How to Build a Strong Supply of Breast Milk

Because so many variables impact a mother's milk supply, the cause of a low supply is not always obvious. Sometimes the origin of a mother's difficulty remains a mystery and cannot be traced back to any one cause. Of course, having a history of surgery such as breast reduction will affect a mother's potential to produce a full supply; however, she can still breastfeed. Although some factors that affect milk supply are outside a mother's control, many factors are within her control.

Consider Marla, whom we met at the beginning of this article. Most likely, she would have developed a full milk supply if she had breastfed baby Henry early and often during the first weeks of his life instead of having him under the care of a hired baby nurse. Missing out on these early feeding opportunities suppressed Marla's milk supply.

A variety of situations or conditions have the potential to delay the arrival of a mother's mature milk. Having a difficult birth or a cesarean section may delay a mother's experience of primary engorgement. Diabetics may also experience delayed primary engorgement. Even being a large-size woman can put a mother's milk supply at risk. Experiencing greater than expected blood loss while giving birth or having a retained placenta inside the uterus after birth can lead to milk supply problems. Of additional concern are hormonal birth control measures that are prescribed or administered too early in the postpartum period. Birth control hormones can short-circuit a new mother's ability to establish a full milk supply.

To review, pregnancy prepares your breasts for breastfeeding. In fact, your body assumes that you will breastfeed and prepares early breast milk for your baby's first meal. After giving birth, the hormonal landscape shifts within your body and culminates with the arrival of your high-volume mature milk. It is important to navigate smoothly through this time to protect your future milk supply. Once this phase of engorgement passes, your body will be ready to learn just how much milk your new baby needs.

ASSUME
Assume that you will easily build a strong supply of mature milk for your baby. Keep a positive breastfeeding mindset, and don't be discouraged if you have a risk factor that may predispose you for a delay in the arrival of your mature milk. I have worked with many new mothers who had multiple risk factors for delayed primary engorgement. Many of these mothers welcomed the arrival of their mature breast milk right on time. Assume you will be a breastfeeding success story, and chances are you will be.

BREAST CHANGES
During pregnancy, your breasts will grow larger, and the color of your nipples may darken. Your breasts will prepare colostrum for your baby's first meal. This early breast milk will be available even if your baby is born earlier than expected. About three to five days following your baby's birth, your breasts undergo more changes with the arrival of your mature breast milk. Primary engorgement is a turning point in your breastfeeding relationship. Your breasts will become larger, fuller, and warmer. The color of your breast milk will gradually change from yellow to white. Finally, your baby will respond to this high volume milk by swallowing frequently during feedings, and you may notice breast milk in and around your baby's mouth after feeding.

COMMUNICATE
In the hours, days, and weeks that follow your baby's birth, it is important to send your body the message that you want to breastfeed your baby. By clearly communicating your intention, your body will respond by making a strong supply of breast milk. Begin by breastfeeding after birth. Keep your baby close to you so that you can breastfeed frequently. Breastfeeding after birth and breastfeeding frequently sensitizes your body to the hormones that regulate your future milk supply. Manage the swelling that can accompany primary engorgement by applying cold or heat treatments to your breasts. Reducing the swelling of your breasts will facilitate milk removal and help you to remain comfortable.

Excerpted from The ABCs of Breastfeeding: Everything a Mom Needs to Know for a Happy Nursing Experience by Stacey H. Rubin, M.N., APRN, IBCLC. Copyright © 2007 Stacey H. Rubin, M.N., APRN, IBCLC. Published by AMACOM Books, a division of American Management Association, New York, NY. Used with permission. All rights reserved. www.amacombooks.org.