| Mother2Mother Services |
| Education and Support for Nursing Mothers |
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| Common Concerns p. 7a |
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| Starting Solids; Supply Issues: Low Supply Suspected |
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| SUPPLY ISSUES |
| Do You Suspect a Low Supply? |
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| By far the most common reason given by many mothers for stopping nursing and resorting to formula is low supply. Sadly, many of these mothers were mistaken about their supply. Mothers may think their supply has dropped for reasons that often indicate nothing more than the mother's body has finally adjusted to the beautiful demand-supply nursing relationship. These reasons include, but are not limited to, no longer feeling let-down, breasts not feeling full, and no longer leaking. |
| Sometimes, mothers feel they must not be making enough milk because their baby will suck down several ounces of expressed breast milk or formula immediately after a nursing session. This is not unusual even if the baby is getting quite a lot of milk from the mother's breast. Breast-fed babies have such a strong sucking reflex that they can drain a bottle long before their bodies have had the chance to inform their brains that they are full. Also, bottles simply drain into the baby's mouth, whereas the baby must work to get milk from the breast. A baby may not be able to do anything other than swallow down the milk fed via bottle, as the baby is unable to control the flow well -- unlike when nursing. Thus, a baby may overfeed via bottle. However, the frequent offering of supplements of formula can turn the mother's belief that she has a low supply into a self-fulfilling prophesy: the baby filled up on formula will not ask to nurse as frequently, and the decreased demand to nurse will lead to a decreased supply of milk, necessitating an ever-increasing amount of formula, and leading, eventually, to a weaned baby and a mother who truly believes she is incapable of making enough milk to sustain her children. |
| Additionally, many mothers mistakenly believe they have a low supply when their babies go through a growth spurt and want to nurse much more frequently. |
| A baby who is fussy is also not necessarily a hungry baby. Many babies go through a fussy period each day, often cluster feeding in the evenings. Additionally, fussiness at the breast could be a sign of an oversupply, rather than an undersupply. It could also be a sign of reflux and/or the baby being sensitive to something in the mother's diet (most commonly, the protein -- not the lactose -- in cow's milk products). |
| A mother may also become concerned about her supply if her baby nurses frequently, especially if she's comparing her baby to formula-fed babies. Breastmilk digests very quickly, and breastfed babies also naturally take smaller feedings than formula-fed babies. Breastfed babies are supposed to nurse very often -- usually 10-12 times daily (or even more) in the newborn period, and not slowing to less than 7 times daily until well-established on solids after about 9 months of age. |
| Supply issues can be divided into two general categories: oversupply and low supply. While an oversupply may sound like a dream come true to mothers dealing with a low supply, it carries its own set of problems -- including an increased risk for mastitis, a serious breast infection. Most low supply issues can be avoided by: early, frequent nursing; not using pacifiers; not supplementing unnecessarily; not starting solids too quickly; recognizing when your baby is distracted and offering to nurse in quiet settings to counteract this distractibility and maintain supply; not using estrogen-containing birth control methods; and avoiding chronic use of Sudafed and other medications known to decrease supply. |
| Pumping output is another reason moms may mistakenly suspect they have a low supply. Pumping output often decreases over time, even though a mother's supply is fine. Additionally, a baby doesn't just use suction to get milk out, but also milks the breast with his tongue and compresses the sinuses while nursing, making it unlikely that the pump can get as much milk out of the breast as the baby can. Pumping is also dependant on the quality of the pump itself (with pumps, generally speaking, you get what you pay for), and is a learned skill, different from nursing. Some moms with excellent supplies are never able to pump worth a darn, and a stay-at-home mom may need to pump several times to store up even one relief bottle of milk, as her baby is getting the milk directly "from the tap," so to speak. |
| How then, do you know if you really have a supply issue? The "gold standard" is weight gain. After the baby is 5 days old, your baby should gain about 6 ounces per week through 4 months of age, then 4-5 ounces per week through 6 months of age, then 2-4 ounces per week through one year of age. |
| What if my supply really is low? |
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| If your baby is not gaining well on your milk alone, it is important to determine the reason for the slow gain. A reflux baby may learn that nursing results in pain (from the reflux), and therefore feed only in small amounts. This will eventually lead to the mother actually having a supply issue, as the baby isn't really demanding as much milk from the mother's body as the baby needs. (More on low supply next page.) |
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| Last Updated February 2, 2004 |
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