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A while back I shared a picture on Instagram of an info graphic that stated these examples of breastfeeding issues are commonly mistaken for, but NOT actually indicators of low milk supply. For fear of stealing someone else’s work I will just tell you what the graphic said:

• Shorter feeds
• Not leaking anymore
• Milk is the “wrong” color or too thin
• Frequent nursing
• Inability to pump or express milk
• Not feeling milk ejection (or let down)
• Softer breasts
• Baby wakes up a lot

I realized that the post was only half helpful when a follower of mine responded with “well, what do they mean then?” and I thought to myself… “that is a good question!” But the answer is long and there isn’t one clear one.

As women we are made to feel like breastfeeding is natural and normal, so it should come easily. We are also trained to doubt our bodies from the moment we become pregnant. We should just listen to our doctor, and often times blindly enter postpartum with this new issue to address – breastfeeding, without any real knowledge about how it is supposed to go.

I struggle to navigate the fine line of preparing moms to breastfeed. How do you talk about it without romanticizing it and setting moms up for failure because they are having challenges that they didn’t expect, but how do you keep it real without making it sound so hard and awful that they expect to fail because it they have heard it can be really difficult.

The truth is, it is both. Both hard, and gets easier. It is both awful, and wonderful. It can be painful, and it can be the smooth sailings. It is all the things, and being educated about the realities one may face while breastfeeding is the most helpful. The bottom line and one thing I wish I could change for all women is that most problems are exacerbated by our self doubt. Doubting our ability to breastfeed, doubting our body’s adequacy, and doubting that we actually know what our baby or our body are telling us. I wish women (in every aspect of life) were believed when we said we know our bodies, and felt confident trusting that knowledge because our bodies are very strong, capable, knowledgeable, and trustworthy.

I thought in honor of World Breastfeeding Week I would elaborate more on this post and break down what these signs actually do mean. If they aren’t signs of low supply, what are they signs of? How can I tell what low supply actually is then? And how do I figure out the difference?

First up is shorter feeds:

If your baby is suddenly not nursing as long, it is time to assess your baby. Are they gaining weight and pooping? If it is a yes, yes answer then I wouldn’t worry for one second. Are they getting older and more efficient at the breast? Are they becoming more aware of their surroundings and distracted sometimes to nurse for as long? Have they started solids and are interested in more than just milk?

It is likely that as your baby grows they will becomes better at removing the milk from the breast, and they will also over time, nurse less and less. You may feel like all you do is nurse a newborn, but overtime the feeds will dwindle down to maybe only two or three times a day as toddlers. Your body adjusts to these changes and continues to customize milk to the needs of the baby/toddler. A more concerning issue would be too long of a feed. If baby is nursing 45 minuets on each breast there is a possibility they are struggling to remove the milk.

Not Leaking:

Congratulations! Your milk supply is regulating and your boobs are adjusting to making the right amount of milk for you and baby. Leaking is common during pregnancy as your body prepares to make milk. Leaking is very common in the early postpartum days as your hormones regulate and your supply becomes established by baby’s nursing patterns. Overtime, you will get your period back and your body will heal and you won’t be a leaky, covered in milk, postpartum, new mom forever. It is normal and nothing to worry about.

Milk color changes and consistency:

Breastmilk is pretty much the closest thing on our planet to magic. Our milk is always changing and customizing itself to meet baby’s needs. If you notice sometimes that your milk changes in color it is usually to address something going on with baby.

You see, babies transfer their saliva to our breast when they latch. Our bodies take that and use it to make milk according to the messages we get from the saliva. If baby is fighting off a bug, or has a cold, our milk can double up on needed nutrients to help baby along. It is not uncommon to see blue, green, or orange tinted milk, especially if you know baby has an ear infection, for example. Breastmilk is also higher in fat content at different times of the day, or produces more or less of some nutrients depending on when baby will be sleeping and waking up. Milk is usually made to be a perfect fir for the baby it is feeding.

Frequent Nursing:

I feel like this is the most confusing problem for a lot of women. They think, “surely he shouldn’t need to nurse this much!” But yes, they do. Whenever I was around family, and Holden nursed a lot I would hear comments like “wow he is so hungry!” or “eating again?!” and it would sometimes make me question why he was nursing so much, and there is no way for this not to be a loaded answer, but there are so many reasons why babies could have an uptick in how much they nurse.

They often call this “cluster feeding” and they may be having a growth spurt and need more milk, and are signaling to your body to get busy. They could be teething, or not feel well, or be overwhelmed and want to nurse for comfort. They could be sick and getting those extra antibodies from your milk. They may have slept a long time earlier and have woken up extra hungry. Do we as adults have the same sleep patterns or hunger patterns everyday? I sure don’t. Over analyzing the baby’s need for the breast is searching for a problem. Breast are made to feed babies and make milk. Lets stop questioning why our babies want to be near them and just follow their lead.

Additionally, all breasts are very different. Different sizes, different shaped nipples, different milk storage capacity. No two women or babies will breastfeed for the same duration, frequency, or with the same out put. That doesn’t make one bad or one good. It just makes them different. A woman with a large milk storage capacity may only breastfeed her baby every four hours, or every three hours on one side each feed. Another woman with a smaller milk capacity may need to breastfeed her baby every two hours on each breast for 15 minutes before baby is full. Both are meeting their baby’s needs, and both have adequate supply, but both are very different and that is ok. We need to stop believing an over supply, or engorgement, and 4+ ounces on each breast from the pump is the norm, or even desirable. Ideas like that make mothers who are meeting their baby’s needs doubt their supply and can ruin an otherwise great breastfeeding relationship.

Inability to express milk/ respond to the pump:

This is incredibly frustraing for women who experience this. Especially women returning to work and relying on expressed milk to feed their baby. But the truth is – pumps can’t do what a baby can do with jaws and tongue and suction designed to withdraw breastmilk. Babies are more efficent at removing milk, and a pump will never be an adequate refelection of how much milk your breasts actually produce. Some women just do not respond to the pump as well as others. Women with really stong let downs, or very large milk storage capacity may have no trouble at all with pumps, and other women who breastfeed babies wonderfully, without issue may never get more than half an ounce at a time. It doesn’t make them a low supplier – it just makes them not a responder to the pump.

Some women also pump in addition to breastfeeding and expect to get full bottles of milk on each side despite their baby drinking most of it through the day. If you are exclusively breastfeeding and pumping additionally to build a stash, but only getting an ounce or two… that is normal! And probably for the best. Otherwise you could have an over supply, which leads to another slew of issues.

Not feeling milk ejection:

Some women never feel a let down. Some women will feel a let down and then over time it fades away. Maybe your milk has regulated where the let down is not as forceful. If baby is satisfied at the breast- trust that baby is satisfied. Baby will often times clinch fist when she is hungry and relax her hands when she is full. Or may pass out “milk drunk” if you will, in a floppy, relaxed, deep sleep state from being full. You don’t need to see the milk or feel the milk coming out to tell if baby is getting it.

Soft Breasts:

When your milk first comes in often times your breasts will feel large, hard, and full. That is not how they should stay. If you notice your breasts getting hard and full like that frequently it could lead to some negative side effects. One being loss of supply due to your body making milk that isn’t being removed. Milk production is supply and demand, so if you have too much supply and not enough demand (oversupply) then your body will adjust overtime to make less milk. If you are waiting until your breasts feel full like that to nurse or pump, you may sabotage your own supply. You may also risk a clogged duct or mastisits.

Moral of the story is big, full, hard boobs are a sign milk needs to be removed. If you are feeding baby frequently, once your milk regulates your breasts shouldn’t be getting hard like that anymore. If you go longer than normal between a feed, say baby sleeps 7 hours unexpectedly instead of 4, you may wake up with really full breasts, but softer breasts overtime are a sign or regulating milk production to the needs of baby, and is not something to worry about.

As your breastfeeding relationship continues into nursing a toddler, you may notice that your breasts never get full anymore, but there is still milk there that baby can access.

The worrisome/horrible/terrible “baby wakes up a lot” complaint:

Firstly, babies do that. They wake up. In the middle of the night, and they want to eat when they do. They are biologically programmed to nurse every few hours. They have little tummies, and breastmilk is easy to digest causing them to need frequent feeds. Babies require that physical check in with their care provider. It helps regulate their temperature, heart rate, breathing, and blood sugar. It honestly isn’t safe for babies to stay in a deep sleep state for too long. It is a survival adaptation, and it tapers off overtime. As the months continue baby will sleep for longer and longer stretches and nurse less frequently at night.

If they randomly change this up after weeks or months of longer sleep stretches you may want to re-read the frequent nursing section. They may be in a sleep regression, growth spurt, have a tummy ache, or be fighting an illness. They could be teething, or be constipated, or just want to be close to the mother who they grew in for 9 months and feel safest when they are close by.

Sleep is another developmental milestone. When babies or toddlers being to “sleep through the night” it will be when they are developmentally ready. Do I still have an almost 4 year old who wakes up at 2 am every night? Yes. Do I also have a 2 year old who sleeps most nights all the way through? Yes.

This is a time to follow baby’s lead. Take some deep breaths. Call upon the Lord for grace, patience, and strength. And remind yourself that this will not last forever. And one day- you will miss it.

probably.

This is not to discount that low supply is a real issue and a super frustrating and crushing problem for many women. But with the right information we can weed out the low supply issues from the women being led to believe they have low supply. The truth is we all want to provide for our babies. We want them to be nourished and cared for. It is a terrifying thought for mothers to think that they are depriving their baby of what they need.

If your baby is pooping and peeing adequately and gaining weight, but dealing with some of the issues listed above- supply is probably NOT the issue at hand.

If baby is not pooping/peeing enough. Not gaining weight. If you have a lot of pain while nursing, or a baby who is never satisfied, maybe even frustrated at the breast, or an overly sleepy (lethargic) baby who is nursing for too long then we may want to look at supply as an issue.

In order to get the situation assessed properly it is best to consult an IBCLC. NOT a pediatrician. Pediatricians are NOT breastfeeding experts. Growth charts are based on formula growth patterns and there is a lot of formula pushing that could happen under their watch. There is nothing wrong with needing or using formula, but there is something wrong with not helping a woman successfully breastfeed when she wants to successfully breastfeed. Pushing an alternative as her only option is not support. An IBCLC can address many different issues. Latch improvements will help baby remove the milk more effectively. Tongue/lip/cheek ties can be checked to also help baby effectively remove milk. If they can’t remove the milk properly they can’t get enough to eat. Without the milk being removed from the breast, your body may not know to make more milk, which will hinder milk supply. It is a vicious cycle. Retained placenta will also cause a delay in milk production (in addition to other severe problems.)

I hope this is helpful and informative on a week like world breastfeeding week, where the goal is to educate women for better breastfeeding outcomes. Most women who want to breastfeed, but struggle in someway are in need of more support, information and resources. I want all women who want to breastfeed to have access to this information and support.

Never be afraid to reach out for support, but also never be afraid to listen to your body and your baby. It is ok to trust your instincts and follow the lead of your little one.

If you have any other breastfeeding questions or needs, feel free to send them my way! If I can’t help as a CLC- I will be more than happy to refer you to an IBCLC who can!

Alexa <3