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The Truth About Breast Milk Supply and Demand

I have now nursed seven babies, some of them through difficult circumstances such as oral surgery or having a broken arm. I’ve breastfed for various lengths of time, with my longest nurser going past her 2nd birthday. I have also nursed through sickness, sometimes the baby’s and sometimes my my own. I have even nursed through pregnancy, continuing to nurse until 30+ weeks gestation three times now. I have experienced mastitis half-a-dozen times, worked through latching issues, supply issues (both too little and too much), teething, thrush, sore nipples and dirty looks from strangers. I persevered through baby having reflux, or certain foods causing fussiness that required me to alter my diet for baby’s sake. I have read books about breastfeeding and spent many, many hours talking to other mamas about their nursing experiences.

When my firstborn son was just six months old I was surprised (but happy!) to learn that I was pregnant again. Up to that point I had been breastfeeding, but I did not know if it was even possible to continue to nurse while pregnant. It wasn’t long before my milk supply began to dwindle – as evidenced by my baby’s fussiness and desire to nurse more frequently without acting satisfied. I had intended to breastfeed him much longer, but I found myself supplementing with formula and solid foods. This caused my supply to drop even more and soon we were no longer nursing. This made me sad.

The following year, when my daughter was seven months old, I needed oral surgery to remove four severely impacted wisdom teeth. This meant that for a couple of days I was unable to breastfeed. Just this small disruption caused a severe decrease in my milk supply despite my efforts to pump until I was cleared to nurse her again. I found myself once more at the store reading the back of formula cans to try to find the healthiest one for my baby. After a few minutes of trying to decipher unpronounceable ingredients, and a few pronounceable ones that I consider to be less than healthy (high fructose corn syrup, anyone?) I put the cans down and told my husband, “I’m not doing this again.”I decided to persevere and see how long we could go. I nursed my daughter very frequently, and to my surprise within days my milk supply picked back up and we were able to breastfeed until she was sixteen months old.

seven healthy, happy children

seven healthy, happy children

Through all of this I discovered that much of what I thought I knew at the beginning about breastfeeding was incorrect. But of all the misinformation, there are two particular fallacies that I find very grievous – and most grievous is how prevalent they are. The two I am talking about are these:

Fallacy #1. Some women just cannot make a large enough quantity of milk to feed their babies.

And the second is very similar.

Fallacy #2. Some women just cannot make a sufficient quality of milk to nourish their babies.

While it IS possible for a mother to be making inadequate amounts of milk or poor quality of milk, the fallacy lies in blaming genetics and ignoring the fact that both scenarios are frequently easy to remedy. Milk supply can be increased. Milk quality can be improved. Grieving mothers who have been led to believe that their bodies just don’t work right deserve to know that it isn’t their bodies that have failed them. Many were sabotaged by the bad advice and misinformation perpetuated by mainstream experts – many of whom have never even put a baby to their breast. (If they even have breasts at all, as most men do not.)

I hope you will accept my experience combined with my extensive research as my credentials in lieu of letters after my name, and allow me to share some of the knowledge I have acquired in over a decade of breastfeeding.

Diet Matters

If I gave you a package of hotdogs, a head of lettuce, and three eggs, then asked you to bake a cake, you would find yourself at a loss. These are not the proper ingredients to make anything worthy of being called cake. So it is with nursing. Your body requires the correct ingredients. You can’t sip a diet soda and eat a candy bar and expect your body to turn it into something nutritious for your baby. You have to put nutrients in if you want nutrients out.

Does this mean nursing mothers can never eat junk food? No. But the diet required for making healthy breast milk is a little more essential and much the same as the diet required for keeping anyone healthy. Vegetables, fruits, grains, and lots of protein are all necessary. But there is something else, often overlooked, that is especially important for making breast milk and that is healthy fat.

Pop quiz!
Q: Is there such a thing as healthy fat?

If mainstream assertions are believed you will think that “healthy fat” is an oxymoron. Naturally-occurring saturated fats have been lumped in with artificially produced, hydrogenated ones, and thus wrongly demonized. They have been blamed for many things from obesity to heart attacks and they get little exposure for their importance to your body and the body of your baby.

The truth is that your baby’s brain and body require a lot of fat for him to grow and develop normally. We all know that a chubby infant is a good thing, and your body knows it too – it wants to make fattening milk! Did you know that when breast milk is expressed into a bottle and left in the fridge to cool it will separate into two layers, with cream on the top?

A low-fat diet poses a severe impediment to a mother’s ability to produce sufficient milk. New mothers need to make eating healthy fats a priority in the first weeks postpartum and probably for the duration of the nursing relationship. Real butter, eggs, nuts, olive oil, cheese, avocados, red meat, and cream are all good examples of natural sources for these fats. Notice donuts are not on that list. Sorry.

There are also foods that especially promote lactation called galactagogues. The word galactagogue is from the Greek galaktos, “milk” and agogos, “guide”. These foods contain substances that induce the secretion of milk. My favorite of these is oatmeal. I often tell new mothers “Eat ice cream, and oatmeal, and ice cream on oatmeal!” The healthy fat of real cream in a good quality ice cream when joined with the stimulating effects of the oatmeal almost always create a boost in milk supply.

Have More

A mother should be eating not only the right foods, but in sufficient amounts. The postpartum weeks are NOT a good time to skimp on calories in the hopes of fitting back into your skinny clothes sooner. A lot of breastfeeding woes could be solved with this simple advice. EAT MORE!
And with “Eat more!” I also frequently find myself saying “Drink more!” Remember that diet soda we talked about? It is high in sodium and thus will not hydrate you sufficiently for producing milk. Drink water. Lots of it! Other clear liquids such as tea are useful as well. Herbal teas that serve as galactagogues, such as Fenugreek or Blessed Thistle, are usually the first recommendation to a mother struggling to nurse.

It is also worth mentioning that some herbs have the opposite effect and can hurt the milk supply, such as sage. But unless you eat sausage at every meal, this probably won’t be the main culprit to blame for breastfeeding issues.

Frequency is Key

What you eat is important, but so is how often you nurse – ESPECIALLY at the beginning when baby is just a day or two old. At that critical time, nursing your baby for ten minutes every two hours is good. Nursing for ten minutes every hour is even better. Since duration is important as well you could go ahead and nurse for twenty minutes every hour. At least until your milk comes in within a few days. When supply is well established just follow baby’s cues and let him set the feeding schedule.

A lot of new mothers’ efforts are hindered when they are told not to nurse too often or for too long. You really can’t nurse a newborn too much, and the frequent latching on – if even for two minutes – is helpful for mother and baby to learn what they are doing. Getting all of the colostrum at the beginning is important too, but perhaps that is a topic for another day.

Fun Fact!
The economic realities of supply and demand are at work in the breastfeeding relationship.

If the baby demands more, your body will increase production and supply it. If your baby isn’t consuming everything available, your body will make less. Every time baby latches on and nurses the hormone Prolactin is released, telling your body to make milk for next time. There is only one way to tell your body to increase the amount of milk it is making and that is by letting the baby feed at an empty breast. If you feel like you’re running on empty but baby is not satisfied, keep on nursing. Your body is exquisitely designed to tell what is going on. Your brain gets the message “Hey, this baby wants more than what we’re making!” It then sends out the appropriate hormonal signals to tell your body to make more. These increases can happen as soon as the next day, frequently to the very hour. If your baby nurses longer at 10am one day then at 10am the next day your body will make extra. If you offer the baby formula or a pacifier instead then the message to make more never gets sent – or worse your body gets the idea that demand has decreased and so responds by decreasing the supply.

I’ve heard it said that a mother shouldn’t have to be a human pacifier. Do you know what a pacifier is? It’s a fake, rubber mother! In some countries they even call them dummies. (The pacifiers, I mean) If you feel like a human pacifier, you are doing your job correctly. But please, don’t throw binkies at me; I’ve given them to my babies at times too. In fact, they make excellent teething toys.

Rest easy

Diet and frequency of nursing are definitely the most important factors, but I would be remiss if I didn’t mention the effects of exhaustion and stress on milk supply. It is important for mama to get enough rest. I would say get lots of sleep, but with a newborn that is unlikely. It isn’t healthy for an infant to sleep long stretches, so neither will you. Catching naps during the day and (if possible) learning to nurse reclining or lying down can make this easier on a mother. There are lots of us who have fallen asleep nursing sitting up though.

Stress can interrupt the hormonal functions of a woman’s monthly cycle, and it can also mess with the hormones for nursing. A new mother who is tense about nursing, perhaps because of sore nipples or maybe just overall apprehension, might not achieve letdown for a couple of minutes. A mother who is relaxed will usually have it within thirty seconds. Not all women can feel the letdown, so even just worrying about whether or not the milk is flowing yet can hinder the process.

In the four to six weeks after giving birth it is a good idea to lay low. Stay home, kick up your feet. If you are strapping baby into an infant seat every day and going places, then baby is likely spending less time in your arms nursing than he would otherwise.

I think I can’t

I’ve heard it a lot of times now. “I tried everything and I just couldn’t make enough milk.” Some careful inspection usually reveals that the “everything” were misdirected attempts to stimulate a boost in milk production. Breast pumps are far less efficient at sending those hormonal signals needed to increase supply than the mouth of a baby. Supplementing with formula or baby cereal has to be done very carefully or not at all while trying to increase supply or it will counteract all efforts.

But is it possible that some women really just cannot produce enough milk? Extreme circumstances aside, such as previous breast-reduction surgery or severely taxing medical conditions like cancer, I would say no. If your body has the right ingredients and the demand (hormonal imperative) to make milk, it can’t not do it. As with anything physical, like losing weight, some people will find it easy and others will have to work at it. Some mothers will be able to eat what they want and not worry about timing and still maintain a plentiful supply. Others will have to be more purposeful about their diet, fluid intake, and watching the clock to be sure baby nurses often enough. Life is not fair. Sorry.

A large number of women are told they can’t make enough milk, or good enough milk. In my reading I have yet to come across a satisfactory explanation of what this mysterious lactation-inhibiting malady is that suddenly afflicts so many modern women. My conclusion has been that a lot of women simply don’t understand how they should be eating and how often they should be nursing.

This is too complicated, I quit.

So prevalent is the idea that many women won’t be able to breastfeed that even mothers who would be just fine struggle with insecurity about it. Don’t second guess yourself. If you find all of this information completely overwhelming, don’t let that stop you from trying. You can still nurse without knowing every detail about how lactation works. Your body was made to do what it needs to do to nourish the baby it gave birth to.

The physical and emotional benefits for both mother and baby are so well documented that it is worth the sacrifice and perseverance to try to breastfeed as much and as long as possible. Ignore the mainstream voices that plant doubt and discouragement. Nurse the baby.

Try to learn to take advantage of nursing your baby as a time to rest.

Try to learn to take advantage of nursing your baby as a time to rest.

Recommended Reading

Ina May’s Guide to Breastfeeding by Ina May Gaskin
The Nursing Mother’s Companion by Kathleen Huggins
Get Your Fats Straight (The Healthy Home Economist Guide) by Sarah Pope

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  • Mary (http://owlhaven.net)

    Excellent, comprehensive advice! Thanks for sharing. One added factoid for anyone who is interested: it is even possible to produce milk for an adopted baby. I nursed three of mine, one for 6 months and the other two for almost two years each.

    Mary

  • http://anemoneflynn.com Anemone Flynn

    Thanks for the post, Rachael! This is very helpful and informative. :-)

  • http://www.chapterandpage.com/ Abigail Page

    I think it will still be a little while before I have a baby, but this makes me so excited :)

  • Rachael Fortner Wheeler

    I did know this! And I think it’s great.
    Years ago a woman from our church was adopting a newborn shortly after having lost a baby to stillbirth. I asked her if she was going to nurse and she didn’t know that was even possible. She came back months later and said that because of my question she did some research and went on to have successful breastfeeding with her adopted son.

  • IdahoMom

    Generally helpful information and good reminders about diet and breastfeeding! You’ve obviously done lots of research and are passionate about breastfeeding. However, I would take caution when claiming that only women who have had breast surgery or cancer are unable to produce enough milk. Women with Breast Hypoplasia or Insufficient Glandular Tissue (IGT) will very often seriously struggle to produce enough milk to sustain their infant, if they produce milk at all. These women will try EVERYTHING you’ve mentioned and MORE to no avail, only to feel looked down upon by the pro-breastfeeders who assume they just haven’t tried everything or hard enough. Insufficient supply due to hypolasia/IGT is a real condition with very real side effects beyond the aesthetic – not the least of which is that many women are devastated to discover that they are physically unable to nutritionally provide for their child like they always assumed they would. Low milk supply is not always just a result of poor diet, lack of confidence, or not offering the breast enough.

  • Rachael Fortner Wheeler

    Thank you for your reply! If you notice, I used cancer and and surgery as examples of extreme circumstances. I did not mean that they are the only conditions that might prevent successful milk production. There are always those rare cases and exceptions to the rule. Breast deformities such as breast hypoplasia would qualify in my mind as extreme circumstances, in that they are rare and the exception to the norm.
    I am a little less sure about IGT, because it seems more a theoretical explanation than a proven condition. I am glad to see that there is research going on to look into it.
    I still maintain that a true inability to breastfeed is rare. Very rare. And not a pervasive problem as mothers are commonly led to believe.

  • ellienau

    This is a great post, I have to thank you for sharing! I myself am a mother of two and a birth and postpartum doula. I have attended and hosted breastfeeding support groups around my town, and am a breastfeeding educator and strong advocate. I think it is difficult and challenging to get some mamas to understand the points you were making during your post, and I appreciate how you wrote and worded things. It made it very easy to follow, and I truly hope that women who take the time to write about such delicate, yet important factors about breastfeeding, like you, continue to set great examples. I am always pleasantly reassured when I see posts like yours – giving mamas answers and confidence with gained wisdom! I was particularly drawn to your post because of the analogies you used and how well the message was communicated. Again, it’s not always easy to express the importance of breastfeeding in the correct way without hindering the mamas fragile, emotional state. I am proud of your post, thank you again!

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