How to get the breast milk flowing

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.

Low milk supply? How to increase breast milk supply

Many mums worry they have a poor milk supply, but it can be hard to know for sure. Read on to find out whether you really have low milk supply and what you can do about it

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“Have I got enough breast milk?” is something new mothers often worry about – but chances are, if your baby’s healthy and growing well you’re doing great. However, if you’re concerned about your breast milk supply, it’s important to seek advice early. If it turns out things are fine, you’ll quickly be reassured. Plus, you’ll avoid the trap of giving your baby formula unnecessarily, which may cause your own milk supply to drop.

Reasons for low milk supply

A small number of new mums have difficulty producing enough breast milk due to medical reasons, which include:

Excessive blood loss (more than 500 ml/17.6 fl oz) during the birth or retained fragments of the placenta can delay your milk coming in (which usually happens around three days after the birth).¹
A history of polycystic ovarian syndrome, diabetes, thyroid or other hormonal disorders. Mums with these conditions sometimes experience a low milk supply.²
The rare medical condition mammary hypoplasia, in which there isn’t enough milk-producing glandular tissue within the breast.³
Previous breast surgeries or breast trauma – although many mums who have had surgery go on to breastfeed successfully.⁴

If any of these conditions applies to you, see a lactation consultant or breastfeeding specialist.

How breast milk supply works

Once your breast milk has come in, your breasts start to make milk through a process of ‘supply and demand’. Each time milk is removed, either by your baby feeding or by expressing, your breasts make more.

That’s why giving bottles of formula can reduce your milk supply – your body isn’t getting the message to produce more breast milk, because none is being removed.

The way your baby nurses also affects your supply. The more frequently and effectively she breastfeeds, the more milk you’ll make. If your baby doesn’t take enough milk during a feed, it’s essential to express regularly to protect your milk supply – see below for more advice.

Signs your baby isn’t getting enough milk

Even though low milk supply is rare, your baby may still struggle to get enough for other reasons during her first few weeks. She may not be breastfeeding frequently enough, or for long enough, particularly if you’re trying to stick to a breastfeeding schedule rather than feeding on demand. She may not be latching well, or might have a condition that makes it harder to take in milk.

The following are signs your baby isn’t getting enough milk:

Poor weight gain. It’s normal for newborns to lose 5% to 7% of their birth weight in the first few days – some lose up to 10%. However, after that they should gain at least 20 to 30 g (0.7 to 1 oz) per day and be back to their birth weight by day 10 to 14.^5,6,7 If your baby has lost 10% or more of her birth weight, or she hasn’t started gaining weight by days five to six, you should seek medical advice immediately.
Insufficient wet or dirty nappies. The number of poos and wees your baby has per day is a good indicator of whether or not she is getting enough milk – see our article explaining the pattern your baby should be following in Breastfeeding your newborn: What to expect in the first week. Seek medical advice if you’re concerned or if you have noticed her dirty nappies decreasing in wetness and heaviness.
Dehydration. If your baby has dark-coloured urine, a dry mouth or jaundice (yellowing of the skin or eyes), or if she is lethargic and reluctant to feed, she could be dehydrated. ⁶ Fever, diarrhoea and vomiting, or overheating, can cause dehydration in infants. If you notice any of these symptoms, seek medical advice quickly.

Find out the top 5 tips to know if your baby is getting enough milk

Misconceptions about low milk supply

Newborns typically feed very often – around 10 to 12 times a day, or every two hours – and this is not a sign that you don’t have enough milk. Don’t forget that your baby also nurses for comfort, and it’s difficult to tell how much milk your baby takes during each feed – amounts can vary.

The following are all perfectly normal and are not signs of a poor milk supply:

your baby wants to feed frequently
your baby doesn’t want to be put down
your baby is waking in the night
short feeds
long feeds
your baby will take a bottle after a feed
your breasts feel softer than they did in the early weeks
your breasts don’t leak milk, or they used to leak and have stopped
you can’t pump much milk
you have small breasts

What to do if you have low milk supply

If you suspect your baby is not getting enough milk, see a lactation consultant or breastfeeding specialist. They will assess whether you have low milk supply and observe a breastfeed to see if your baby is latched on well and taking in enough milk. They may suggest adjusting your feeding position or your baby’s latch so she can feed more efficiently.

You could also try having more skin-to-skin contact with your baby before and during feeds to stimulate the hormone oxytocin, which gets your milk flowing. Or use relaxation techniques, such as listening to your favourite calming music, to reduce any anxiety that could be affecting your supply.⁸

With support, most mums with low milk supply are able to partially breastfeed their babies, and some will manage to develop a full milk supply.

If your baby is not yet taking enough milk directly from the breast, perhaps because she was premature or has special needs, you may need to express to protect your milk supply, and your healthcare professional may prescribe galactogogues (medication to increase milk production).

If you’re not yet able to express enough breast milk for your baby, you’ll need to supplement her with donor milk or formula, under the guidance of a medical professional. A supplemental nursing system (SNS) can be a satisfying way for her to get all the milk she needs at the breast.

How to increase milk supply with a breast pump

If you need to encourage your milk supply in the first five days after birth, you can use a double electric breast pump with initiation technology, such as the Medela Symphony. This type of pump is designed to mimic the way a baby stimulates the breasts while feeding, and has been found to increase longer-term milk production.⁹

Once your milk has come in, double pumping means you can express more milk in less time.¹⁰ This method also drains the breasts better, which also helps with milk supply.

Although every mum is different, it’s often a good idea to express milk straight after, or an hour after, a feed. This may seem counterintuitive, because it’s usually easier to pump from a full breast. But you should think of your pumping session as ‘putting in a milk order’ for the next day.

At first you may only collect small amounts, but don’t be discouraged – with regular pumping, this will increase. Aim to be removing milk (by breastfeeding as well as pumping) eight to 12 times a day, including one session at night when your levels of the milk-producing hormone prolactin are highest. The more frequently milk is removed, the better. After two or three days of regular pumping you should see a significant increase in supply. For advice on getting more milk from each pumping session, read breast pumping tips.

Hands-on pumping to increase expressed milk

If your baby is not breastfeeding directly at all, or you can’t yet pump enough milk for her, a technique called ‘hands-on pumping’ can be useful. It has been shown to increase the amount of milk mums can express in a session.^11,12 The whole process takes around 25 to 30 minutes. Remember, the emptier your breasts, the more quickly they’ll make milk.

Follow these simple steps:

Massage your breasts.
Double pump using an expressing bra to keep your hands free.
While pumping, use your fingers and thumb to compress your breast for a few seconds. Release and repeat. Use compressions on both breasts until your milk flow slows to a trickle.
Massage your breasts again.
Finish by hand expressing or single pumping, using breast compressions and switching between breasts to drain them as fully as possible.

Once your baby is gaining weight and you’ve increased your supply, then you can move on to feeding her exclusively at the breast.

References

1 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia. 2007;12(4):211-221.

2 Vanky E et al. Breastfeeding in polycystic ovary syndrome. Acta Obstet Gynecol Scand. 2008;87(5):531-535.

3 Neifert MR et al. Lactation failure due to insufficient glandular development of the breast. Pediatrics. 1985;76(5):823-828.

4 Neifert M et al. The influence of breast surgery, breast appearance, and pregnancy-induced breast changes on lactation sufficiency as measured by infant weight gain. Birth. 1990;17(1):31-38.

5 C Tawia S, McGuire L. Early weight loss and weight gain in healthy, full-term, exclusively-breastfed infants. Breastfeed Rev. 2014;22(1):31-42.

6 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p.

7 World Health Organisation. [Internet]. Child growth standards; 2018 [cited 2018 Feb]

8 Keith DR et al. The effect of music-based listening interventions on the volume, fat content, and caloric content of breast milk-produced by mothers of premature and critically ill infants. Adv Neonatal Care. 2012;12(2):112-119

9 Meier PP et al. Breast pump suction patterns that mimic the human infant during breastfeeding: greater milk output in less time spent pumping for breast pump-dependent mothers with premature infants. J Perinatol. 2012;32(2):103-10.

10 Prime DK et al. Simultaneous breast expression in breastfeeding women is more efficacious than sequential breast expression. Breastfeed Med. 2012;7(6):442-447.

11 Stanford University School of Medicine [Internet]. Stanford, CA, USA: Maximizing Milk Production with Hands-On Pumping; 2017. [Accessed 30.04.2018].

12 Morton J et al. Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. J Perinatol. 2009;29(11):757-764.

Pumping when mom needs to go away | Philips Avent

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Even if you don't have the opportunity to be near your baby, you can be sure that by pumping, he will receive all the necessary nutrients from breast milk. Perhaps you are already using a breast pump to continue breastfeeding when you go to work, or you just want to have more free time between feedings. nine0003

3 Philips Avent products to help you pump and store your milk comfortably:

Not sure when to start pumping or when to use a pump? Don't worry, we've put together a quick guide to help you learn how to express milk and learn about the benefits of using a breast pump. We'll also give you tips on how to express your milk when you're away from home, how to keep it adequate, and how to store it safely. nine0003

When should I start expressing milk?

Most women begin to express milk after six months, but there are circumstances that force them to do so sooner.

If you intend to express milk as early as possible, the answer to the question “When can I start expressing milk?” will be: "A few hours after birth." Some mothers find that expressing milk is effective at a very early stage, especially if the baby has latch-on problems, as pumping improves the flow of milk to the breast. nine0015

Other mothers start pumping after breastfeeding is established because they want someone in the household to help with feeds while they are away or with feeds after they go to work.

There are no specific rules about when to start pumping, so you can do whatever works best for you. Whatever your needs, you can pump to make your schedule less dependent on feedings.

How to express breast milk: general questions

How long should I express milk? How much milk do I need to express? What equipment do I need for this? Every mother has questions about this topic, however, once she starts expressing milk, she easily adapts to this process.

Most moms find a breast pump to be the easiest way to express breast milk. The principle of operation of different breast pumps may vary slightly, so read the instructions for use before using the device. Remember that it can take 1-2 minutes for milk to come out of your breast during pumping, so don't worry if you don't see it right away! nine0003

Not sure how long to express milk? If you are not in a hurry, try to express milk until you feel that your chest is empty. Due to the individual characteristics of each woman, the pumping time will be different.

The amount of milk expressed will depend on when you last breastfed and how long you have been using the pump and are accustomed to using it. Even your internal state and time of day can affect the amount of milk. If you have problems with lactation, check out our tips for increasing your milk supply. Generally, the best time to express is in the morning. During sleep, there is an increase in the level of hormones responsible for the production of milk. nine0003

Should breastfeeding be combined with pumping? Wait about an hour between pumping and the next feeding. So you will be sure that the baby will have enough milk! Feed your baby as much as it takes to keep him full and happy. Use a breast pump to fully express milk from your breasts and save excess milk.

How to Express Breast Milk: Practical Tips

Whether you are expressing milk at home (for a night feed) or at work, there are a few key points to keep in mind to help you. nine0003

1. Plan ahead. If you have to leave your baby, start using a breast pump a few weeks in advance. This way you will store enough milk for your baby and get used to using a breast pump.

2. Be ready. You may be aware of the so-called "oxytocin reflex", which stimulates the flow of milk due to the release of the hormone oxytocin. Oxytocin increases the secretion of breast milk that can be expressed. The production of the hormone can be caused in many ways, even just by looking at the child. Therefore, many mothers find it effective to look at a photo of their baby while pumping while away from home. After you finish pumping, you can also use bra pads to keep your breasts dry and protect your clothes from milk stains. nine0015

3. Get comfortable. The more comfortable you feel, the easier it will be to express milk. Find a quiet, private place and feel free to change the lighting and music to your liking. It is helpful to find a seat with good support so that you can sit comfortably with the pump in front of you.

4. Express as many times as you would like to breastfeed your baby. To maintain the required supply of milk, express it as often as you normally feed your baby. Thus, if the baby usually has three feedings during your absence, then you need to express milk at least three times. nine0003

How to choose the best breast pump for expressing milk

There are several different types of breast pumps, each with its own advantages. Choose the one that will help you feel comfortable in your daily life. Perhaps you prefer to have a device that is designed to be used on the go? Or do you need a breast pump that will allow you to express milk quickly?

Storage and preparation of milk after pumping

After you have expressed your milk, remember to freeze or refrigerate it. Then, before feeding the baby, it must be thawed and warmed up. Here are some tips on how to store breast milk:

Use sterile milk storage containers or freezer bags to collect and store milk.
Do not fill the container to the upper limit, because. when frozen, breast milk "expands", the optimal portion for storage is 60-120 ml. nine0088
Label the container with the pumping date or write the pumping date on the container with a permanent marker.
Store milk in the refrigerator at 2-4°C for up to 24 hours.
After cooling the expressed milk in the refrigerator for 0.5 hours, the milk can be frozen in the freezer and stored there for 3 months.
Place the milk closer to the back of the refrigerator or freezer than in the door to keep the milk at a constant temperature. nine0088
Thawed milk placed in the refrigerator should be used within 24 hours.
Do not refreeze defrosted milk.
Transport milk in an insulated container with an ice pack.

Use these tips to prepare your expressed milk for nursing:

Thaw or warm breast milk under running warm water, in a bain-marie, or with a bottle warmer. nine0088
Do not use a microwave oven to heat milk.
Do not heat milk to boiling point.
Shake the milk bottle before feeding until smooth.
Check milk temperature before feeding. The most optimal temperature is the average between body temperature and room temperature. To check the temperature of milk, you can drop it on your skin.

Advice for first-time moms

If you are just starting to express milk, remember that this process may not be entirely comfortable. The more relaxed you are, the easier it will be to express milk. Sometimes this will be difficult to do, for example if you are trying to express milk during a busy work day or in an unfamiliar place; therefore, it is necessary to practice well at home and show patience. You will soon learn how to express breast milk. In the next article, you will learn how to store breast milk! nine0003

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How much should a newborn baby eat

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Home ›› How much milk should a newborn baby drink?

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Like every new mom, you're probably wondering, "How often should a newborn eat?" and “How many milliliters does a newborn baby drink at a time?”. A mother's body is designed to provide her baby with all the nutrients she needs, but every mom needs practical advice and confidence when it comes to how much milk a newborn should drink. nine0003

Whether you are breastfeeding, bottle feeding or a combination, here you will find all the information you need to know about how much food your baby needs to grow and develop properly.

Signs indicating that the child is hungry

Every mother has a wonderful maternal instinct, but we cannot guess the child's desires the first time. Over time, you will learn your child's unique gestures and body movements, as well as signs that he is hungry. In the meantime, here are some of the most common signs that a child is hungry:

turns head towards your breast or bottle;
clenches;
puts pens in mouth;
pouts, smacks or licks lips.

If your child is showing any of these signs, they may be trying to tell you it's time to eat. Ideally, your baby should be fed on demand when he is hungry. If you're breastfeeding, on-demand feeding is a good way to keep your milk supply going as your body will naturally respond to your baby's needs and continue to produce the required amount of milk. Bottle-feeding on demand can also be beneficial for your baby, as it allows him to self-regulate his feeding needs. nine0003

How much breast milk should a newborn drink?

So, how much should a newborn baby eat? A remarkable feature of each child is its uniqueness, so it would be wrong to feed the baby strictly according to the instructions. Don't panic if the recommendations below don't fit your own feeding schedule, but please contact your healthcare provider or pediatrician if you have any questions.

Although every baby is different, newborns typically eat every two to three hours, for a total of 8 to 12 meals a day. nine0003

How many milliliters does a newborn baby drink? At the very beginning, your body will only produce a small amount of yellowish and thick breast milk called colostrum. This milk is an ideal source of nutrients that your newborn needs, in addition, it has many immunological components. ¹

How much milk does a newborn baby drink? Infants drink 30-60 ml per feeding, while this volume increases to 60-90 ml by two weeks of age. So don't worry if you don't feel like your body is producing much milk in those first few days after your baby is born! Feeding times will also vary, ranging from 10 to 30 minutes at the very beginning and then gradually increasing as your baby grows.

How much bottle-feeding breast milk does your baby take

If you choose to bottle-feed your baby from time to time, do so at the same intervals and for the same period of time as if you were breastfeeding. Pumping is a great option for breastfeeding your baby. It will allow you to separate from the baby if necessary and at the same time retain all the benefits of breastfeeding. nine0015

It's also important to get a bottle that helps make bottle feeding more natural for both you and your baby. For example, take a look at this Philips Natural bottle. Its wide, physiologically shaped nipple promotes a natural latch that is identical to that of a mother's breast, making it easier to alternate between bottle and breastfeeding.