8 Frustrating Breastfeeding Challenges—and Solutions

Many new moms worry from the start that they will not or do not have enough milk to feed their babies. Most times, the fears are unwarranted and once Mom learns how to assess her supply, she becomes much more confident of her ability to provide what her baby needs. A lot of moms will ask, "How do I know how much she is drinking?" Breastfeeding moms do not necessarily need to know to the ounce how much their babies are drinking, but there are many ways to determine how efficient your supply is.

• Are you feeding Baby at least eight times per 24-hour period?
• Is Baby latching effectively to maximize milk intake?
• Can you hear your baby swallowing as she is drinking?
• Are you keeping track of the wet and soiled diapers throughout the day? (By the time a baby is a week old, he should be wetting six to eight diapers and soiling at least four times in a 24-hour period.)
• Look at your baby: Does she look content and satisfied after a period of active eating?
• Does she generally sleep contentedly for two to three hours? (She may have a few fussy periods or cluster feeds in the evening or wee hours of the morning where she wants to feed more frequently—this is normal!)
• Do you notice a softening of your breasts after feeding? (Before feeds they will feel more full and firm.)

If you can answer yes to these questions, your baby should be getting what she needs. According to the World Health Organization (WHO) report on growth rates for breastfed babies, infants will gain on average between 4 and 7 ounces per week in the first four months or so of life. You should be visiting your pediatrician for weight checks periodically to assess her growth and chart her progress. Generally if all is going well, the scale will tell the tale!

If your baby is not gaining well and is more fussy than usual, not gaining as she should, or suddenly wanting to nurse much more frequently, your milk supply may need to be assessed. Sometimes when a baby is going through a growth spurt (about every three weeks), they will nurse more frequently. Be patient: If it is a growth spurt, after a few days of more frequently nursing she will settle back into her routine.

Possible causes of low milk supply:

• Supplementation of formula
• Over-use of pacifier
• Maternal illness or return to work (fatigue and illness can put a temporary dent in your supply)
• History of hormonal issues (i.e.: infertility)
• Poor latch
• Premature baby
• Sleepy baby (insufficient stimulation can lead to low supply)
• Breast reduction or augmentation (more common with reductions)
• Limiting time at breast

Without knowing the exact cause of a specific low-supply situation, the following are good low milk supply treatment strategies to implement:

• Rest, eat well, and increase fluids by mouth.
• Spend time working with a professional to determine the cause.
• Avoid bottles and supplementation (unless medically necessary).
• Make sure your baby is wetting and soiling the right amount of diapers for her age.
• Breastfeed frequently—the more milk that is removed, the more your body will make.
• Make sure Baby is latched properly.
• If Baby falls asleep after nursing from the first breast, change her diaper, wake her up, and encourage her to nurse on the second breast.
• If recommended by a lactation consultant, try pumping a few times a day to increase stimulation.
• If recommended by a lactation consultant and your doctor, the use of herbal supplements called galactogogues—milk supply boosters!—may help.
• In some cases your doctor may write a prescription for medications that may boost supply.