Help, I don’t have enough breast milk!

Breast milk is produced on demand, so the more baby drinks, the more mummy will produce. — Filepic

The majority of breastfeeding mothers will have plenty of breast milk and their babies will thrive.

However, a variety of factors can cause a mother to have a low milk supply.

Such mothers need not worry though, as there are many ways to help them increase their milk production.

In this column, we will examine how milk production works and how to increase breast milk production.

On demand

Breast milk is produced according to demand.

Any time milk is taken from the breasts (whether by breastfeeding or by a pump), there will be more milk produced in the breast to replace it.

Empty breasts produce new milk faster, full breasts produce new milk more slowly.

Therefore, the more you breastfeed or pump, the more milk will be made.

But the process of emptying your breasts depends on effective milk removal.

The production of milk supply will not be fully stimulated if your baby is not emptying or draining your breasts thoroughly.

A good breast pump can help with milk removal in such a situation, while you work with a lactation consultant to improve your baby’s latching and positioning to encourage and enable them to drink more.

And of course, you should ensure that you drain your breasts thoroughly if you are exclusively pumping breast milk for your baby.

A lactation consultant explains how to use a breast pump to a new mother. Breast pumps can be used to completely drain a breast of milk, which will help stimulate production of more milk. — TNS

Stimulating supply

There are many ways to naturally encourage better milk production.

These include:

> Frequent feeding

Your milk supply will be improved if your baby is allowed to feed as often as he needs.

Breastfeeding more frequently at certain times of the day – known as feeding in clusters – is completely acceptable.

When breastfeeding sessions are closer together, breast milk contains more fat, and therefore, your breasts will produce more milk.

> Correct latching and positioning

It’s a good latch if your baby’s mouth covers lots of breast tissue and not just the nipple.

Additionally, positioning is important for your baby to get a good mouthful of milk, as well as feel comfortable and stable at the breast.

As your baby latches well and begins to consume breast milk, you may hear your baby swallowing or observe her pausing to swallow.

Breastfeeding should not hurt and sore nipples actually indicate that something is wrong.

> Breast compressions

Breast compression refers to gently massaging and applying steady pressure to a breast during a breastfeed in order to stimulate another milk let-down (a reflex that makes milk flow).

When your baby stops actively sucking and swallowing after less than 10 minutes, or falls asleep after less than 10 minutes of swallowing, gentle breast compressions may increase milk flow, causing baby to start sucking again and further stimulating supply.

> Pumping and hand expression

Pumping or hand expression is extremely helpful if your baby is not latching, if you are pumping to store breast milk, or if your baby is not emptying the breasts properly.

A breast massage during pumping and hand-expressing excess milk after pumping have been shown to significantly increase milk supply.

However, if you are working with a lactation consultant and have improved your positioning, feeding frequency and are using breast compressions, pumping may not always be necessary.

> Feed from both breasts

By giving your baby both breasts at each feed and letting him finish each side at his own pace, you can increase your milk supply.

Keeping to one breast per feed will help reduce the milk supply.

Once your baby has finished sucking on the first breast, offer the second breast and use breast compressions when his sucking slows down on the second breast.

Allowing a baby to use a pacifier can stifle their hunger cues and influence how they latch on and suck from mother’s breast. — AFP

> Monitor active feeding and swallowing

It is normal for your baby to be the one to end the feed once she has had enough milk.

It is likely that she will fall asleep after active sucking and swallowing for roughly 10 to 30 minutes.

During this time, her hands and face will be relaxed, and she will release the breast naturally.

Pay attention to the baby who is “hanging out at the bar without buying any drinks”.

While she may stay latched for an hour or more, close inspection will show that she is not actively sucking or swallowing milk.

This baby may sleep with hands clenched in tight fists and may have a worried expression.

In this case, you will need to pump and top up your baby’s feed with a bottle of breast milk or formula.

> Avoid pacifiers and inconsistent feeding

Dummies (pacifiers) can cause babies to miss feedings or to go longer between feedings as their hunger cues are stifled by an empty teat.

Pacifiers may also influence how babies latch on and suck, as pacifier teats are different from breast teats.

Also, delaying or scheduling feeds because you think your baby won’t get hungry again can prevent them from getting all the milk they need.

> Diet

Breast milk production can be affected by mother’s diet as certain nutrients are particularly important for milk production.

If the breastfeeding mother’s diet does not supply these nutrients, milk production could be affected.

> Galactagogues

Galactagogues are certain herbs, foods and prescription medicines that are said to stimulate breast milk production.

Examples of these are fenugreek, oats, and domperidone (usually used to treat nausea or vomiting).

That said, galactagogues cannot replace the stimulus provided by frequent milk removal.

Take the time to identify and resolve whatever is decreasing your milk supply first, then galactagogues may help.

> Acupuncture

Some mothers with inadequate milk production may find acupressure, acupuncture or manual therapy helpful if any of the important nerves involved in milk let-down are impaired or if any of the mother’s spinal vertebrae are misaligned.

In China, acupuncture has been used for 2,000 years to increase milk supply.

It is reported that specific acupuncture points can increase prolactin levels, thus increasing milk supply.

Prolactin is a hormone that helps produce breast milk.

Fenugreek, which has a long history of use as a spice and medicine, can also help to stimulate breast milk production when consumed by mother. — Filepic

Other causes

Increasing milk production in breastfeeding mothers can be done in a variety of natural ways.

But it is also possible that there may be other reasons why a mother’s milk supply is low.

Some medical conditions, such as hormonal imbalances or androgenic issues, or medications, can reduce breast milk supply.

See your doctor to discuss solutions and to ensure that your baby is getting enough supplementation and is growing well.

Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician and gynaecologist, and a functional medicine practitioner. For further information, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.