to produce enough milk but your baby may have difficulty removing that milk if she has latch or suck problems. Your body then receives the message to decrease production. Check if your baby is latching on properly. An effective suck consists of “a wide-open-mouth, followed by a pause as milk fills your baby’s mouth, then a lifting of his lower jaw as he swallows. Deep, rhythmic swallows mean that your baby is taking in large amounts of milk”, The Ultimate Breastfeeding Book of Answers describes. A lactation consultant can help to check your baby’s latch.

Is my body the problem?
Is the low milk supply caused by a problem within my body? Did I start out with the ability to produce a full supply, only to have the ‘supply-and-demand chain’ disrupted?

For Sherrie, whose children are now 10, 7 and 3, her babies led the way. “What I found most intriguing was that the child himself determined my milk supply. My supply simply followed the baby’s feeding pattern!” Let your baby communicate his needs to your body. Your body will respond accordingly. Remember to take care of your body and mind, equipping yourself with the energy and nutrients you need.

Does my baby have unlimited access to breastfeeding?
Feeding frequently without scheduling or timing feeds allows your baby to drain the breasts adequately. Avoiding pacifiers or bottles helps your baby to keep breastfeeding effectively, encouraging supply. Finally, breastfeeding directly at night promotes milk production because the hormonal response to baby’s suckling is greater at night.

Breastfeeding is Designed to Work!

Mothers living in very different conditions, from past generations, and from cultures throughout the world have been able to produce sufficient milk for their babies no matter what circumstances they are in. Milk production is a robust process, designed to work despite the toughest challenges. So trust in yourself, in your body, and in the design and synchrony of breastfeeding!

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Understanding Your (Breast) Milk Supply