Is there enough milk?

 

It seems a mother’s lot is always to worry, whether her child is 2 days or 12 years old. One of the biggest worries for a breastfeeding mom may be whether you have enough milk for your baby. Even when things seem to be going well and baby is gaining weight (that’s the ultimate test isn’t it?), things can shake your confidence.

  • Not getting much milk when pumping: First reaction, “Surely the baby can’t be getting much milk if that’s all there is!” The amount of milk you express may not always reflect how much milk there is. For instance, the wrong size breast shield can severely limit the amount of milk expressed. (The good news is that the best pumps now have options for different flange sizes.) Different women respond differently even to the best pumps, but generally the better the breastpump, the greater likelihood you will be able to express more milk.
  • Not feeling a “let-down”: You may worry if you don’t feel a milk ejection reflex, especially if you have heard vivid descriptions of the sensation from friends. The fact is not all women can feel their let-down, ever; even if they do it can change over time.
  • Never felt engorged: You may have also heard dramatic stories of milk coming in and presume the lack of such drama is a problem. If fact, if a baby has been nursing well from the beginning, it may be that you and baby are closely in step with one another early on. As long as the baby is gaining normally, most likely there is plenty of milk.
  • Not leaking much or at all: Some moms find their breasts leaking constantly. Other moms leak only after a couple of hours as their breasts fill in anticipation of another feed. However, similar to the absence of engorgement, the absence of leaking may just mean your body adjusted more quickly to your baby’s needs. Those moms whose bras and shirts are constantly wet will be envious.
  • Breasts feel soft: One of the best ways to assess whether a baby had a good feed is for you to learn the feel of your breasts when full and then after emptying. These cues help you let go of the clock and quit timing baby’s feeds, but still have some confirmation the baby got enough to eat. Early in breastfeeding, breasts usually feel full prior to most feedings. After a couple of months, most women notice less variation in how their breasts feel before and after a feed. This is a normal process as the breasts get more efficient at producing a generous amount of milk when demanded, even without pre-filling and storing as much as before.
  • Milk color is different than expected: The color of a your milk is sometimes troublesome. Actually, sometimes it’s not you who is as concerned about this as perhaps your mom or an aunt. Women a generation ago were often told their milk wasn’t rich enough and should switch to formula to ensure a healthy baby. (The fact is human milk does look a bit like skim cow’s milk. But the difference is not fat content; there is less casein in human milk and casein reflects light more white light.) Your milk may also reflect different colors because of various foods you eat.

Unfortunately, perceived low milk supply often leads to true low milk supply. If you have these concerns but don’t get the information and encouragement you need, you may begin offering supplements. Every ounce of supplement a baby gets is an ounce of milk your body won’t make; what was once just a worry becomes real.
--Sue Petracek, IBCLC