“Am I starving my baby?” is a question I hear often.
Milk supply is a very popular topic of conversation. Many new moms worry that they aren’t producing enough milk and that they are “starving their babies” by trying to breastfeed. This self-doubt is largely a result of their lack of breastfeeding education and is fed by fear-provoking medical providers, myths shared by family and community members, and the false realities of social media.
Medical providers are quick to scare new moms about breastfed babies losing weight after birth, but fail to explain that some weight loss is normal. According to Stanford Medicine, “it is normal for term infants to lose up to 7% of their birth weight before regaining it by day 10.” Additionally, grandmas and aunties work hard to convince moms to “put some cereal in that baby’s bottle” or to “give that baby some formula,” like somehow human milk for human babies is insufficient. And, don’t get me started on the social media trend of “feeding the freezer” or storing insanely large amounts of breast milk, way more than needed for a baby’s tiny stomach and more than those babies will likely ever use.
Those are a few examples of how society destroys what little confidence new moms have in their ability to properly nourish their babies. While my one piece of advice for all expecting parents, who are planning to breastfeed, is to take a prenatal breastfeeding class or to have a prenatal lactation consultation; there are many new moms who haven’t done so and who are trying their best to make breastfeeding work.
To help more moms walk confidently in their breastfeeding journeys, I’m aiming to educate and empower by sharing:
- how breast milk is made,
- how much milk baby needs,
- how to know if baby is getting enough,
- how to increase breast milk supply, and
- when to seek help.
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How breast milk is made.
Breast milk production begins during pregnancy and up until about day two following birth, production is regulated solely by hormones. According to kellymom, after both the baby and the placenta are birthed, breast milk production switches from hormonal (endocrine) control to autocrine (local) control, which requires baby’s suckling or alternative breast stimulation for milk to be released. Therefore, breastmilk production switches to a “supply and demand” process. Generally speaking, the more you feed your baby or the more you empty your breasts, the more milk you will produce.
How much milk baby needs.
Contrary to what you may think, babies have tiny stomachs and do not require a lot of milk. According to La Leche League Canada, at one day of age, babies’ stomachs are about the size of a cherry and can only hold about 1 teaspoon of milk. So, those drops of colostrum (the thick antibody-rich first milk) are more than enough for baby. By one week, babies’ stomachs are about the size of an apricot and can hold between 1-1.5 ounces of milk. By one month, babies’ stomach is about the size of an egg and can hold between 2.5-5 ounces of milk. So those Instagram posts of overflowing 8-ounce baby bottles are in no way a depiction of how much milk babies need.
According to kellymom, “research tells us that exclusively breastfed babies take in an average of 25 oz (750 mL) per day between the ages of 1 month and 6 months.” The amount of expressed breast milk to feed a baby is calculated based on the number of feeds per day. There are 24 hours in a day and on average breastfed babies hunger about every 2-3 hours. If feeding your baby every 3 hours, that would be 8 feeds a day. If feeding your baby every 2 hours, that would be 12 feeds per day. So, that’s 8-12 feeds a day.
Now, let’s factor in the 25 ounces of milk per day. A baby eating 12 times a day would need a little over 2 ounces per feed. And, a baby eating 8 times a day would need a little over 3 ounces per feed. That’s 2-3 ounces of breast milk needed per feed.
So many moms reach out in a panic about only pumping 2 ounces from one breast, not realizing that their baby only needs 2-3 ounces total. Nor have they been taught that pumping output is not equivalent to breastfeeding output as babies are always more effective at removing milk than a breast pump.
How to know if baby is getting enough.
Now that you know how much milk babies need, let’s discuss how to know if they are actually getting enough milk. The key to good feeding is a good latch (or attachment to the breast).
In order to get a good latch, both mom and baby should be as comfortable as possible. To do so, the mom should sit to feed the baby at first signs of hunger and not wait until the baby is overly hungry, crying, and agitated. When the baby first begins to “root” or show interest in feeding, the mom should get seated in a comfortable position with lots of pillows to prop the baby on so the baby can be close to the breast. There are several ways a mom can position the baby at the breast. I find the “cross-cradle” or the “football” hold to be the easiest during those early days.
Once mom and baby are in position, there are a few steps to take to help the baby achieve the deepest latch possible:
- mom should place her nipple to the baby’s nose,
- wait for the baby to open wide,
- touch the bottom of her areola to the baby’s chin, and
- then gently tilt the baby’s head so its upper lip closes over the nipple.
Kellymom has a great illustration of this process for achieving the perfect latch.
Once the baby is latched comfortably and without pain, there are signs to tell if they are feeding well, including:
- feeling consistent suckling,
- hearing swallowing
- seeing milk in the baby’s mouth,
- baby seeming content and relaxed with unclenched fists after feeds,
- feeling softer breasts after feedings,
- baby having appropriate amounts of wet and soiled diapers, and
- baby gaining weight consistently.
If these signs of a good feed are present, there’s no need for a mom to question her supply.
How to increase supply.
Though rest, nutrition, and hydration are important for maintaining a good milk supply, the most effective method for increasing breast milk supply is to remove more milk. While pumping is breastfeeding and there are exclusive pumpers, babies are always more effective at removing milk than pumps. So, if a mom wants to make more milk, she should perfect her baby’s latch, cuddle up with her baby, and put the baby to the breast often.
For my moms looking to increase supply, I recommend they latch their baby as much as possible. If the baby makes a coo, latch them. If the baby whines, latch them. And, of course, if the baby cries, definitely latch them. While babies cry for reasons beyond hunger, when trying to increase supply, I always recommend latching. And for extra breast stimulation, I recommended pumping for a few minutes (10 mins should be enough) after each session. Additionally, if they are up for it, they can grab some nipple butter and add a power-pumping session to their schedule.
More importantly, moms supplementing feeds with formula or breastmilk need to express milk each time the baby has a bottle. Often pediatricians recommend formula supplementation for moms who come in saying they have a low supply. However, because these professionals are not trained in lactation, they fail to provide the mom with a care plan for maintaining her supply. So, the moms start out supplementing a few feeds but end up needing to supplement even more feeds because they fail to remove milk. If the mom’s goal is to eventually be able to exclusively breastfeed, she will need to remove milk each time her baby is bottle-fed.
Breastfed babies eat (from breast or bottle) 8-12 times a day. To be able to meet the baby’s demands, moms need to remove milk from their breasts (by nursing, hand expressing, or pumping) 8-12 times a day. If milk is not used (removed), it is lost. Full breasts signal to your body that your baby doesn’t need it, so you begin to produce less. On the contrary, empty breasts signal your body to make more. So, to make more milk, remove more milk.
Just as a deep latch is important for effective milk removal, so is proper breast pump flange fit. Anytime pumping moms have concerns regarding supply, I recommend they measure their nipples to determine their proper flange size. They can download a free nipple ruler or purchase a nipple ruler from Amazon. Most moms are using the wrong flange sizes—usually too large—and therefore have low output and do not effectively drain their breasts, which signals to their bodies to make less milk.
While I sometimes recommend a few supplements to help with clogged ducts, I rarely recommend supplements for low milk supply. I often find that with proper rest, nutrition, and hydration, and after a few days of effective milk removal, many moms notice an increase in supply.
When to seek help.
For those who’ve tried all the recommendations listed above and still struggle with supply, or for those who prefer personal coaching, I recommend they consult a lactation professional. A Certified Breastfeeding Specialist (CBS) or a Certified Lactation Counselor (CLC) can help with the normal course of lactation, can provide guidance around positioning and latch, and can help families determine if their babies are getting enough milk. For more complex issues regarding breast milk supply, like breast surgeries or medical issues for mom or baby, families should consult an International Board Certified Lactation Consultant (IBCLC). These professionals can be found online or healthcare providers can provide referrals. Additionally, insurance companies can provide lists of in-network providers.
If you haven’t already, check out our blogs, “Anxious About Breastfeeding? Do This One Thing for Greater Success!” and “15 Breastfeeding Essentials for New Moms.“
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