Myths About Breastmilk and Low Supply

Danielle Dent-Breen's picture
breastfeeding baby

As a brand-new nursing mother, I worried almost incessantly about my milk supply. And now as a mom with years of experience, I have found that the number one obstacle new moms face in establishing a healthy breastfeeding relationship is overcoming that same worry.

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Is your milk supply really too low?
It’s actually quite possible that your supply is actually perfectly adequate for your baby. Many first-time moms easily mistake normal infant breastfeeding behavior, and normal physiological processes of the breast as an indication that their supply is lacking. During the first six weeks or so, the mother’s body works in tandem with the baby to regulate the production of milk to meet the baby’s needs.

In reality, the following myths are not true indications of breastmilk supply.

Your breasts suddenly seem softer, don’t leak milk, or only leak a little.
Leaking and engorgement are completely normal in the first few weeks, but often stop after your milk supply has adequately adjusted to the baby’s needs.

Your baby nurses often, or more often than normal.
Breastmilk is very easily digested—usually in only 1.5-2 hours—so breastfed babies need to eat more often than formula-fed babies. Babies also have not only a strong sucking instinct, but a need to be in close, continuous contact with their mom for emotional security. Babies will nurse more frequently or lengthen the duration of feedings in preparation for a growth spurt. As the baby nurses more, and sucks at the empty breast, it signals your body to increase milk production for the next feeding. It is important that you do not give baby supplemental feedings of formula or previously pumped milk, as it will interrupt the natural signals for your breasts to make more milk and keep up with baby’s growth.

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You get little to no milk when you pump.
The truth is, pumping is a very different physiological process than nursing, and a baby is always much more efficient at removing milk from the breast than the pump. Some women, even with an abundant milk supply, are never able to really establish a freezer stash of pumped milk. In my own experience, even when I was tandem nursing a toddler and a newborn, I was unable to ever pump more than a couple ounces at a time.

Your baby gulps down a bottle of formula after feeding
Many babies experience normal fussiness during the first couple months of their lives. This commonly takes place in the evening hours, when the baby and the parents are both tired. The best thing to do during these times is to offer the breast as much as baby wants it. This is often referred to as “cluster feeding”, and can be physically and emotionally exhausting for parents. Some babies will become so upset during their fussy time of the evening that they will have a difficult time calming down enough to breastfeed, and will appear to refuse the breast. Parents, when unable to soothe the baby may “break down” and offer a bottle, thinking that the fussiness of the baby is related to low supply or milk quality.

When the baby is given a bottle, that baby’s mouth fills with milk, the baby is forced to swallow, and this swallow initiates another suck, which again fills the mouth, causing the cycle to repeat over and over again, and making it appear that the baby is hungrily gulping down the bottle, when in reality, the baby is simply reacting reflexively to the artificial nipple. Understandably, this only reinforces the parents’ fears, and in turn, they offer more and more bottles, eventually leading to a true low supply.

How to truly know if baby is getting enough milk:
If baby is gaining weight with exclusive breastfeeding, that is the best indication that the baby is getting enough. All babies lose 5-7%, up to 10%, of their body weight in the first few days after birth. Baby should begin to gain weight by around day 5, at 2/3 to 1 oz per day. In addition, once mom’s milk has come in, babies should be experiencing 6 or more wet diapers per day, and 3 or more dirty diapers with yellow, seedy stools. During feeding, Mom should listen to observe normal breastfeeding suck and swallow sounds. The baby will pause during feeding to swallow after approximately every two to three sucks.

If you truly suspect that you have a problem with breastmilk production, it is important to get in touch with a board certified lactation consultant, or your local chapter of La Leche League. Hospitals and your pediatrician’s office will most likely allow you to come in for a weight check free of charge. If baby is not gaining or is losing weight, it is very important that you see your pediatrician to rule out any medical conditions that may be causing this issue. Some babies may require medically necessary supplementation while working with the physician and lactation consultant, but if at all possible, this should be done with a

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Comments

This article is very irresponsible and does not account for the millions of women who actually do have a supply and whose babies get hospitalized for starvation-related complications due to exclusive breast-feeding like jaundice, dehydration and hypoglycemia. A widely publicized case of an exclusively breastfeeding child who starved to death 12 hours after discharge was exhibiting all the conditions you describe above as normal. The conditions you describe absolutely describe insufficient breast milk. If you can't pump it or weigh it with a scale or can't see it with your eyes, the milk is not there. It is irresponsible to hide the very real and dangerous consequences of ignoring signs of low supply in order to convince mothers to avoid supplementation that can save her baby's brain and life.
Thank you for your comment. Please know that the story to which you are referring is one where the baby's care was terribly, tragically mismanaged at the hospital, and does not negate the validity of the points made in this article.The baby in question was only 3 days old... For many, many breastfeeding mommas,their milk does not even come in fully on day 4 or 5, and this is completely normal and expected. Their babies don't starve. Re-hospitalization due to low milk supply is actually quite rare. That said, if there's ever a doubt in your mind that your baby is getting enough to eat, contact an IBCLC immediately. Statistics tell us that more and more mothers are successfully breastfeeding. Data supports professional support prenatally and through breastfeeding establishment as a big part of that success. True causes of low supply (milk transfer issues and hormonal issues) can also be assessed quickly by knowledgeable professionals. The vast majority of women can nurse their babies (and it's not even always difficult!) and do not need to fear breastfeeding.