How do i get breast milk

Low Milk Supply | WIC Breastfeeding Support

Many moms worry about low milk supply, but most of the time your body makes exactly what your baby needs, even if you don't realize it. There are also ways to tell if your baby is getting enough milk. If you aren't making enough, there are ways you can build your supply. And your WIC breastfeeding staff is always there to help!

Am I Making Enough Milk?

First, look for these signs that your baby is getting enough milk. For example, pay attention to the number of wet and dirty diapers and your baby's weight gain.

Things you should NOT worry about:

How your breasts feel. Your breasts will feel softer and less full as your milk supply adjusts to your baby's needs. This does not mean you have low supply.
If your baby nurses for shorter periods of time, such as only 5 minutes on each breast.
If your baby's feeds are bunched together. This is called cluster feeding and happens when your baby starts nursing more often and for longer. This can happen in the evenings or because of growth spurts.
Not getting much milk when you express. Your baby is much more effective than a pump or hand expression at getting out milk. Find tips to help you pump.

If you are still concerned, talk to your baby's doctor about their growth.

Causes of Low Milk Supply

While most moms make plenty of milk, some do have low milk supply. This might happen if you:

Limit your baby's breastfeeding sessions. Remember, the more you feed on demand, the more milk you make.
Give your baby infant formula instead of breastfeeding.
Introduce solid foods before baby is 4-6 months old.
Take certain birth control pills or other medicine.
Don't get enough sleep.
Drink alcohol or smoke.
Have had breast surgery.

Talk to your doctor if you have hepatitis B or C, herpes, or diabetes. These conditions may also affect milk supply.

Increasing Your Milk Supply

Breastfeeding frequently—especially in the first hours, days, and weeks—is the main way to increase your milk supply. Your body will make milk to meet your baby's demand.

Try these tips to help you make more milk:

Breastfeed every time your baby is hungry. In the early weeks, your baby will eat 8-12 times every 24 hours. It's best not to put your baby on a strict feeding schedule. Follow your baby's cues, and let your baby tell you when it's time to eat.
Make sure your baby is latching well.
Offer both breasts at each feeding. Let your baby finish the first side, then offer the other side.
Empty your breasts at each feeding. Hand express or pump after a feeding to draw out all the milk and signal your body to make more.
Avoid bottles and pacifiers in the early weeks. Feed your baby from your breast whenever you can.
Get plenty of sleep, and eat a healthy diet.
Pump or express your milk. Pumping or expressing milk frequently between nursing sessions, and consistently when you're away from your baby, can help build your milk supply.
Relax and massage. Relax, hold your baby skin-to-skin, and massage your breasts before feeding to encourage your milk to let down.
Take care of yourself. Get plenty of rest, eat well, drink enough fluids, and let others help you.

Consider Charting Your Progress

Record how often your baby is breastfeeding, for how long, and on which sides. If you are supplementing with infant formula, record how much your baby is getting and decrease the infant formula as your milk supply increases. WIC breastfeeding staff can help you determine how much infant formula your baby needs.

Still Have Questions?

Contact your WIC breastfeeding expert. They can talk to you about supply concerns and give you tips to increase your supply to meet your baby's needs.

Breastfeeding Without Giving Birth - La Leche League International

Alyssa Schnell, St. Louis, Missouri, USA

Alyssa Schnell is an International Board Certified Lactation Consultant (IBCLC) based in the United States. She speaks internationally about inducing lactation and relactation and specializes in helping parents who have not given birth (non-gestational parents) to breastfeed their babies. In this article Alyssa discusses how parents who have not given birth can breastfeed by inducing lactation and how La Leche League Leaders can support them.

Breastfeeding is a special gift a baby receives from their gestational parent^[1]. However, many non-gestational parents—adoptive parents, intended parents (through surrogacy), parents whose partner is birthing, and transwomen—are finding out that this wonderful experience is also available to them. Because parents who haven’t given birth do not have the hormones of pregnancy to get their bodies started with making milk, they need more information and support to make breastfeeding a reality.

Why Would a Non-Gestational Parent Choose to Breastfeed or Chestfeed?

Attachment. Breastfeeding helps the parent and baby form a secure attachment, a particular concern when babies are separated from their gestational parent or gestational carrier (in surrogacy).
Nutrition. Human milk provides the optimal nutrition and necessary immunities for human babies.
Healing. Breastfeeding can help heal the heartache of infertility, and provides a biological connection between mother/parent and baby. Breastfeeding is much more than breast milk. Breastfeeding is a close, intimate, physical and emotional relationship between two or more people who love each other.
Sharing. When both parents are breastfeeding, they share the caregiving role.

Facts about breastfeeding without birthing

Women have breastfed babies they did not birth throughout history. With the easy availability and common use of bottles and infant formula in modern developed countries, culture has largely lost track of how breastfeeding can also be an option for non-gestational parents.
Non-gestational parents can start preparing for breastfeeding as soon as they decide to grow their family^[2], after an adoption match has occurred or once their partner or gestational carrier is pregnant. They can even wait until the baby is in their arms.
The amount of milk produced when inducing lactation can vary widely. While some parents make no milk and others make all the milk their babies need, most will make a partial milk supply. Fortunately, breastfeeding is possible no matter how much or little milk is produced—even if it is none at all! Human milk feeding can be simulated with a nursing supplementer: a bag or bottle that holds human milk or formula carried to the nipple via a tiny feeding tube. Parents who are not making any milk may also choose to feed with a bottle while their baby comforts and connects with them by suckling at the (dry) breast.
Newborn babies are wired to initiate breastfeeding, but with gentle and patient encouragement, along with a few handy tools and techniques, even older babies can learn to breastfeed.
Some mothers will take medications or herbs to help them make more milk, but this is not essential. The only necessary component to induce lactation—the official term for making milk without pregnancy and birth—is to stimulate and drain the breasts. That stimulation or emptying can happen with baby breastfeeding, with an electric breast pump, or using a variety of manual techniques.^[3]
The composition of milk produced by inducing lactation is comparable to that produced following birth.^[4],^[5] The milk does not contain dangerous levels of artificial hormones—in fact, it very rarely contains any artificial hormones at all. In most cases, the only artificial hormones that are taken are estrogen and/or progesterone before there is milk production (Step 1 below.) Progesterone and estrogen levels are high during pregnancy and taking these hormones artificially may help to make the body think it is pregnant. Estrogen and progesterone play a role in breast development in pregnancy.
It is not necessary to be fertile—or even to have ovaries or a uterus—to breastfeed. The hormones responsible for milk production (prolactin) and milk ejection (oxytocin) are released from the pituitary gland located at the base of the brain.
Both parents, whether or not one has given birth, can share the breastfeeding role. This is called co-nursing.

How to induce lactation

As stated above, the primary way to induce lactation is through breast emptying: breastfeeding, pumping, or hand expression. The effectiveness of these physical techniques can be enhanced with the use of galactogogues: medications, herbs and homeopathic remedies that support the production of milk. These tools can be put together in a variety of ways to be effective and applicable to each individual parent. While the use of medications, herbs or homeopathic preparations is an individual choice, parents should always discuss their individual situation with their health care providers.

Generic protocols are available (such as Dr Jack Newman’s protocol) or an experienced International Board Certified Lactation Consultant (IBCLC) can work with parents to develop a personalized protocol customized to meet their specific health history, circumstances, and values. The process can be broken down into three steps:

Step 1: Preparing the Breasts for Lactation

This step mimics the hormonal and breast changes that occur during pregnancy. This step is not about making milk; it is about growing and developing the glandular breast tissue in preparation for making milk. Many parents will take hormone therapy for a period of time to achieve this. However, this step is optional.

Step 2: Starting to Make Milk Before Baby Arrives

Milk is often produced very, very slowly when lactation is induced compared with the sudden increase in milk supply between days 3-5 following birth. In order to have a milk supply by the time baby arrives, parents will often start the process of growing their milk production several weeks or months before. The main component of Step 2 for many parents is frequent pumping. Ideally, parents will express their milk as frequently as a baby nurses—just like for birthing parents, frequent breast drainage “places the order” for healthy milk production. Parents can store any milk they produce for use when baby arrives.

Step 3: Feeding Baby and Continuing to Grow Milk Production

This is the big payoff! Baby is here and the parent can begin feeding baby their milk. This step generally involves putting baby to breast.

Not every parent’s protocol will use all three steps. Each parent’s needs and circumstances determine which steps will be appropriate for them. For most parents with adequate information and support, milk production begins within 6-8 weeks of beginning the process of inducing lactation.

What is the role of a La Leche League Leader?

Although extremely rewarding, inducing lactation can be a challenging breastfeeding situation. Mothers/parents need and deserve all of the support they can get. While working with an International Board Certified Lactation Consultant (IBCLC) is highly recommended, La Leche League Leaders can also play a very valuable role. As always, Leaders provide essential information and encouragement. More specifically, La Leche League Leaders may:

Refer parents to resources on inducing lactation (see below).
Provide support for inducing lactation.
Facilitate La Leche League Group meetings where older babies who are bottle-feeding can observe breastfeeding babies, and parents can participate in a breastfeeding culture. Group meetings are also opportunities for parents to connect with other mothers who are nursing in a variety of situations.
Facilitate healthy social media information and interaction.
Share information about donor milk.

Breastfeeding without birthing may not be easy, but it is possible and it is powerful. La Leche League Leaders can be part of the team supporting these parents and their babies.

Resources for La Leche League Leaders and parents

La Leche League Inducing Lactation and Relactation Facebook Group
“Breastfeeding an Adopted Baby”, LLLI website
Breastfeeding Without Birthing by Alyssa Schnell
Breastfeeding Outside the Box podcast or other podcast app

Alyssa Schnell has been helping parents and babies with breastfeeding for the past 17 years, first as a La Leche League Leader and now as an International Board Certified Lactation Consultant (IBCLC). Her private practice, Sweet Pea Breastfeeding Support, provides individual lactation consultations either in person or by phone or video-conference for parents throughout the United States and beyond. Alyssa is also the co-host of the Breastfeeding Outside the Box podcast, which is devoted to families breastfeeding or chestfeeding in extraordinary situations. Alyssa enjoys working with all parents and babies, but she has a special place in her heart for helping non-gestational parents to breastfeed/chestfeed their babies. She is the author of Breastfeeding Without Birthing: A Breastfeeding Guide for Mothers Through Adoption, Surrogacy, and Other Special Circumstances and is an international speaker on the topics of inducing lactation, relactation, and other related topics. Alyssa lives in St. Louis, Missouri, USA and is the proud mother of three breastfed children—two by birth and one by adoption.

^[1] Some notes about language: The term “gestational” is used throughout this article instead of “biological.” In surrogacy, the intended mother is often the biological mother (baby is often conceived with her egg) even though she is not gestating (pregnant with) the baby. And oftentimes same-sex female couples will conceive baby via in vitro fertilization (IVF) using the egg of one parent (biological parent) implanted in the uterus of the other parent (gestational parent). This article also attempts to use gender-inclusive language such as parent versus mother and breastfeeding/chestfeeding versus breastfeeding. Some of the parents referred to in this article may be cis male, trans male, or non-binary.

^[2] Note: inducing lactation with medication should not be started unless the parent has an approximate timeline for their baby’s arrival. Taking medication without a definite end could be hazardous.

^[3] Other manual approaches might include breast massage, nipple manipulation (gently pulling out and twisting of the nipple), and a partner suckling.

^[4] Kulski, J. K., Hartmann, P. E., Saint, W. J., Giles, P. F., & Gutteridge, D. H. (1981). Changes in the milk composition of nonpuerperal women. American journal of obstetrics and gynecology, 139(5), 597-604.

^[5] Perrin, M. T., Wilson, E., Chetwynd, E., & Fogleman, A. (2015). A pilot study on the protein composition of induced nonpuerperal human milk. Journal of Human Lactation, 31(1), 166-171.

Breast milk production | Baby's needs

Did you know that the amount of breast milk adapts to your baby's needs? In this article, you will learn amazing facts about breast milk production in the first days, weeks and months.

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Your body is capable of producing breast milk for your baby at every stage of development. Understanding how milk production “turns on”, what happens to milk when you feed your baby, and why production adjusts to his needs as he grows, will help you start this amazing process in the right way.

Day one: milk production at birth

The baby is usually ready to breastfeed from birth. When he grabs the breast and begins to suck rhythmically, the milk-producing cells “turn on” and the formation of the first breast milk, colostrum, starts. ¹ Try to feed your baby as much as possible in the first hour of his life, and then as soon as he shows interest in feeding. This will help lay the foundation for good milk production later on. ²

The first days: the arrival of milk

At this stage, your body's level of progesterone, the
pregnancy hormone, which begins to fall after the placenta comes out, is reduced, and the hormones responsible for milk production - prolactin, insulin and hydrocortisone - are included in the work. These hormones will help start milk production. ³ Around the third day of your baby's life, milk will begin to come in and you will feel that your breasts have filled up and become noticeably firmer. ¹

First month: shaping milk production

During the first weeks, your body will be especially sensitive to the amount of milk produced as it learns to produce the right amount. Prolactin levels increase dramatically each time you empty your breasts, thereby helping shape the lactation process. It also contributes to the maturation of your milk in terms of composition. At this stage, transitional milk is produced and the amount continues to grow. ^3.4

For good long-term milk production, it is very important that you are close to your baby during the first few weeks. The more often you breastfeed, the more milk will be produced. This process resembles the law of supply and demand. Each time after emptying the breast, whether it is feeding the baby or pumping, even more milk will be produced.

Remember that it is normal for newborns to eat frequently, perhaps even every 45 minutes, and this does not mean that they are not getting enough milk. Frequent feedings help shape milk production, so feed your baby on demand, not on a schedule.

“In the first few weeks you may feel like you don’t have enough milk because your baby will be feeding all the time, but that’s okay,” says UK mom-of-two Jo, “We tend to think that the baby wants to eat every few hours, but that is not necessarily the case. "

Don't forget that babies also breastfeed for comfort. Breastfeeding helps them calm down and adjust to their new life outside the womb. In addition, feeding helps to establish a connection between you.

Stable milk production in the first month

If you follow your baby's needs and feed him as often and for as long as he wants, milk production should adjust. ⁵

Some mothers try to increase the period between feedings so that the breasts can produce more milk during this time, but this should not be done, as this may have the opposite effect. ²

If you are unable to breastfeed directly for the first two weeks, express your milk to build and maintain your milk supply during this critical period and beyond.

Did you know that feeding your baby extra formula unnecessarily can reduce your milk production? The chest will not receive a signal to increase production, because it will not be emptied. In addition, if the baby sleeps longer after formula, he may miss his usual next feeding time.

This is a kind of “supplementing trap”. After three to four days of formula supplementation, during which the breasts have emptied less, the body will receive a signal that breastfeeding has stopped, and the amount of milk produced will begin to decrease. As a result, the baby will remain hungry and will need additional formula supplementation. And so on in a circle ... As a result, this will lead to really low milk production, and the baby will eat mainly the mixture.

Breast milk production after six weeks

After a month of breastfeeding, post-feeding bursts of prolactin secretion begin to decrease, milk matures, and the body gets used to producing as much milk as your baby needs. In fact, the chest begins to work "on autopilot." ⁴ You may also notice at this time that your breasts are softer and your milk flow has stopped.

At this stage, women often have fears of "losing milk".
However, this only means that milk production has been established and now fully meets the needs of the child. It is noteworthy that although the baby continues to grow, he will consume approximately the same amount of milk both at six weeks and at six months. You may notice that the baby began to suckle the breast longer, but less often. On some days he may eat a little less than usual - his appetite changes in the same way as an adult.

Now your body will produce exactly the amount of milk,
as much as your baby needs. Therefore, the more milk the baby
drinks (or you express), the more it will produce.

How does this happen? The reason for this is thought to be the so-called "feedback lactation inhibitor" that controls milk production. The more milk in the breast, ² the higher the inhibitor level, so a full breast produces less milk than one that has been emptied.

What is the rate of milk production?

Mothers often worry about their milk supply and think about how to increase it. However, if the baby is healthy and growing well, problems usually do not arise.

“I was worried that my newborn daughter was not getting enough milk as she was feeding very quickly and always from one breast even though I offered both,” says Marjorie, mother of two in the UK, “But when I pumped from using a breast pump, I was surprised at how much milk I produced, and calmed down. I just had to keep feeding her little and often.”

Keep in mind, however, that not all mothers are able to express a lot of milk right away. You can also try hand expressing milk and see if there is a change in breast fullness.

If you're worried about your milk supply, read our tips for symptoms of too little or too much milk.

Literature

1 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia 2007;12(4):211-221. - Pang, W.W., Hartmann, P.I., "Lactation initiation in the lactating mother: secretory differentiation and secretory activation. " G Mammary Gland Biol Neoplasia. 2007;12(4):211-221.

2 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet Gynecol Neonatal Nurs . 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Milk Production". F Obstet Ginecol Neoneutal Nurs. 2012;41(1):114-121.

3 Ostrom KM. A review of the hormone prolactin during lactation. Prog Food Nutr Sci . 1990;14(1):1-43. - Ostrom KM, "Review of the role of the hormone prolactin during lactation." Prog Food Nutr Sai. 1990;14(1):1-43.

4 Cox DB et al. Blood and milk prolactin and the rate of milk synthesis in women. Exp Physiol. 1996;81(6):1007-1020. - Cox D.B. et al., Effects of blood and milk prolactin on milk production in women. Exp Physiol. 1996;81(6):1007-1020.

5 Kent JC et al. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3): e 387-95. - Kent J.S. et al., "Amount and frequency of breastfeeding and fat content of breast milk during the day." Pediatrix (Pediatrics). 2006;117(3): e 387-95.

How to improve breastfeeding and increase breast milk

Breast milk is very important for the health of the baby and mother. We will share the secrets of how to improve lactation

All articles 07/30/2020

Everyone is well aware that mother's milk contains everything that a baby needs in the first months of life. These are proteins, fats, carbohydrates, vitamins in the optimal qualitative and quantitative composition, as well as enzymes, hormones, antibodies and immune cells that protect the baby from allergies, infections and chronic diseases.

We have written about the benefits of breastfeeding more than once, and today we will give you recommendations on how to maintain and increase the amount of breast milk:

Feed your baby on demand. It is especially important to do this in the first month of the baby. The child requires constant attention. Between feedings can pass no more than an hour. This is a completely normal process. The more he suckles it, the sooner milk production will begin.
Try not to give a bottle. If necessary, supplementary food or water can be given from a spoon. The mechanism of pacifier and bottle sucking is different from breast sucking and can lead to improper attachment and failure.
Let the baby stay at the breast for as long as he needs, even if it is more than 30-40 minutes. Use this time to relax or sleep.
Take care of a menu that can quickly increase lactation. It should be as satisfying as possible and high in protein.
Drink as much liquid as possible: 1.5-2 liters of pure water per day will support lactation at the right level. Weak warm tea, compotes, dill water, fruit drinks are also recommended.
Eat in a comfortable position. Make sure that the child completely captures not only the nipple, but also part of the areola. So the milk will be released in the right amount and the nipple will not be injured. If you feel pain, then the baby is doing something wrong. Take the breast out of the baby's mouth and help him grasp it correctly.
Remember oxytocin is a hormone that is responsible for the release of milk from the breast. It is helped to form in the female body in sufficient quantities: relaxation, warmth, massage, rest, contact with the child, support from loved ones, self-confidence.
Turn on your favorite movie or music, prepare warm tea, something tasty and enjoy motherhood!

A personal pediatrician will help to establish lactation and give answers to all questions - a reliable and qualified assistant in this crucial period of a baby's life.