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January 19, 2019
When you are a breastfeeding mum, there is no more divisive topic than milk supply.
When you mention milk supply to a group of mums, the types of responses you will commonly hear are things like: 'how is baby's output?' 'What makes you think you have low supply?' 'Real, diagnosed medical reasons for low supply are few and far between'.
Mixed in with lots of: 'I swear by lactation cookies or lactation tea', 'Oats are my saviour', 'Milo works for me', 'I eat salmon (or insert food that works for that mum) and my supply goes through the roof'.
These are all very valid points for different reasons. Let's break fact from fiction and look at the crux of supply issues.
To do that, we first have to understand how breastfeeding works. And to summarise a whole, complex range of theory into one line, breastfeeding is a supply and demand relationship. That means the more milk that is demanded by the baby or the pump, the more milk will be made for that baby or pump. This mechanism and beautiful little relationship is why people say 'most women can make enough milk for their baby and supply issues are few and far between.'
That theory is great, but for that supply to meet that demand, the breast has to be adequately stimulated and the milk has to be removed. The removal part is what causes the supply issues for most women who suffer from supply issues, not the ability to produce enough when the demand is effectively communicated to the brain and breast and that milk is adequately removed.
Now the good part of that, is that in many cases when the root cause is the removal of the milk (which will explore further below) this can be addressed and fixed.
It is a good time to also note the difference between supply types. What I mean by that, is that when you first have your baby, supply is hormone driven, the drop in certain hormones and the removal of the placenta signals your body to make milk. Supply changes to supply/demand anywhere from 6-12 weeks which is the specific type we are talking about in this blog.
At this point you might also be thinking, hang on you sell malt, lactation tea and cookies, won't that increase my supply? And the thing is while it most definitely will help (and was it was my saving grace), there is no magic potion, cookie or supplement that is going to magically increase your supply if you haven't got breastfeeding set up correctly - that is baby is latching correctly and/or pump is set up correctly/is effective for you and you are frequently and adequately draining the breast. Galactagogues (our lactation tea and lactation cookies etc) work best when they can do their job in the correct environment.
Think of it this way, if you fill a car up with petrol but it has a small leak in the fuel tank, the car will still work, it will still produce and function but it isn't going to go as far as it could if it didn't have the leak.
Galactagogues in this example are like the petrol, they will still work, but they will work best and deliver the best outcome if the hole in the tank is fixed.
I want you to be educated and have long term, healthy, success and enjoyable breastfeeding relationships and the first part to that is making sure the mechanics are addressed and understood. Once that is assessed, then absolutely, supplements that support your supply are no problem, but you shouldn't be looking to them to fix your supply issues, the root cause has to be addressed and fixed (if possible).
So outside of medically diagnosed supply issues (like insufficient glandular tissue/hypoplasia, endocrine disorders, previous breast surgery etc) what can cause these 'situational' low supply issues?
These types of supply issues (which are the most commonly experienced by women) are:
Incorrect/Poor Latch and or positioning.
An incorrect latch can be caused by lack of knowledge/education on what a correct latch is/feels like. Or can be caused by other issues, such as tongue and lip ties, palate issues, or medical issues with baby, tired baby from a complicated or long delivery or instrumental birth causing pain/discomfort. All these things can cause inefficient removal of milk - nipple shields can also cause a reduction in milk transfer and consequentially - lowered supply. If you are experiencing any of these things, please seek the immediate assistance of a International Board Certified Lactation Consultant and one that is experience in ties if your nipples are damaged/grazed or breastfeeding is painful. Those things are not normal and not just a part of breastfeeding. Ties can be the culprit and you need a health professional trained in them. I have heard so many stories of midwives, doctors and nurses all telling new mums that their baby doesn't have a tie before they find someone trained in them and can help them get the issue sorted.
For many mums for many different reasons, pumping milk and feeding via a bottle is the only way they can get breastmilk to their baby (myself included with my 4th baby). A breast pump isn't as efficient as removing milk as a baby, so increasing supply can be a hard slog with a pump, hence why pumping mums often have to work hard to train their breasts to react to the pump and do other tips and tricks to get the volume of milk needed to feed their bubs. Having to pump is why I created my lactation tea - I needed to pump more milk and outside of pumping more frequently, my tea blends saved my journey and allowed me to get more milk. I know personally that my pumping output isn't a reflection of how much milk I have, but when it is your only source of removing the milk, you work with what you have got!
Insufficient breast stimulation.
Baby's breastfeed for so many other reasons than just hunger and it is not only good for our baby's, the stimulation of the breast is great for our milk supply. That is why the use of a pacificer/dummy isn't recommended in those early days, as the use of them can reduce the amount of time baby is on the breast stimulating.
Feeding to a schedule/formula instead of allowing baby unrestricted access to the breast. Both of these things can cause the amount of time baby is on the breast to be reduced and hence reduce the much needed stimulation. Read more about The Top Up Trap.
Low milk supply can be increased by:
Most importantly, if you do believe you have supply issues, find a IBCLC -international board certified lactation consultant who can work with your individual situation and come up with a plan. You can also get in touch with the Australian Breastfeeding Association.
If you do believe you have supply issues, making sure you baby is getting adequate milk is your number one priority which is a combination of weight gain and adequate wet and dirty nappies in a 24 hour period. Immediately talk to your midwife, lactation consultant or doctor to check this if you have any concerns.
Find a lactation consultant:
Australian Breastfeeding Association:
The next question that most women have after wanting to know how to increase their supply is 'is my baby getting enough milk'. Read that blog post next!
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