The Vicious Circle of Low Milk Supply

After receiving a phone call from a concerned husband seeking advice regarding his wife’s apparent low milk supply with her 6 day old baby I’ve decided to write this blog to share what I advised on what is such a common issue with breastfeeding – that of keeping up with baby’s demands for feeding, feeling like you don’t have enough milk, feeling like you’re not filling your baby.

Firstly a couple of pointers I wish to state:

1) Breastfeeding is the most natural thing in the world for some, but for others it can be a struggle and take some time, effort and perseverance to succeed. The fact that I am talking about this issue does not mean that all breastfeeding mothers will experience this, I’m not trying to make breastfeeding sound like a negative experience, I’m just being open, honest and realistic as to what new mums can experience so that if this is you I want you to know that you are not alone and you are not certainly not a failure.

2) Breastfeeding should not be painful, if it is please get your latch/position checked with your Midwife/ Lactation Consultant and ask them to look at your baby’s tongue to check for “Tongue-tie”. In the same way, please make sure if you are having issues with supply/demand then please get your baby’s positioning at the breast checked out – because if they are not positioned correctly they can be suckling but not draining the breast.

So on with some advice on the supply and demand issues of breastfeeding:

• Anxiety – This plays such a massive role in the low milk supply story for a lot of women. Lactation is a very hormonal process, the hormones have to be at the right levels in order for the process to begin and be sustained. You may initially be anxious about getting the baby in the right position to feed, or maybe you have sore nipples or it could be a more generalised anxiety? However when you are anxious your body produces adrenaline, this adrenaline overrules the prolactin hormone that is trying to produce the milk and your production slows down. Typically you then become anxious because of the reduction in your supply – which creates more adrenaline which again stamps out prolactin and so the negative cycle goes on! So in short the key is to recognise the anxiety and then work to reduce it. All of the following will help combined with reassurance and support from health professionals, friends and family.

• Rest – Make sure you rest as much as possible, this is easier said than done with a baby who seems to be constantly feeding! However when they finally sleep – you must sleep. Don’t try to multitask and do loads of jobs – your job needs to be sleep in order to reenergise your body to produce milk. Partners want to help but sometimes they don’t know how – get them involved with taking baby out for a walk in the pram, a couple of laps round the block will get baby to sleep, whilst not being far away from you, enabling both of you to relax with the idea. If visitors want to come, let them come and take baby out for a walk whilst you and your partner both get some rest. Go to bed early in the evening if the baby is sleeping – allowing you a block of sleep before the middle of the night shenanigans begin! If you’ve had a sleepless night – have a PJ day in bed to rest and relax with baby close by.

Drink – You really need to increase the amount of fluids you are drinking to assist with the milk production. Clear fluids are best and avoid caffeine. There are some herbal tea blends available to support lactation or you can just buy a fennel tea. Every time you sit to feed baby you should also have a drink to hand. Don’t wait until you feel thirsty before you have a drink – the feeling of thirst is your body’s final step in trying to let you know you are dehydrated.

Food – It is so easy to forget to eat or not feel hungry when you are caring for your new-born for what seems like every hour of the day – but you must feed yourself in order to be able to feed your baby. You may be recovering from a long labour or even surgery or excessive loss of blood so your body needs fuel to mend, recharge and to be able to provide milk. Without calories it will be like running on a flat battery and your milk supply will be the first thing to be affected. Things like jacket potatoes, beans, wholemeal toast and fruit are all quick and easy to grab. You can also get some cereal bars aimed at breastfeeding to give you a boost of calories in a small convenient way. Another thing to consider is the offers of help that family & friends might be making – don’t be polite and decline! Take them up on their offer and ask them if they can cook you a meal to bring round, maybe a casserole or lasagne? Failing that did you know that Toby carvery do a take away service!

• Bosom Buddies – This is Natural Birthing Company’s unique set of blended breastfeeding oils developed in conjunction with a qualified aromatherapist, ensuring they are totally safe for breastfeeding mothers. The “Aah” blend supports lactation with key ingredients of Lemon Grass, Fennel and Mandarin essential oils. Lemon Grass and Fennel have galactogogueproperties which mean they help with the formation and secretion of milk. Whereas Mandarin (and Lemon Grass) also have beneficial effects on low mood and anxiety. The oil is applied by adding a couple of drops to a bowl of warm water, mixing to disperse the oil and then submerging a couple of flannels into the solution. Apply the warm wet flannel compresses to the breasts, cover yourself over to keep cosy warm and relax back for 30 minutes. During this time you can refresh the compresses back in the solution to maintain a warm temperature. The oils work by sinking in through the skin tissue and also by inhalation. The process can be done as often as required and is preferable shortly before a feed or expressing.

• Support/positive role models – There is nothing like the love and support from family and friends to help a new breastfeeding mummy through a rough patch. Women who’ve been through the same experience are sometimes the best people to learn from. Even it’s it just hearing their empathy rather than being told to “just give the baby a bottle” which isn’t always what you need to hear. Search online for “Infant feeding cafes” in your area or ask your Midwife/Health Visitor for information of suitable groups. A lot of these will also have specialist Breastfeeding supporters involved.

• Iron count – As a result of childbirth many women can end up being anaemic and may be prescribed iron tablets. Symptoms of anaemia are shortness of breath when walking, feeling tired, light headed and dizzy. If you are experiencing any of these symptoms you should discuss them with your health practitioner. Anaemia can also have a part to play in low milk supply, therefore it’s doubly important to boost your iron supplies if you are breastfeeding. You can increase your iron intake through your diet without any need for supplementation but this can be a longer process. If you have been prescribed tablets try to take them will a small glass of orange juice as the vitamin C will help with the absorption of the iron. Also leave it 30 minutes before drinking tea or coffee because these have the opposite effect and stop the iron tablets from being absorbed. If the iron tablets cause side effects, there are alternative forms of iron in tablets or liquids – speak to your pharmacist or nearest health shop.

• Pumping/Expressing – This is something to consider, whether it be by hand or with an electrical/manual breast pump. The theory of pumping is based on the supply and demand principle of lactation. In effect the suction and nipple stimulation cause the release of prolactin (hormone involved in the making of the milk) and oxytocin (hormone involved in the delivery of the milk). The best time to pump is after a feed, letting your baby have what he needs first. Once the baby is settled then pump for 10 minutes on each breast. Do not fret if you don’t see any milk or you get very little – the whole point of pumping in this situation is to stimulate your body to produce more milk. So a full session with no milk will still be beneficial because you will be stimulating the hormones to make more milk ready for the next feed. But don’t forget you need to relax, because the vicious circle of anxiety ↔ low milk will be in full force here if you’re not careful!!

• Supplementation – Just to mention about giving baby formula milk – understanding the supply and demand theory of lactation; that being the more the milk is demanded, the more your body will supply, you can understand why giving your baby formula may not be in the best thing when it comes to resolving the low milk issue. Yes it may fill the baby and allow them to settle, thereby giving you a break – but in the long run it could well makes things worse. However as already mentioned being tired and miserable will not help your low milk supply either! So if you need a break from it all then the choice is yours – however go sparingly as a large feed will stretch your baby’s stomach and get him used to larger volumes.

I hope I’ve given you some pointers on how to rectify a low milk supply. Here’s some breastfeeding support contact details for further on the spot information and advice:

National Breastfeeding Helpline 0300 100 0212 (9.30am – 9.30pm)

Association of Breastfeeding Mothers 0300 330 5453 (9.30am – 10.30pm)