Boosting Your Milk Supply
Milk is produced in glands buried deep in the breast, not in fatty tissue, so breast size is no indication of how much milk a mom can produce. Usually milk is produced according to supply and demand: you produce what your baby needs. If a mother finds she is having difficulty producing enough milk, there are several ways to boost supply.
La Leche League recommends that moms encourage babies to breastfeed frequently and for as long as they like. Breastfed babies regulate themselves; they take what they need at each feeding and from each breast; this ensures that the baby gets plenty of milk because the mother's milk supply is then boosted by frequent stimulation. Research now shows that restricting the amount of time at the breast and extending time between feedings can reduce not only a mother's milk supply, but also the fat content of her milk—resulting in a hungry, crying baby.
Dr. Miriam Stoppard, author of Your New Baby, says that looking after yourself properly by staying relaxed, eating well, and drinking enough fluids will help ensure you have enough milk for your baby. "You produce the most milk in the morning when you are rested," says Stoppard. "If you become tense during the day your supply could be poor by evening. Go through your antenatal relaxation routines and have a rest every day." A good tip for mothers worried about producing enough milk is to pump first thing in the morning, then feed your baby after he wakes up and is hungry. This will not only add to your back stock of frozen or refrigerated milk, but according to Stoppard it will also encourage your body to produce more milk to supply the increase in demand.
It is also important, Stoppard adds, to "eat a well-balanced diet that is fairly rich in protein. Avoid highly refined carbohydrates like cakes, biscuits or cookies, and sweets, and also avoid spicy foods which could affect your milk and upset your baby's stomach." Stoppard and La Leche League both advise that moms stay adequately hydrated too, drinking plenty of water throughout the day and during feedings if necessary.
In an important side note, Dr. Stoppard says moms should discuss methods of contraception with their doctors, since some birth control pills may decrease milk supply.
If Your Baby Has Tongue-Tie
Not getting enough sucking stimulation is another cause for insufficient milk supply. A sleepy, ill, or jaundiced baby may not nurse vigorously enough to empty the breasts adequately. Even a baby who nurses often may not provide the stimulation necessary if he is sucking weakly or ineffectively.
According to La Leche League, a baby with a short frenulum, also known as tongue-tie, may also suckle ineffectively. In a tongue-tied infant, the band of tissue that attaches the tongue to the floor of the mouth is attached close to the tongue tip, restricting tongue movement. Breastfeeding difficulties caused by tongue-tie are usually proportional to the tightness of the frenulum, the shortness of the free tongue, and the flexibility of the floor of the mouth.
Treatment of tongue-tie varies according to how well the tongue functions. If the tongue looks very tight but the baby is sucking properly and gaining well, swallowing comfortably, and the mother is not in pain or distress, there is less concern than if the tongue does not look classically tied, but the baby has difficulty moving milk, or the mother is in pain from the baby's sucking.
If you suspect your baby has tongue-tie, get a referral from your child's doctor to a specialist—such an oral surgeon, otorhinolaryngologists, or pediatric surgeon—who is familiar with tongue-tie. The physician may recommend a frenotomy, in which the frenulum is snipped with sterile scissors under a local anesthetic. This procedure involves little bleeding and is a low-risk operation. Some babies can go directly to breast after the frenotomy, while others may take a week or two to figure out how to use their newly freed tongue.