#56 | Breastfeeding Mini: The Importance of Establishing Your Milk Supply in the First Month

October 19, 2020

It's not your boobs! It's your baby. One of the biggest misconceptions that new mothers have around breastfeeding is that they won't be able to produce enough milk to meet their baby's needs. And one of the top three reasons that mothers stop breastfeeding is a sense of insufficient milk production, leaving mothers feeling that their bodies and breasts have failed them. In today's minisode I address the critical window of time for establishing a full milk supply and the three biggest culprits that stand in the way of getting there...and your breasts aren't one of them!

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View Episode Transcript

Hey everyone, it's Trisha. And I am back again with another breastfeeding minisode. This week. So far, we've done two, the first talked about the first few days, and the second talked about the first week of breastfeeding, how to get started and how the initial time he put it in the beginning set stage for success in the long run. So this week, I want to go a little longer out, I want to touch on the first four to six weeks, and I want to get deeper into the concept of your baby being the driver of your milk supply. Almost every first time mother I have ever worked with wonders, if not worries whether they will have enough milk to feed their baby. And certainly if a mother has had difficulty with her milk supply in the past, she definitely worry she will have the same challenge again. In fact, a sense of insufficient milk supply is one of the top if not the number one reason that mothers choose to stop breastfeeding, and many of them feel is their own fault, or the fault of their breasts and body. But it is not true. Your milk supply is regulated by your baby, not your boobs. We learned in the first week of breastfeeding mini how more effort in equals more milk out. And the same holds true for the next month of your baby's life. By the time your baby is six to eight weeks old, your milk supply is pretty well set. And unfortunately, it can be difficult to adjust after this period, it can be difficult to increase it after this period. So the point I'm trying to make is that again, the extra effort of frequently breastfeeding and breastfeeding on demand or on cue makes all the difference in your long term success. The biggest misconceptions that mothers have around breastfeeding is that babies should be put on a feeding schedule, or that breastfeeding will always require this much work, or that their bodies are not capable of producing every single drop of milk that your baby needs. Remember, in a normal healthy mother baby team, your baby regulates your milk supply and your breasts no matter how big or how small, no matter what kind of nipple you have, they are capable of producing everything your baby needs, you just have to listen to your baby. So let's get into some of the details of how this actually works. During the first week, your milk supply is going to increase. It will go from the small little bits of colostrum that you're making in the first few days to around 10 to 12 ounces per 24 hours. And your baby's stomach grows from being about the size of a marble to the size of a golf ball. After that first week, your milk supply continues to increase to around 20 to 24 ounces per day. And your baby will consume anywhere from usually two to four ounces per feed. Sometimes less, usually not much more. by four to six weeks of age, your milk supply will reach its maximum, which is around 24 to 32 ounces per day. And that's all you will ever need to make. I'm going to say that again. That is all you will ever need to make. One of the questions that mothers Frequently Asked me in the early weeks, as they see their baby's appetite growing is how will I ever give up with this. And they're so relieved to know that they don't have to your body is amazing. And it adjusts the composition of your milk to meet the increased demands of your baby. So once you reach that four to six week mark, and you are at full milk supply, that's it. You never have to make more. So you can see how important it is that in the first four to six weeks, you establish that full milk supply. So how do you ensure you get to this point, you feed your baby on demand or on cue you throw up the clock you forget the schedule, you forget all the rules anyone has told you about feeding your baby too much or too often. Babies, like children and adults have appetites that vary throughout the day. I mean, honestly, do you know anyone who eats the exact same amount at every meal, babies are the same. And on top of their appetites being variable, your breast also produce more or less milk at different times of the day. Most women will report that they have the most milk in the morning. This is likely due to the fact that overnight we have higher levels of prolactin. prolactin is the hormone that's responsible for helping us make milk. Also, babies tend to sleep a little bit longer stretches at night. So we may have a four to five hour stretch without feeding, therefore, our breasts are likely going to be fuller in the morning. Alternatively, most women also say that they have less milk in the evening. And this is the time when babies tend to cluster feed. And it's normal. It's normal for a baby to want to feed every 45 minutes to an hour for several hours in the evening. So as long as you're aware that this is expected that this is part of our normal physiology and biology, then you don't have to feel stress that there's something wrong with you or your baby. Fortunately, babies do settle into a more consistent feeding routine as they get older. But we really should not expect this in the first six to eight weeks of life. For some babies, it takes a little bit longer, you and your baby will have your own unique feeding rhythm. And it will not be like your neighbors, or your sisters or your best friends and definitely not like your mothers. If your baby is feeding anywhere from eight to 14 times in 24 hours, and is gaining weight, on average of an ounce per day, sometimes a little more for male babies. And whatever you're doing is right. And you're setting yourself up for success in the long term, while breastfeeding your baby exclusively for six months and continuing through the first year of life, obviously with the introduction of solid foods at some point in there, but still breastfeeding is the recommendation of the American Academy of Pediatrics. Many mothers, including Cynthia and myself, choose to breastfeed for much longer, or our babies choose to breastfeed for much longer. And that's a beautiful thing. Because once you've achieved that full milk supply at that 46 week mark, the journey gets so much easier. It's so much easier than carrying around bottles, preparing formula buying formula, not to mention a lot less costly. So for the mother, who really desires to exclusively breastfeed, I'll say it again, those first four to six weeks mean everything for making your long term success happen. A couple more points quickly before I finish, there are two reasons other than schedules that also can interfere with a full milk supply. The first is the use of supplemental milk in the first six weeks. Any milk that is not from your breast, your pumped milk is okay. Your pumped milk can be given. It's not supplemental milk it is from your breast. So any other milk that's not from your breast will interfere with establishing your supply. I strongly recommend avoiding 100% any other milk other than breast milk in the first six weeks even one or two supplemental feeds can interfere with your body establishing that milk supply because every time your baby gets milk from outside your body, your breasts get the message that they need to make less milk, they adjust very quickly. The second culprit is the pacifier. Well, it's very tempting to offer a pacifier and usually encouraged by hospitals, nurses, mothers, mothers in law's friends, family, whatever. I also strongly discourage the use of a pacifier in the first six weeks. Now I know a lot of people are going to be thinking, Wait, I have used it, it worked. If everybody around me uses it, what if I just use a little bit. The problem of using the pacifier in the first six weeks is that it inevitably prolongs the interval between feeds. And any amount of prolonging the interval between feeds can impact your ability to getting to that full milk supply. The only exception I have to this rule is the use of a pacifier for very short term when your baby refuses to take the breast. So if you're trying to breastfeed, and they are your baby is very worked up and they can come down and they are willing to suck on a pacifier as opposed to your breast then, okay, but only until they are calm. Usually, I recommend that you use your finger instead. The reason for that is that the finger is easy to take back. The pacifier is easy to leave in and to leave in for longer periods of time or to sort of be so relieved that we finally got our baby to calm down and they're sucking on the pacifier and they're happy. And we need that moment of rest. And it just feels easier to use a pacifier. But again, in those first four to six weeks, any amount of prolonging intervals between feedings can interfere with establishing that critical point of getting to the full milk supply.

And after six weeks, you can definitely use the pacifier as needed. All right, that covers it for today. If you take away just one piece of information from these first three episodes on breastfeeding, it is that when in doubt, and your baby's waking is good. Let your baby lead the way. Trust your baby. Listen to your baby.

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Between episodes, connect with us on Instagram @DownToBirthShow to see behind-the-scenes production clips and join the conversation by responding to our questions and polls related to pregnancy, childbirth and early motherhood.

You can reach us at Contact@DownToBirthShow.com or call (802) 438-3696 (802-GET-DOWN). 

To join our monthly newsletter, text “downtobirth” to 22828.

About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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