Supporting Breastfeeding

La Leche League Canada

Establishing Your Milk Supply

on September 22, 2014

 

A baby’s need for milk and his mother’s ability to produce it in just the right quantity is one of nature’s most perfect examples of the law of supply and demand.  Until the mass production of artificial formula, the survival of the human race depended on mothers’ ability to produce enough milk to nourish their babies.  Establishing and maintaining an ample milk supply can be easy, as long as you understand how it is regulated.  Knowing how to avoid things that upset the balance of supply and demand is important when establishing your milk supply.  A baby who is not gaining well should be checked by a doctor.  However, knowing the following information will enable you to improve weight gain while protecting the breastfeeding relationship.

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Milk is produced almost continuously:  the more often the baby nurses, the more milk there will be.  Frequent nursing and effective sucking signal the mother’s body to produce the amount of milk her baby needs.  These are the keys to an abundant milk supply and a contented baby.  The first milk the baby gets after birth is called colostrum.  It is rich in antibodies and other protective factors.  The small quantities give babies a chance to learn how to suckle without being overwhelmed by milk.  Production of colostrum starts during pregnancy and continues even after the mature milk comes in.

The delivery of the placenta tells the body to start producing milk.  This happens whether a mother is breastfeeding or not.  By day 3-5, mother’s milk comes in and volume increases. Frequent nursing and regular removal of the milk stimulates the breast to produce more milk. Milk changes through a feeding and throughout the day to meet a baby’s changing needs. Foremilk, at the beginning of a feeding session, contains less fat and more water.  Hindmilk, later in the feeding, contains more fat and is higher in calories.  Babies need both foremilk and hindmilk to provide total nutrition

Breastfeeding early and often is one of the most important factors in getting breastfeeding off to a good start.  Babies who are allowed to breastfeed within an hour of birth and then at frequent, unrestricted intervals, help mother establish a good milk supply sooner than those who are put on a strict feeding schedule.  Newborns usually nurse about every two hours, or at least 8-12 times per day; some may nurse even more frequently.  Feeds may not be spaced evenly throughout the day.  Some babies cluster several feeds together and then sleep for a longer stretch.

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Holding the baby skin to skin on your chest calms and soothes him after the journey of birth; it can help baby to regulate temperature and heart rate.  Skin contact also heightens the hormones that naturally produce milk.  Many babies can latch more easily when they are gently welcomed to the mother’s breasts.  In fact, many babies who are held upright between the mother’s breasts respond by squirming and bobbing until they position themselves at the breast and latch on.

Allow the baby to nurse as long as he seems interested, right from the start.  It may take the milk a few minutes to let down, or start to flow, so limiting breastfeeding to a short time frame may mean the baby won’t get sufficient milk.  A baby needs to nurse long enough to get the milk flowing and also to receive hindmilk.

Offer both breasts at each feeding, especially in the early days.  A newborn should be nursing on each breast at least every two to three hours (except for, perhaps, one longer stretch at night) in the weeks when the milk supply is becoming established.  Let the baby stay on the first breast as long as he is actively sucking and swallowing to ensure he gets hindmilk.  When the sucking slows down, it will be easy for you to release the latch, or your baby may come off by himself.

Offer the second breast.  If baby is still hungry he will latch on and suckle, showing signs of active swallowing with deeper jaw motions; if not, that is alright.  At the next feeding offer this breast first.  Offer both breasts at each feed, but let baby decide if he wants the second side.

Be sure the baby is latched and sucking effectively.  Positioning the baby correctly and ensuring a good latch (attachment to the breast) prevents sore nipples and allows baby to get plenty of milk.  The baby should have a large mouthful of breast tissue; babies breastfeed, not nipple feed.  Sore nipples may be a sign of poor latch; consult a health professional or La Leche League Leader for help.  Newborn babies often become sleepy after a few minutes of sucking. Your baby will feed more effectively when stimulated with some tickles or movement closer into the breast.

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Breastfeed as often as your baby indicates the need; this is called cue feeding.  Some cues include licking lips, restlessness, rooting (turning head towards breast) or mouthing hands. Crying is a late hunger cue.  Nature intended for babies to feed frequently.  Your baby is used to being fed continuously while in the womb.  Some newborns take time to learn their own signs of hungry and full.  They might suckle for several minutes, then come off, but start fussing or rooting if you try to put them down.  Many factors, such as birth experience, maturity, human contact, and access to the breast can affect the baby’s learning.  Respond to his cues and he will learn to trust that his needs will be met; and you will begin to recognize patterns to your breastfeeding sessions.  It gets easier as you get to know each other.  If your baby regularly sleeps more than three hours between feedings and is not gaining well, he may need to be awakened for feedings at least every two hours during the day until your milk supply is well established.

The law of supply and demand also works in reverse: the less often the baby nurses, the less milk there will be.  This might happen if you try to schedule feeds 3-4 hours apart, or if supplemental feedings with formula or water are introduced.  Pacifiers, which satisfy the baby’s need to suck, can also interfere with milk supply.  However, older babies (2-3 months old) do sometimes space their feedings further apart and/or reduce the time they spend at the breast, but still gain well.  This means that they can get the milk they need faster, and mother’s supply is matching baby’s demand.

How do I know my baby is getting enough to eat?  If the baby has six very wet diapers (more if you use cloth) and three to five bowel movements, each the size of a $2 coin, per day (after 3 or 4 days old) and is not being given anything but your milk, you can see he is getting plenty of nourishment.  An older baby may have bowel movements less frequently, but they should be plentiful.  The baby will also start gaining 115-200 grams (4-7 ounces) per week.

Growth spurts or frequency days occur 3-4 times in the first 3 months as the baby matures. Allowing him to nurse on cue, which may seem like all the time, for two or three days will increase your milk supply to meet his needs.  Trust that your milk supply can adjust and increase as your baby grows.

Newborns nurse for many reasons other than hunger.  Your baby may breastfeed often because he likes the feeling of security and close body contact, because he needs to satisfy his sucking need, or because he finds the sound of your heartbeat and the gentleness of your touch a great source of comfort as he adjusts to his new world.  Meeting these needs will not spoil your baby; it will teach him that there are people he can trust to keep him happy, safe and comfortable.

La Leche League group meeting

La Leche League group meeting

 

Mothers need the support of other mothers.  La Leche League meetings can be one place to find this support; Leaders are here to help you enjoy your breastfeeding experience.  With the support of your health care provider to help you see that your baby is growing well, and the practical and moral support mothers find from other mothers, you can ensure your baby thrives on the milk your body provides.  Find out more at lllc.ca

Quick Tips

  • Breastfeed early (within an hour of birth) and often(8-12 times / 24 hours).
  • Skin-to-skin contact between mother and baby enhances milk supply.
  • Ensure baby has a good latch. (Get help if needed, especially if nipples are sore.)
  • Offer both breasts at every feeding in the early days.
  • Ensure baby is actively sucking and transferring milk while at the breast.
  • Supply and Demand—the more the baby nurses, the more milk you will produce.
  • What comes out must have gone in: 5-6 wet diapers and at least 3 bowel movements the size of a $2 coin per day.
  • Babies breastfeed for comfort as well as food.
  • A supportive network of other mothers can help smooth out the bumps in the road.

http://www.lllc.ca/hp-information-sheets

 

If you need more information or have a breastfeeding problem or concern, you are encouraged to talk directly to a La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

 

 

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