Low supply? LOOK HERE FIRST!

Celeste - posted on 07/26/2012 ( 5 moms have responded )

HOW DO I KNOW MY BABY IS GETTING ENOUGH BREAST MILK?
If your baby is getting enough diapers, your baby is getting plenty and your supply is fine.

Wet diapers -- A newborn should have one wet diaper the first day of life, at two days old, two wet diapers and so on until 4 days old. A baby 4 days and older should have 4-6 sopping wet diapers in 24 hours. The colour of urine is also a good indication of adequate hydration. A baby that is transferring milk well, will have light, pale urine. If it is dark (like apple juice) with a strong odor, seek the help of a professional.
Stools (bowel movements) -- If your baby is younger than 4-5 days old, she will have tar-like stools (meconium). Usually at 3 days old, the meconium starts to thin and by 5 days it should be yellow (sometimes green), watery and seedy. Babies younger than 4 weeks usually have several bowel movements in a 24 hour period.
Weight gain -- It is normal for an infant to lose weight in the first few days of life, but most babies are back to their birth weight by 2 weeks old. If your baby is 2 weeks or older and gaining weight, this is a good sign that your baby is getting enough. REMEMBER: Scales can vary and growth charts don't always include breastfed infants (they are usually based off of formula-fed infants). How your baby will gain weight can be due to genetics. As long as your baby is GAINING WEIGHT STEADILY, how ever much (or little) weight that may be, is what is important.



let's discuss what does *NOT* mean low supply
"My baby is fussy all the time! Could my supply be low?"

Crying does not mean low supply.There could be many reasons why babies cry that is not related to supply.

Taken from kellymom:
http://kellymom.com/parenting/parenting-...
"What causes babies to be fussy?

If you feel that your baby’s fussiness is not normal, it’s never a bad idea to get baby checked by the doctor to rule out any illness. A common cause of fussy, colic-like symptoms in babies is foremilk-hindmilk imbalance (also called oversupply syndrome, too much milk, etc.) and/or forceful let-down. Other causes of fussiness in babies include diaper rash, thrush, food sensitivities, nipple confusion, low milk supply, etc.

Babies normally fuss for many reasons: overtiredness, overstimulation, loneliness, discomfort, etc. Babies are often very fussy when they are going through growth spurts. Do know that it is normal for you to be “beside yourself” when your baby cries: you actually have a hormonal response that makes you feel uncomfortable when your baby cries."

Another reason why baby may be fussy is overactive letdown:
http://kellymom.com/bf/got-milk/supply-w...
Does your baby do any of these things?

Gag, choke, strangle, gulp, gasp, cough while nursing as though the milk is coming too fast
Pull off the breast often while nursing
Clamp down on the nipple at let-down to slow the flow of milk
Make a clicking sound when nursing
Spit up very often and/or tend to be very gassy
Periodically refuse to nurse
Dislike comfort nursing in general
If some of this sounds familiar to you, you probably have a forceful let-down. This is often associated with too much milk (oversupply). Some mothers notice that the problems with fast letdown or oversupply don’t start until 3-6 weeks of age. Forceful let-down runs the gamut from a minor inconvenience to a major problem, depending upon how severe it is and how it affects the nursing relationship.


"My baby is nursing frequently, could my supply be low?" Or "My baby is never satisfied, could my supply be low?"

It is very normal for babies to nurse frequently. Babies need to nurse AT LEAST 8-12 times a day. You can never nurse too much, but you can nurse too little

Babies will also go through growth spurts where they will nurse often.

Taken from kellymom:
http://kellymom.com/bf/normal/growth-spu...
What is a growth spurt?

During a growth spurt, breastfed babies nurse more often than usual (sometimes as often as every hour) and often act fussier than usual.

The increase in baby’s milk intake during growth spurts is temporary. In exclusively breastfed babies, milk intake increases quickly during the first few weeks of life, then stays about the same between one and six months. As solids are gradually introduced after six months, baby’s milk intake will gradually decrease.

Physical growth is not the only reason that babies may have a temporary need for increased nursing. Babies often exhibit the same type of behavior (increased nursing with or without increased fussiness) when they are working on developmental advances such as rolling over, crawling, walking or talking. Mom’s milk is for growing the brain as well as the body!

When do babies have growth spurts?

Common times for growth spurts are during the first few days at home and around 7-10 days, 2-3 weeks, 4-6 weeks, 3 months, 4 months, 6 months and 9 months (more or less). Babies don’t read calendars, however, so your baby may do things differently.

Growth spurts don’t stop after the first year – most moms notice growth spurts every few months during the toddler years and periodically thereafter on through the teenage years.

How long do growth spurts last?

Growth spurts usually last 2-3 days, but sometimes last a week or so.

What is the best way to handle a growth spurt?

Follow your child’s lead. Baby will automatically get more milk by nursing more frequently, and your milk supply will increase due to the increased nursing. It is not necessary (or advised) to supplement your baby with formula or expressed milk during a growth spurt. Supplementing (and/or scheduling feeds) interferes with the natural supply and demand of milk production and will prevent your body from getting the message to make more milk during the growth spurt.

Some nursing moms feel more hungry or thirsty when baby is going through a growth spurt. Listen to your body — you may need to eat or drink more during the time that baby is nursing more often.



"My breasts seem softer and empty now, could my supply be low?"

Soft breasts are working breasts. Full breasts slow down production. Read this article, it explains how milk production works.

http://kellymom.com/pregnancy/bf-prep/mi...

Also, around 3 months, supply regulates meaning your supply is right where it needs to be. It has responded to your baby's needs. This is also normal!

"I can only pump 2 oz, does this mean my supply is low?"

No, never judge supply by pump output. Please note that average pump output is 1/2 to 2 oz from BOTH breasts. Also, it is normal for pump output to decrease over time. This doesn't mean supply is decreasing.

Also, babies are much more efficient than a pump.

Finally, if your baby is getting plenty of diapers, your baby is getting enough:
Go here on more information about diapers:
http://kellymom.com/bf/got-milk/supply-w...


If your baby is not getting enough diapers, here are ways to increase supply (taken from kellymom)

http://kellymom.com/bf/got-milk/supply-w...
OK, now on to things that can help increase your milk supply:

Make sure that baby is nursing efficiently. This is the “remove more milk” part of increasing milk production. If milk is not effectively removed from the breast, then mom’s milk supply decreases. If positioning and latch are “off” then baby is probably not transferring milk efficiently. A sleepy baby, use of nipple shields or various health or anatomical problems in baby can also interfere with baby’s ability to transfer milk. For a baby who is not nursing efficiently, trying to adequately empty milk from the breast is like trying to empty a swimming pool through a drinking straw – it can take forever. Inefficient milk transfer can lead to baby not getting enough milk or needing to nurse almost constantly to get enough milk. If baby is not transferring milk well, then it is important for mom to express milk after and/or between nursings to maintain milk supply while the breastfeeding problems are being addressed.
Nurse frequently, and for as long as your baby is actively nursing. Remember – you want to remove more milk from the breasts and do this frequently. If baby is having weight gain problems, aim to nurse at least every 1.5-2 hours during the day and at least every 3 hours at night.
Take a nursing vacation. Take baby to bed with you for 2-3 days, and do nothing but nurse (frequently!) and rest (well, you can eat too!).
Offer both sides at each feeding. Let baby finish the first side, then offer the second side.
Switch nurse. Switch sides 3 or more times during each feeding, every time that baby falls asleep, switches to “comfort” sucking, or loses interest. Use each side at least twice per feeding. Use breast compression to keep baby feeding longer. For good instructions on how to do this, see Dr. Jack Newman’s Protocol to manage breastmilk intake. This can be particularly helpful for sleepy or distractible babies.
Avoid pacifiers and bottles. All of baby’s sucking needs should be met at the breast (see above). If a temporary supplement is medically required, it can be given with a nursing supplementer or by spoon, cup or dropper (see Alternative Feeding Methods).
Give baby only breastmilk. Avoid all solids, water, and formula if baby is younger than six months, and consider decreasing solids if baby is older. If you are using more than a few ounces of formula per day, wean from the supplements gradually to “challenge” your breasts to produce more milk.
Take care of mom. Rest. Sleep when baby sleeps. Relax. Drink liquids to thirst (don’t force liquids – drinking extra water does not increase supply), and eat a reasonably well-balanced diet.
Consider pumping. Adding pumping sessions after or between nursing sessions can be very helpful – pumping is very important when baby is not nursing efficiently or frequently enough, and can speed things up in all situations. Your aim in pumping is to remove more milk from the breasts and/or to increase frequency of breast emptying. When pumping to increase milk supply, to ensure that the pump removes an optimum amount of milk from the breast, keep pumping for 2-5 minutes after the last drops of milk. However, adding even a short pumping session (increasing frequency but perhaps not removing milk thoroughly) is helpful.
Consider a galactagogue. A substance (herb, prescription medication, etc.) that increases milk supply is called a galactagogue. See What is a galactagogue? Do I need one? for more information.

Who to contact if you suspect low milk supply?

If you’re concerned about your milk supply, it will be very helpful to get in touch with a La Leche League Leader or a board certified lactation consultant. If your baby is not gaining weight or is losing weight, you need to keep in close contact with her doctor, since it’s possible that a medical condition can cause this. Supplementing may be medically necessary for babies who are losing weight until your milk supply increases. If supplementing is medically necessary, the best thing to supplement your baby with is your own pumped milk.