When You Aren't Making Enough Milk
In general, the more you breastfeed, the more milk you'll produce. But if you get off to a relatively rocky start with nursing--whether it's because you and your baby are separated in the hospital for longer than normal, your child isn't latching on well, or another reason--establishing an adequate milk supply can be a big challenge. Even when everything goes right, some women don't make enough to meet their baby's needs. This is most common among moms who have multiples, those who have had breast-reduction surgery, and possibly women who give birth later in life. "In my experience, the older a woman is when she has a baby, the more likely she is to have milk-supply problems," says Rosenfeld. Experts aren't certain why, though they suspect it may be because a woman's body becomes less efficient over time at producing breast milk.
If your baby repeatedly seems hungry after you breastfeed him, you may have a low milk supply. Talk to your pediatrician about having your infant weighed before and after a feeding to see how much milk he received, suggests Sheela Geraghty, M.D., medical director for Cincinnati Children's Center for Breastfeeding Medicine. She may recommend that you pump your breasts in addition to breastfeeding to increase your supply and that you top off the meal with some extra pumped milk or give your child a supplement of formula for a short period of time.
Helpful hints: Nursing is more effective at stimulating your milk production than pumping, so it's important to keep it up even if it's a struggle. While some women who have sore nipples may decide to pump exclusively for a while, this strategy could cause your supply to dwindle further.
If you need to supplement your infant's diet with pumped breast milk and formula, they may be mixed together safely in the same bottle. Dr. Geraghty recommends that you prepare several smaller bottles (about 2 ounces each) in case your child doesn't finish. Once a baby sucks on a bottle, the remaining contents should be discarded. As you initiate bottle-feeding, begin with the smallest nipple size, since a slow-flow one most closely mimics your own body. Many moms of twins find that it works best to nurse only one baby at each feeding and bottle-feed the other, alternating so that each child gets to nurse at every other feed.