Establishing Your Milk Supply

Almost everyone giving birth can establish and maintain a good milk supply with the right information and support. When you understand how your body and your baby’s body work together to build your milk supply, it is easier to avoid choices that can negatively impact milk production. The hours and days after your baby’s birth are very important in getting things off to a good start. But even with a difficult start, milk supply can be improved in the early weeks. If you are concerned about your baby’s weight gain, have your baby checked by a healthcare professional, doctor or midwife.

Early and Often

Breastfeed early and often
An important first step in establishing a good milk supply is to breastfeed, or chestfeed, your baby within the first hour after birth. After that , allow your baby frequent, unlimited access to your breast in the early days and weeks. Newborns usually feed about every two to three hours (on average), or at least 8-12 times in 24 hours. Occasionally, babies can thrive on fewer feedings per day but they should be monitored for appropriate weight gain. Many babies nurse even more frequently. Nursing sessions may not be spaced evenly throughout the day. Some babies cluster several feeds together and then sleep for a longer stretch. Milk production is a “supply and demand” relationship. The more milk your baby drinks, the more milk your body will produce.

Immediately after birth, ask for your baby to be placed skin-to-skin on your belly, just below the breasts. Your baby can be dried off by the birth attendant while on your body, and then covered with a light, dry blanket. Your baby’s hands should not be dried. The smell of your nipples is similar to the smell on your baby’s hands and this will help your baby to find your nipples. If needed, adjust yourself into a comfortable reclined position. Ask that your baby be left undisturbed on your body for at least an hour or until after the first feeding is finished. Given time and patience, most babies can make their way to the chest and latch themselves for this first feeding. See the following video by Global Health Media.

The first milk the baby gets after birth is called colostrum, which your body begins producing in the last few months of pregnancy. It is rich in antibodies and other protective factors. The small quantities give your baby a chance to learn how to suckle without being overwhelmed by large volumes of milk. The delivery of the placenta signals to the body to begin producing mature milk and by day 3-5, the milk “comes in” and the volume increases substantially.

Hold baby skin to skin often
It can be helpful to think of your body as your baby’s natural habitat. It is beneficial to hold your baby skin-to-skin not only during the immediate postpartum period but for weeks, and even months afterwards. Being skin-to-skin with you helps your baby remain calm while learning to breastfeed. Using the senses of touch and smell, your baby can find the nipple and latch on. Skin-to-skin time helps to regulate your baby’s temperature and heart rate. It also heightens your hormones that are involved in milk production.

Latch

Ensure latch and sucking are effective
With a good latch your baby takes a large mouthful of breast which gently stretches your nipple to the soft part of your baby’s palate. When this happens, your baby is able to effectively remove the milk. This ensures that your baby gets plenty of milk and your body gets the message to keep making more milk. A deep latch also prevents the nipple from being pinched by the tongue and the hard palate. A shallow latch often results in sore nipples. Please see “Position and Latch” for more information on achieving a comfortable latch. In a small percentage of babies the tongue is restricted because of a tight frenulum or tongue tie. Because of this the baby may not be able to pull the nipple deeply into the mouth. If the latch is still painful even after trying to improve it, you are encouraged to seek the help of a professional International Board Certified Lactation Consultant (IBCLC). Then, if necessary, you may want to consult with a healthcare professional who specializes in diagnosing and treating tongue ties.

It is important to note the difference between “drinking” and “sucking”. Swallowing is a sign that your baby is drinking the milk. Your baby’s chin will move up and down when sucking but when there is a mouthful of milk your baby’s chin will drop with a longer “pause” in order to swallow. You may hear a “kah” sound as the baby breathes out after a swallow. If swallowing slows down, you can gently squeeze or compress your breast with your whole hand when your baby starts sucking. This will increase milk flow and encourage your baby to keep drinking. Your baby may want to continue sucking for comfort as the milk flow slows down. This can be very pleasant for both baby and mother.
Sleepy

Feed when baby shows signs of hunger
Every baby is unique and so it is important to watch your baby to know when it’s time to feed. Feeding when your baby shows signs of hunger is called “cue-based feeding”. Some cues that your baby is hungry are: restlessness, rooting (head turning towards your chest), head bobbing on your chest, mouthing hands and licking lips. Crying is a late hunger cue. If you wait until your baby is hungry you may find that your baby is too upset to be able to latch effectively. In the early days it is common for babies to latch and pop off several times until the milk starts flowing. Eventually your baby will learn to latch once, suck and wait for the milk to flow. You also will begin to recognize patterns in your nursing sessions as you get to know your baby. When you respond to your baby’s cues, your body gets the message to make the amount of milk that your baby needs. And your baby learns to trust that their needs will be met.

Sleepy baby
If your baby regularly sleeps more than three hours between feedings and is not gaining well, he may need to be awakened for feedings around every two hours during the day until your milk supply is well established. While your baby is sleeping, watch for movement. This is a sign of light sleep. You can wake your baby more easily from a light sleep than from a deep sleep. Gentle ways to wake your baby are:

  • holding your baby skin-to-skin,
  • unwrapping or undressing your baby,
  • holding your baby upright,
  • moving your baby’s arms and legs or rubbing his feet,
  • dimming the lights,
  • wiping baby’s face with a damp cloth,
  • talking to your baby putting a few drops of colostrum into his mouth to taste,
  • using the laid-back position to encourage him to latch. (See Position and Latch)

Offer both breasts at each feeding
It is important to offer both breasts at each feeding, especially in the early days in order to ensure a plentiful milk supply. Let your baby stay on the first breast as long as you see active sucking and swallowing. When the sucking slows down, your baby may come off the breast or you can release the latch. This is often a good time to do a diaper change or gently place your baby upright on your chest to encourage a burp. At this point offer the second breast. Most babies will take some milk from the second side and some will take a lot. Occasionally, your baby may not want any at all. This is sometimes described as “the first side is the main course and the second side is dessert.” At the next feeding, offer this second breast first.

Demand and supply
The more milk your baby drinks, the more milk your body will make. This is why it is so important to follow the tips above to ensure a plentiful milk supply. But it is important to know that supply and demand can work in reverse as well. If supplemental formula is introduced, your body will not get the message to make that amount of milk the next day. This will lead to a decrease in your supply. If you need to supplement with formula, it is important to express milk from your breasts, by hand or with a breast pump, to stimulate your body to produce more milk the next day. You may not get much milk when you do this, but your body will still get the message to make more milk.

Milk supply can also decrease if you try to space your baby’s feedings farther apart than your baby wants. It’s helpful to let your baby decide when to go longer between feedings. This often happens around 2-3 months of age. Your baby may go longer between feedings and spend less time at the breast. This is because they are able to remove the milk much faster than they used to. If your baby continues to gain well and then your body is making what your baby needs. If your baby is not gaining well, consult an International Board Certified Lactation Consultant (IBCLC) for information and support.
Establishing a supply

Use of a soother/pacifier/dummy
Most breastfed babies don’t require a soother because they naturally get enough comfort sucking at the breast. Soothers were invented for bottle fed babies because, when full, they may need more time to suckle. During breastfeeding, suckling happens naturally because the milk flows more slowly at the end of a feeding. This gives the baby time to suckle for comfort and not get a lot of milk. Hunger and sucking needs are both met by breastfeeding.

If you use a pacifier in the early days and weeks, you may miss your baby’s cues to feed. This may delay the next feeding, or your baby may completely miss the next feeding. This could affect milk production and baby’s weight gain.

If you find that you want to use a soother, it is best to wait for at least a month before introducing it. Giving babies soothers or bottles before they have learned how to breastfeed can be confusing for them. Give your baby a chance to learn one thing at a time.
Establishing Supply

Growth spurts or frequent-feeding days
Three to four times in the first three months your baby will go through growth spurts. This usually involves very frequent feeding for two to three days. Follow your baby’s cues and feed as often as your baby will go to the breast and your milk supply will increase to meet your baby’s growing needs.

Babies nurse for many reasons other than hunger
Your baby may nurse often because of the feeling of security and comfort from being close to your body and hearing your heartbeat. This is normal and helps to support healthy development. Your baby may also nurse to satisfy the need to suck. Meeting these needs will not spoil your baby. It will teach your baby to trust that you will keep them safe and comfortable.

Recovering from a difficult start
Sometimes breastfeeding gets off to a difficult start for one reason or another. It can be encouraging to know that by following these tips you can increase your milk supply and improve your baby’s weight gain while also protecting the nursing relationship.

Mothers and parents need the support of others
La Leche League Canada meetings can be an excellent place to find support from others on the same journey you are on. Leaders are trained volunteers who are here to help you enjoy your breastfeeding experience. Use our meeting calendar to find information about upcoming meetings.

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Updated June 2022