How do you know if you are making enough breastmilk … and if you're not, how do you increase your breastmilk supply?
What is Normal Breastmilk Supply?
The first breastmilk you make is called colostrum. It is sticky, and thick and can be clear, white, yellow or brown in color. The baby usually eats about a teaspoon to a tablespoon at each feeding during the first several days of life. The colostrum changes to a more liquid substance within a few days after delivery. This first breastmilk will still contain some of the yellow colostrum for the first 2 weeks, but after that the breastmilk will look whiter in color. A full breastmilk production is said to be about 750 ml/day (25 ounces) but some women may be producing closer to 4000ml/day. (133 ounces) So how in the world do you know if the amount of breastmilk you are making is enough, especially if you aren't pumping?
- In the first couple of weeks, seek help if your baby is displaying the following:
- Brick dust colored urine (uric acid crystals), no urine for 6 hours, or dark colored urine after day 3 of life
- Fewer than 4 urinations a day after day 5 of life
- Still passing black meconium stool after day 5
- No daily stools once the mature milk came in
- Noticeably sunken fontanelles (soft spot on the top of the head) when baby is held upright.
- Noticeably increased yellow tint to babies skin along with increased sleep and decreased time spent eating
- Baby is still below birthweight by 2 weeks of age
Signs that Your Baby is Getting Enough Breastmilk
- Day 1 = one wet and one black meconium stool. (more is fine)
- Day 2 = two wets and one or more black stools
- Day 3 = three wets and one or more black or green stools
- Day 4 = four wets (no longer dark) and one or more green stools
- Day 5 = five wets and one or more green to yellow stools
- Day 6 on = six to eight wets a day and one or more yellow stools a day
These numbers represent the normal transition time frame and the minimum amount desired. Your breasts should become fuller as the mature breastmilk comes in between 3-5 days post-delivery. The way to get your breastmilk to come in and keep the baby happy is to put the baby to the breast as often as he is showing hunger cues (rooting, trying to latch onto anything that touches mouth, turning head to side with mouth open, fussing, crying) and at least by the 3 hour mark. It is best to NOT let your newborn sleep longer than 3 hours during the day and 4 hours at night.We know breastfeeding is hard so always remember that breastfeeding benefits mom as well as baby as you're along your breastfeeding journey with your baby.
Best Strategy for Bringing in a Healthy Breastmilk Supply
- Frequent breast stimulation: Both breasts should be "stimulated" at least 8 – 12 times a day. (in the beginning and when you are trying to increase your breastmilk supply) Whether from the baby sucking or from a pump or both - the breasts MUST have that frequent removal of milk in order to make more milk! So the very first thing to try to increase your supply is to increase the stimulation to the breasts! Pump after feedings and/or in between feedings – even if very little to nothing is coming out!
- Rest, fluids and food: Foods that are said to help increase production are: steel cut oats (old fashioned oat meal), dark leafy greens, almonds, coconut milk, and protein. Be sure to drink at least half your body weight in ounces. (140 # = 70 oz/d) Eat 3 well balanced meals and 2-3 snacks of fruit and/or protein each day. Be sure to rest during the day as you will be up frequently at night as well!
- Avoid artificial nipples: All sucking should be at the breast in the beginning, as this will help bring your breastmilk in quicker and prevent any nipple confusion. If your baby requires supplementation while you work on increasing your breastmilk supply, you have several options available for you. You might want to look into a supplemental nursing system or lactaid that allows you to feed the baby at the breast while giving formula though a tube taped to your breast. If you would prefer to use a bottle, look up "paced bottle feeding" on You Tube. If you are first feeding the baby at the breast and then "topping off with a little formula", be sure to pump after each bottle given so that your body understands that it needs to make more.
- Avoid the following: Diuretics, cold medications that contain: pseudoephedrine or phenylephedrine, estrogen containing oral contraceptives and excess stress.
- Seek help from a lactation consultant: There are multiple reasons for supply issues and a visit with a lactation consultant could help you find and correct any underlying causes. (from anatomical issues, poor suck, tongue ties, PCOS, retained placenta, thyroid disorders, insufficient glandular tissue and more) Our recommendations will be based on your history.
- Try adding herbs: One of my favorites for those with no thyroid issues is UpSpring's Milkflow Fenugreek and Blessed Thistle drink packets and capsules! There are so many things to choose from in the stores but MOST of them don't contain enough of the right ingredients to be helpful! UpSpring developed their Milkflow drink mix and capsules with the advice from lactation consultants as well as their bioengineers and chemists.
- Be patient! It takes at least 3 days for the increased demand to bring in the increased breastmilk supply!
Lastly, if you have heard that "even a little breastmilk is better than none" – that is so true! Your breastmilk is dynamic and contains living microorganisms that help fight disease and keep your baby healthy. If you are struggling, contact a lactation consultant who will be able to help you figure out what you can do. Go to www.ilca.org/home and click on the "find a lactation consultant" to find one near you.
-Linda Hill RN, IBCLC