If you're a breastfeeding new mom, you've probably already discovered that nursing can be confusing and occasionally difficult. From getting your baby to latch on properly to mastering the football hold, there's plenty to stress out over—but few things make a new mom worry more than the topic of breast milk supply.
Building, maintaining, and even increasing milk supply is just one piece of breastfeeding success, but it's certainly an important one—and one that's commonly misunderstood by moms and professionals alike. It's normal for new moms to have lots of questions about whether or not they are making enough breast milk to feed their babies.
The good news is that the vast majority of mamas will create an appropriate supply just through breastfeeding on-demand and frequent skin-to-skin contact with their babies. Still, it helps to understand some of the factors that can negatively impact your ability to produce enough of that liquid gold. Surprisingly, these eight things can reduce your breast milk supply:
Pseudoephedrine, a common ingredient in many over-the-counter allergy and cold medications can decrease breast milk production. This is not good news for nursing mamas that suffer from severe seasonal allergies, but all is not lost: a dosage of this drug isn't likely to affect breast milk production once your supply is well-established. So while you might consider avoiding it in the first few weeks after giving birth, you may be able to take it later on without much risk to your milk supply.
Hemorrhage after birth is a scary experience--and it certainly doesn't make things any better to know that it can also inhibit early breastfeeding. Basically, the thinking is that the traumatic birth and maternal stress experienced during a large loss of blood can inhibit lactogenesis, or the making of milk. Having a hemorrhage can affect when your milk comes in and how much you end up making, especially if the hemorrhage caused you to be separated from your baby.
But don't be discouraged: Once you feel up to it, you can certainly start to breastfeed frequently, letting your body know that there is indeed a baby that needs to be fed. Pumping can also help you increase breast milk supply after a hemorrhage.
Hypothyroidism, or a low-functioning thyroid, can interfere with milk production. The thyroid helps in the regulation of both prolactin and oxytocin, two main hormones involved in breastfeeding, although research has been scant on the exact effect of the thyroid on breast milk supply. If you realize your baby isn't getting enough breast milk, one of the first things to do is to have your thyroid checked. Postpartum thyroiditis, in which the thyroid gland becomes inflamed, will affect 4 to 9 percent of women in the first year after giving birth. This condition can eventually cause low thyroid, so it's important to be proactive with thyroid conditions as a new mother.
You've likely heard of galactogogues—herbs like fenugreek that can help induce, maintain, and increase milk supply. There are also quite a few herbs and spices that can lower your milk supply. Sage, peppermint, oregano, lemon balm, parsley, and thyme are said to decrease milk flow during breastfeeding when taken in large quantities. But don't freak out: If you're not eating copious amounts of them, you'll likely be just fine. You can still cook with them or use them in other useful ways in your home. However, if you're an essential oil user, you may want to do more research about certain oils made with these herbs to find out if and how they can affect breastfeeding.
The majority of hormonal birth control methods are just fine for breastfeeding. But a few of them, especially those containing estrogen, could affect the amount of breast milk you make. Birth control options that have progestin only (as opposed to progesterone and estrogen) are generally a better choice for nursing moms. The Mirena IUD, the shot (Depo-Provera), the implant (Implanon), and the mini-pill are examples of progestin-only birth control options.
If you're concerned about hormones and breastfeeding, make sure you talk with your provider and make it clear that maintaining a good milk supply is important to you when deciding on post-birth contraception.
A woman's surroundings—or even her mother's— may play a role in her milk supply. A small study conducted in 2006 found that daughters of women who grew up in a pesticide-contaminated agricultural valley of Mexico had a much higher incidence of insufficient mammary tissue—or, in some cases, no mammary tissue—than those living on a hilltop in the same area.
"We're seeing a dramatic increase in the number of women who have primary problems, possibly because of environmental contaminants," says Diana West, IBCLC, a coauthor of The Breastfeeding Mother's Guide to Making More Milk. "Lactation consultants around the world are reporting increases in the numbers of women who can't produce enough milk."
"Interventions are allowing people to get pregnant when they wouldn't otherwise, causing babies to be born to women who might not have fully functional reproductive systems," West says. "For example, many women with PCOS [polycystic ovary syndrome, a condition that can cause ovulation problems] also have much less functional breast tissue."
"Many women want to schedule feedings and stretch out the nighttime interval, which throws a wrench in the supply-and-demand of breastfeeding," says Nancy Hurst, Ph.D., R.N., IBCLC, assistant director of the lactation program and Mother's Own Milk Bank at Texas Children's Hospital in Houston. "If the breasts aren't completely emptied early on—and often—a woman can really take a hit in terms of her potential ability to produce milk."
If you've ruled out the factors above and are still worried about your milk supply, what can you do? For starters, continue to breastfeed your baby! Cindy Chavez, an international board-certified lactation consultant and state coordinator of the New Mexico Breastfeeding Task Force, says that for most moms, simply increasing the number of times you breastfeed will help with increasing milk supply.
"There's great comfort to be had in knowing that a mother's milk supply is based on supply and demand," she says. "Most babies throughout the first year of life need to nurse eight to 12 times in a 24-hour period. So the easiest and most effective way of producing more milk is to nurse more frequently."
Another option: Meet with a lactation consultant. "Many times moms get misinformation about how to tell if their baby is getting enough from health professionals, family members, or friends," says Felisha Floyd, an IBCLC and president of the National Association of Professional and Peer Lactation Supporters of Color. These people may mean well, she adds, but they're not required to have updated research-based information like a lactation consultant does.
With bottle-feeding, it's easy to tell if your baby's getting enough food; not so with the breast. "Breasts aren't clear and calibrated," says lactation consultant Nancy Hurst. Since you can't tell what's going in, the alternative is to watch what comes out. "I recommend the 'Rule of 4,' " says pediatrician Marianne Neifert, M.D. "By 4 days of age, a breastfed baby's stools should turn yellow and seedy; he should have at least four stools a day; and that pattern should continue for at least four weeks."
Also, he should urinate at least six times a day and the urine should be clear, not dark yellow. Your newborn should breastfeed at least eight times in 24 hours, and you should hear frequent swallowing while he nurses. Schedule an extra weight check if you have any concerns.