Too little milk? How to increase milk production

October 26, 2010

What does a mother need to do to establish good lactation and maintain it until the moment when the baby prefers a spoon and a mug?

The best food for a baby is mother's milk. Every child's milk is ideally suited to his mother's milk. Breastfeeding provides all the necessary nutrients and water, strengthens the child’s immunity and gives a unique closeness between mother and child. In most cases, up to six months the baby does not need any other food at all. But what does a mother need to do to establish good lactation and maintain it until the moment when the baby prefers a spoon and a mug?

How does milk appear?

Breast-feeding

If the option of breastfeeding is available to you, choose it. After all, mother's milk is the best food for a baby.

The main condition for establishing lactation for a healthy woman is feeding itself.
Milk is secreted in response to the baby sucking at the breast, and the weaker the baby sucks, the worse the lactation. This is a natural mechanism that produces exactly as much milk as the baby needs. Therefore, it is very important
in the first days of a child’s life to put him to the breast and not to interrupt his appetite, without feeding or supplementing him with anything. If this is not possible, the breast must be expressed to achieve milk release. Also, milk begins to be released as a reaction to the baby's crying. Simply put, the best condition for establishing lactation is for the mother to be close to the baby.

How to start breastfeeding, or how to make sure you always have enough milk

Authors : La Leche League International

It is best to start feeding immediately after birth, as soon as the baby is ready to latch on. A healthy full-term newborn usually experiences a peak need to suck 20 to 30 minutes after birth, unless sedated by drugs or anesthesia administered to the mother during labor. In the first hour of life, newborns are quiet, awake, and able to attach to the breast and suckle effectively. Research shows that most newborns, when placed immediately on their mother's belly, find the breast and begin nursing in less than 50 minutes. Separating mother and newborn at this critical time means that this first opportunity is missed. Later, the baby may want to sleep and lose the natural need to search for the nipple, which can create some difficulties in establishing feeding. Thus, one of the most important steps to establish adequate milk supply is to allow the baby to breastfeed within the first hour after birth. Even if a mother is able to put her baby to the breast immediately, sometimes babies are unable to latch on properly in the early days after birth. This may be the result of an epidural or other anesthesia given to the mother during labor. Some types of drugs used for anesthesia can reduce the baby's ability to spontaneously find the breast and interfere with normal feeding behavior, and can also raise body temperature and cause crying. It is important to understand that unsuccessful feeding immediately after the birth of a child is not a death sentence. It must be remembered that it is very useful to feed the baby frequently in the first days in order to activate as many prolactin receptors as possible. If feeding your baby in the first hours after birth is not possible, the best alternative is to express by hand or with a breast pump until the baby begins to feed on his own. This will help activate the maximum prolactin receptors and minimize the consequences of delayed initiation of feeding. In the best way, the first meeting and acquaintance of the child with the mother takes place in a calm, pleasant, familiar environment. Although this environment may be difficult to create in a hospital setting, the mother will benefit from feeling supported, encouraged, and reassured.

Feeding after a cesarean section It happens that feeding immediately after a cesarean section is impossible. If the operation was performed under general anesthesia, the mother may not immediately recover enough to be able to cope with the baby in the first hour after birth. Even if the mother has had an epidural and the mother is awake, suturing takes up a significant portion of the first hour, and feeding during this time may be inconvenient. Additionally, the newborn may be drowsy and unable to breastfeed if the mother received pain medication prior to surgery. Some studies suggest that emergency caesarean section may delay the onset of lactation. However, frequent latching after a caesarean section, as soon as possible, will help minimize any of these problems if they occur. Know that many women have had plenty of milk and breastfeed successfully after a C-section.

The Great Importance of Colostrum Mothers need to understand and appreciate the enormous benefits of colostrum, the translucent, yellowish “precursor milk” that is produced in the breasts in the first few days. Colostrum, like the milk that comes later, nourishes and protects the baby like the placenta during pregnancy. Colostrum is low in fat and carbohydrates and high in protein; This is exactly the balance of nutrients that a child needs in the first few days. It is easily digested and contains active cells that protect the newborn from bacteria, viruses and allergens. Colostrum coats the intestinal mucosa from the inside and prevents the absorption of substances that provoke allergies. Immunoglobulins IgG and IgA are present in colostrum in higher concentrations than in milk. These immunoglobulins also stimulate and strengthen the child's own immune system, and research indicates that the benefits last a lifetime. Moreover, colostrum acts as an effective laxative, expelling meconium from the intestines, and along with it getting rid of bilirubin, a substance that causes jaundice. And when milk comes in, colostrum does not suddenly disappear - the transition from colostrum to milk occurs gradually, over the first two weeks. This is why milk expressed during this period will appear more yellow than milk expressed later. Some women do not see colostrum before giving birth or are unable to express it after giving birth. If a woman does not see colostrum or cannot express it, she may worry whether she will be able to breastfeed or whether she will have milk. In fact, if colostrum is not visible when the baby nurses, this does not mean that it is not there. Colostrum is produced in very small quantities (on average only 7.4 teaspoons (36.23 ml) per day, approximately 1.4 – 2.8 teaspoons (6.86 – 13.72 ml) per feeding) and is immediately swallowed child. Sometimes colostrum is not golden yellow in color, but completely transparent, similar to saliva, and then it is even more difficult to notice. Colostrum is so valuable for a child that even a tiny amount of it will be a priceless gift, for which it is worth making every possible effort.

Shared stay Many hospitals allow mother and child to stay together in the same room. This is usually called cohabitation. Although in the past generation newborns were usually kept in separate nurseries, research has shown that there is no reason to separate mothers from healthy newborns, even for a short time. Moreover, skin-to-skin contact helps stimulate prolactin, the hormone responsible for milk production. According to a 2005 recommendation from the American Academy of Pediatrics (AAP), being together is good for both of you and allows you to start feeding your baby as early as possible, which is optimal for producing enough milk.

Feed often As you know, a child should be fed as often as he wants. The baby needs to be put to the breast every two to three hours during the day and every four to five hours at night, for a total of at least 8-12 feedings per day. The time between feedings is counted from the beginning of one feeding to the beginning of the next. Feeding usually lasts 20 - 40 minutes, but the duration of feeding does not need to be monitored. During the newborn period, especially in the first week, feedings seem to last constantly, and the mother does not have enough time for anything in the short intervals between feedings. Some newborns feed quite greedily until milk comes in because they are hungry. Such frequent feedings speed up the flow of milk. Frequent feedings are normal and necessary to stimulate the maximum number of prolactin receptors*, which are responsible for producing the maximum amount of milk. The first month of a child’s life is a learning time for both. During this time, the baby improves his sucking skills to suckle more effectively, receiving the required amount of milk in a shorter time. Close contact with the baby allows the mother to recognize early signs of hunger (restlessness, mouth opening, etc.) in time, which allows her to feed the baby without waiting for a hungry cry. Minimizing baby crying will save the nerves of the mother and other family members. Feedings will not always continue uninterrupted, although at first there seems to be no beginning or end to the feeding. Remember that you are recovering from childbirth and need rest. Breastfeeding is a natural mechanism that guarantees this rest. Gradually, the intervals between feedings will increase and feedings will become more convenient. The baby will develop certain habits related to feeding, and life will become more predictable. However, the regime that the child comes to will be exactly his regime, meeting exactly his individual emotional and physiological needs. Feeding patterns will change as your baby grows and develops.

Enlist the support of others The period after childbirth is a very difficult time. You feel vulnerable both emotionally and physically. You don't want people who are skeptical or critical of feeding efforts. Although breastfeeding is the biological norm, there are people in our society who are uncomfortable being around a nursing mother and baby. Such people tend to criticize the nursing mother even more if there is any reason to doubt the sufficiency of milk. This difficult attitude towards feeding is explained by insufficient understanding of the process, and sometimes by erroneous ideas about the breast as a sexual object. While establishing feeding, you deserve unconditional support and all kinds of help. You don't want negative comments that can undermine your self-confidence. In the first days and weeks after giving birth, it can be difficult to isolate yourself from negative people. Remember that you have the right to create a comfortable environment for yourself and for establishing feeding. After all, successful feeding is essential for the well-being of the child. In the end, the needs of the child are much more important than the opinions of others. If you find it difficult to avoid contact with critical people, ask your husband or another loved one to make sure that you are not disturbed. “What if your mother or mother-in-law gets bored? What to do with them? Many modern grandmothers may not have their own successful feeding experience. Some of them are sorry that they were unable to feed, and they are ready to do anything so that their daughters can feed. Others may try to justify their experience of needing or choosing to use formula, and your persistent efforts to establish feeding may be perceived as a criticism of their own parenting experience. Do you know the details of the birth and feeding of your mother and mother-in-law? Ask them to tell you about it and listen carefully. It is possible that they did not have the information, support and technical capabilities that you have, not to mention public support for breastfeeding. This conversation will help you express empathy for the difficulties they are going through and reassure them that you know they were great parents under the circumstances and acted on what they knew at the time. Empathy and understanding of their experience will help improve communication between you.

Family responsibilities In the first weeks of breastfeeding, the most important tasks will be caring for the baby, feeding and taking care of yourself. All other responsibilities are not so important after childbirth. If you have older children, you will need to pay attention to them, but in the first weeks, taking care of yourself and your newborn is an absolute priority. If possible, older children may be looked after by the children's father or other relatives during this time. Naturally, family and relatives will want to congratulate you on the birth of your baby and see the newborn, but visiting guests is too tiring immediately after birth, and many women are uncomfortable feeding their baby in the presence of strangers. Try to tactfully reschedule your guests' visits to a later time. If someone still insists, meet the guests in a nightgown or robe. This will make it clear that you are still recovering from childbirth and need peace. You can even go one step further and not get out of bed - this usually guarantees a quick departure for your guests.

Bed rest For those who want to spend the first few days in bed, this can be a very useful way to get a good start to feeding. You can stock up on books and magazines or move the TV to the bedroom, have food and drink nearby and only get up to use the toilet or shower. Feeding the baby on demand and close contact for some time after birth ensures optimal milk production. If you need an excuse for others, tell them that the “doctor ordered” you to go to bed; many doctors actually recommend resting after childbirth, because, despite your high spirits and burst of energy, you have just undergone significant physical activity and need time to recover. If you don't take the opportunity to rest in the first few days, the next few months may be more difficult than necessary, and this can affect your milk supply.

Kitchen and housekeeping These are just one of those responsibilities for which you should not feel responsible. When friends and family ask how they can help you, ask them to bring something for lunch or dinner. Even if two friends bring food at the same time, accept everything with gratitude and freeze what you won't eat today. People sincerely want to help you, and cooked food for a family with an addition is more valuable than another child’s suit. Doing housework, especially if you've been away for a few days, may seem like a pressing need, but the first few days after giving birth are not the time to throw yourself into the house, no matter how busy you are or how many guests you're expecting. Cleanliness and order in the house are not as important as your need for relaxation. Don't be tempted to do all the work yourself because it's easier than asking someone else. In fact, explaining where to put the dishes is much easier than unloading the dishwasher yourself. Remind yourself all the time that housework is not your responsibility. Nothing bad will happen if something is not done. Only the most insensitive dreamer can blame a woman who has just given birth for the fact that her house does not sparkle with immaculate cleanliness.

Eat, drink and sleep well To be strong enough to feed and care for your baby, you need to eat well, drink enough and get plenty of sleep. Never skip meals. Moreover, try to have healthy snacks outside of breakfast, lunch and dinner. Generally speaking, the quantity and quality of your food is more important to you than the quantity of your milk. The body will produce good quality milk even if you don't eat well. But your body and soul need tasty and healthy food. Drinking is in every way as important as eating. Fluid balance must be maintained. It's best to drink water, although decaffeinated teas are also a good choice and have a calming effect. Fruit juices are also healthy and have nutritional value. However, read food labels to make sure that juices do not contain added sugar - these are empty and unnecessary calories. Some mothers have noticed that drinking citrus juices in large quantities can cause anxiety in the child. But you don’t have to drink cow’s milk. Some children are sensitive to cow's milk proteins in their mother's milk, and milk is not an essential nutritional component for adults. Sometimes breastfeeding women are advised to drink milk so that they can produce milk. This is wrong; milk is made from nutrients we get from a variety of sources, not from the milk of another species. Adult cows do not drink any milk and successfully produce milk. After eating and drinking, the next most important need is sleep. You need to sleep as much as you can. Try to sleep at least once during the day - preferably at the same time when the child is sleeping. During the night, your baby will be awake for some time that you would normally be asleep, so it is important to make up for this sleep deficit. The best way to do this is to sleep when the baby sleeps. When your child falls asleep during the day, it is tempting to take a moment to write replies to congratulations, birth announcements, do things around the house, or talk on the phone. But it’s much better to spend this precious time relaxing. Sometimes it can be difficult to fall asleep - the child can wake up at any moment. But it is very important to learn not to worry about it and fall asleep as quickly as possible. If the baby wakes up, you will wake up too and then you will have to try to fall asleep another time. But if the child sleeps for a while, you will also rest.

If You Still Don't Have Enough Milk If you don't have enough milk and are trying to increase your supply, it's especially difficult when you have to take care of your baby and family, not to mention yourself, at the same time. The day consists of constant weighing between the needs of the child, the family and your own. Sometimes it is easier to forget about your own needs, putting them at the bottom of the list of priorities. However, try to remember that your needs determine your condition, which determines how well you meet the needs of others. Trying to do the impossible will exhaust you. It is important to find a reasonable balance and not forget about yourself in the process. Try to find time to simply enjoy the child, who will not be this small for very long. *Prolactin receptors are an important but often overlooked factor in the milk production process. Each hormone has corresponding receptors located on the organs affected by the hormone. Prolactin receptors are primarily located in lactocytes, the milk-producing cells of the mammary gland. When a woman is not pregnant or lactating, she has only a “base number” of prolactin receptors in her mammary glands. Pregnancy leads to an increase in the number of receptors, but not to the maximum number. The final factor determining the number of prolactin receptors that develop is the frequency of stimulation: the more often the baby breastfeeds or the mother pumps, the more prolactin receptors develop. The more prolactin receptors a mother has, the more milk the existing glandular tissue produces. Experts believe that frequent feedings in the first weeks of a baby's life are extremely important for the development of the maximum number of receptors that ensure sufficient milk production in the long term. Without these receptors, milk production will be compromised when prolactin returns to normal, low levels after two to three months.

published 02/27/2014 16:10 updated 03/19/2014 - Natural feeding

Possible problems

It is very important to use correct breastfeeding technique from the very beginning. Incorrect body position of the mother or child, incorrect grip of the nipple in the mouth can cause a lot of problems, such as swallowing air and cracked nipples. After feeding, the nipples should be lubricated with a drop of milk and allowed to air dry. If cracks have already appeared, you will have to feed the baby only with a healthy breast, expressing milk from the diseased breast using a breast pump. Special silicone nipple covers can also help, which significantly reduce pain.

Why is breastfeeding necessary?

Breastfeeding has not only nutritional, but also great psychological significance, influencing the development of mother-child relationships in subsequent age periods**. According to studies conducted in Australia, among such factors of a child’s psychological development as age, education, the presence of bad habits in the mother, lack of breastfeeding for at least 6 months has a 1.45 times greater impact on the child’s mental ill-health than others** *.

Condition level

Most parents worry whether the child is getting enough food (especially if grandmothers constantly say that the grandson is not well-fed enough). You can determine the baby’s condition by the following signs: 1. A well-fed child is a happy child
.
If the baby sucks calmly, making frequent swallowing movements, the milk flows well. If he is worried and angry, sucks, but does not swallow, perhaps there is no milk, or there is not enough milk. If a child falls asleep after eating, he is full. If he continues to cry and fidget restlessly, he is still hungry. 2. Healthy and active
.
If the child is pale and lethargic, he is most likely malnourished. If the child looks healthy and moves actively, then he is definitely not being starved. 3. Accurate counting
.
Buy an accurate digital scale. Weigh your baby before and after feeding. Write down the difference, and in the evening add up what you ate during the day. If the total numbers do not decrease from day to day, it means that milk production has not deteriorated. 4. Control diaper
. A malnourished child urinates less frequently and in smaller volumes. The normal color of urine should be clear or light yellow. Also, with insufficient nutrition, the baby’s stool changes. The so-called hungry stool has a greenish color, scanty volume and irregular consistency. If according to all these signs there is enough milk, there is no need to do anything, there is no need to improve lactation.

Folk remedies to increase lactation

There are many folk recipes for increasing lactation. But it’s always worth remembering: what helped one mother may not help or even harm another. Below we provide several recipes that can cause increased lactation. Before use, be sure to consult with your doctor, because all herbs contain essential oils with a stimulating function and biologically active components with a hormone-like effect.

Infusion of fennel fruits, dill seeds and anise

Mix 1 to 1 anise seeds, fennel fruits and dill seeds. Pour 1 teaspoon of the resulting mixture with a glass of boiling water and let it brew for 10–15 minutes. Take 3 cups per day.

Infusion of cumin, hops, nettle leaves, dill seeds

Mix 20 g of hops, 25 g of dill and caraway seeds and dried nettle leaves. Take 30–40 g from the mixture, dilute with 1 liter of hot water and leave for 10 minutes. Take 50 ml before or during meals.

Anise seed infusion

Pour 2 teaspoons of anise seeds into a glass of hot water and leave for an hour. Take 2 tablespoons 2-3 times a day.

Compliance with the basic principles of breastfeeding and a positive attitude can help the mother both increase lactation and cope with crises, and maintain breastfeeding for a long period. We recommend that all mothers consult a breastfeeding specialist.

Daily control

Many mothers, after 3-4 months of feeding, complain that they have significantly less milk. This illusion often arises due to the fact that milk production is completely normalized, and the milk stops “flowing like a river.” Instead of oozing continuously, it remains in the breast and only leaves when the baby begins to suckle. In this case, there is no need to supplement the baby’s feeding or immediately begin to improve lactation. All you can do is eliminate foods from your diet that affect the taste of the milk
or may harm the baby.
So, garlic and pepper can make milk bitter. Whole cow's milk and legumes can cause gas formation in the baby's intestines. Strawberries, shrimp and peanuts - cause him to be allergic. Salted and pickled foods retain fluid in the body and reduce milk supply. On the contrary, milk
products, fruits (best of all are those that grow in your area), boiled meat and fish, vegetables and vegetable oil will help make milk more tasty and nutritious.

Diet for a nursing mother

What is possible, what is not, and in what mode is it best for a nursing mother to eat? Simple answers to complex questions. .

Next stages of lactation

At the next stages of lactation it is important:

• pay special attention to night feedings; the maximum amount of the hormone prolactin (responsible for the secretion of breast milk) is produced from 4 to 7 am;
• Healthy food;
• if necessary, include lactation products with a lactogon effect in your diet;
• establish a rational daily routine for adequate sleep and rest;
• remain calm and have a positive, positive feeding attitude in all situations.

How to improve lactation

If, however, you or your doctor think that it would be good to increase milk production, use the following techniques. 1. Increase the number of breastfeeds. 2. The doctor may prescribe lactogenic drugs and physiotherapeutic procedures. 3. The amount of milk produced is well influenced by blackcurrant juice, walnut syrup, as well as herbal teas, which include anise, fennel, oregano, hawthorn, nettle and other herbs. Regular hot, freshly brewed green tea, which you can drink directly during feeding, will also help.

Products to increase lactation

To stimulate the production of breast milk, a nursing mother can include special products in her diet, for example, Lactamil. It contains a complex of special herbs that give a lactogenic effect: cumin, nettle, anise, fennel. "Lactamil" contains not only herbs, but also milk protein, fatty acids, dietary fiber, a complex of vitamins, and microelements. Their combination can promote rapid recovery after childbirth and increase the quantity and quality of breast milk. Unlike folk recipes and homemade “herbal remedies,” lactation products undergo clinical trials and have precise dosages of medicinal plants.

Useless knowledge

Sometimes people around you give “useful” advice and “folk wisdom” that are actually quite harmful. For example, there is a common misconception
that beer has a very good effect on lactation.
In fact, it helps no more than any other liquid, interferes with losing excess weight after childbirth, and the alcohol it contains passes into breast milk, which is contraindicated for children. Also, to increase the fat content of milk, many grandmothers recommend eating lard. Most of this fat will not go into milk
, but will be deposited in fat reserves on the stomach and thighs, increasing the risk of diseases associated with excess weight.
The only good advice
that no one will argue with is the importance for successful breastfeeding of a calm and friendly environment in the family, good rest for the mother and attention to her and the baby from others.

Tags:

• Breast-feeding
• Diet
• Babies

3 comments • To leave a comment you must be an authorized user

• Innasokolkina I somehow weaned my son off the breast at the age of two, and that was because of my third pregnancy. And so, I don’t know when they would have left, we were fine, it’s not yet known who was more worried, me or him. (such closeness)
• Lilith The given advice is given, of course, for healthy women with an uncomplicated pregnancy. If you have any doubts, it is always better to ask your doctor. If he doesn't mind nipple training, there's nothing to worry about.
• llo81 Hello, my name is Lyudmila. I am the mother of 9 month old Glebushka and we enjoy breastfeeding)) The article is good, I liked it - short and to the point. The only advice that raises some doubt is the preparation of nipples during pregnancy, because stimulation of the nipples causes contractions of the uterus, and this can be dangerous for women at risk of miscarriage. I think the author of the article should edit the advice somehow.

What affects the amount of breast milk?

If your baby isn't getting enough nutrition, it's most likely because he's not latching on properly, not because you're not producing enough milk. Read how to help your baby latch on correctly. But there are other factors due to which the amount of breast milk decreases:

• You started breastfeeding late (ideally, you can breastfeed your baby immediately after birth, but in some cases this is not possible).
• You are not breastfeeding often enough (experts recommend putting your baby to the breast on demand in the first month of life, but at least 8–12 times a day).
• You are taking certain medications, including those containing pseudoephedrine, or certain types of hormonal contraceptives that reduce milk production.
• The baby does not latch onto the breast correctly, which reduces milk production.
• You had breast surgery.
• The child was born prematurely.
• You have pregnancy-induced hypertension.
• You are overweight or obese.
• You have insulin-dependent diabetes.

When to do “incentive pumping”?

Many mothers prefer to allocate one or two time periods

, where they can do “incentive pumping.”

This means you can pump when:

• Your baby sleeps soundly
  (at night or early in the morning)
• If you are often separated from your baby, you can replace one of your regular pumping sessions with a “stimulus pumping” session
  , for example during an hour-long lunch break. Some women prefer to arrive early and do an “incentive pumping” immediately upon arriving at work.
• Some mothers prefer to combine a “pumping stimulation” schedule with their daily routine
  . This is especially convenient if you pump every 2 hours around the clock. If your baby happens to be ready to feed during your "pumping stimulation" session, you can either feed baby on one breast and pump on the other at the same time (then switch sides), or feed baby first, then pump.

Because prolactin levels (the hormone responsible for milk production) are usually highest between midnight and early morning, some moms choose to pump during this time.

And now the last and most important question.

Is the duration of pumping important?

Different moms have different preferences.

Some prefer a combination of 20 and 10 minute intervals (classic scheme).

Others prefer 10 minute intervals for both pumping and rest (see Jodie's recommendations), while some prefer 15 minute intervals, which add up to an hour and a half session:

• Pump for 15 minutes
• Rest 15 minutes
• Pump for 15 minutes
• Rest 15 minutes
• Pump for 15 minutes
• Rest 15 minutes

It happens that you can devote only 5 minutes to pumping,

and that's okay too, as long as you can
maintain your pumping frequency
(see Diane West's definition of "stimulant pumping" above).

So, let's move on to the next important question.

What are lactation crises

At certain periods of a child’s development, a lactation crisis occurs.

A lactation crisis is a discrepancy between the amount of milk a mother has and the baby’s needs. A child is characterized by leaps in development, during which his needs increase.

Most often these jumps correspond to age:

• 3-6 weeks;
• 3-4 months;
• 6 months.

If a lactation crisis is diagnosed, you need to know how to increase lactation.