Tuesday, September 29, 2009

Are you having a low Breast milk supply?

Right after the birth of their babies and for the first few days, even weeks, many mothers are concerned about not having enough milk. But what most women don't know is that the likelihood that a woman will be physically unable to produce sufficient milk for her baby is actually low.

But we wonder why are so many women out there that believe or worry about not producing enough breast milk?

In our current society, we have lost the Art of Breastfeeding. Many mothers have grown up in families where they are the first women in generations to breastfeed. These mothers don't have a role model to look up to, so they do the best they can with the information and support available to them. Now the real problem as I see it, is that because we are living in a formula-feeding culture, the information they receive may be inaccurate and the support they have may be inadequate-which can discourage their efforts to breastfeed.

Most importantly, is the exposure to formula advertising women are subject to. We just have to look at the message we receive from the hospitals. The very first thing women are given as soon as they leave the hospital, is free formula, which brings the wrong message to new mothers, lowering confidence of mothers in their ability to breastfeed. They told them that IF they want to breastfeed their babies, they MUST make sure the baby is getting enough milk to support her growth. Of course, they also encourage women to NOT FEEL BAD if they have to supplement the feedings with some formula. This, automatically send a message to the new mothers, as if their breast could or could not develop enough milk. So instantly a concern has been created in the women's mind, about their ability to produce enough breast milk. They also are told not right after a few days of birth, they must take the baby to see a pediatrician.

In my many years as a breastfeeding consultant, I have grow tired of hearing the pediatricians tell mothers, that the baby was not getting enough weight and they MUST supplement with formula. Of course, for many women hearing this from a pediatrician means... you must do what he said or else...However, what doctors don't tell mothers is that it's totally normal for a baby to loss weight within the first days of her life. Also, they don't encourage them to trying first other alternative methods such as, herbal remedies and nutrition. The doctors of the old days (my grandmother used to tell me this) would tell women, to just simply put the baby on the breast constantly on demand. The more the better, they also focused mainly on the foods they were eating and encourage them to eat more of others, as chicken soup, lentil stew, even herbs my grandmother always told me.

Milk supply is dynamic. It follows the law of supply and demand. The more frequently and effectively a baby breastfeed, the more milk the mother's breasts produce. Sometimes for new moms, not understanding their baby's behavior can lead mothers to think they don't have enough milk even though they actually do.

Before or after the birth of a baby, Breastfeeding Consultants and La Leche League Leaders can help mothers tremendously. They can help mothers learn about positioning and latch-on so that babies can effectively obtain milk, how to tell a baby is getting enough milk, and how to increase milk supply, if needed. They can also refer mothers to healthcare providers to determine if there are any physiological causes of low milk supply in mother (e.g., a hormonal imbalance, retained placenta, previous breast surgery) or other related to baby (e.g., tongue-tie, low muscle tone, respiratory problems)-many of which are treatable.

Breastfeeding is the natural, physiologic way of feeding infants and young children milk, and human milk is the milk made specifically for human infants. Formulas made from cow’s milk or soy beans (most of them) are only superficially similar, and advertising which states otherwise is misleading. Breastfeeding should be easy and trouble free for most mothers. A good start helps to assure breastfeeding is a happy experience for both mother and baby.

The vast majority of mothers are perfectly capable of breastfeeding their babies exclusively for four to six months. In fact, most mothers produce more than enough milk. Unfortunately, outdated hospital routines based on bottle-feeding still predominate in many health care institutions and make breastfeeding difficult, even impossible, for some mothers and babies. For breastfeeding to be well and properly established, a good early few days can be crucial. Admittedly, even with a terrible start, many mothers and babies manage.

The trick to breastfeeding is getting the baby to latch on well. A baby who latches on well, gets milk well. A baby who latches on poorly has difficulty getting milk, especially if the supply is low. A poor latch is similar to giving a baby a bottle with a nipple hole which is too small— the bottle is full of milk, but the baby will not get much. When a baby is latching on poorly, he may also cause the mother nipple pain. And if he does not get milk well, he will usually stay on the breast for long periods, thus aggravating the pain. Here are a few ways breastfeeding can be made easy:

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1. The baby should be at the breast immediately after birth.
The vast majority of newborns can be put to breast within minutes of birth. Indeed, research has shown that, given the chance, babies only minutes old will often crawl up to the breast from the mother’s abdomen, and start breastfeeding all by themselves. This process may take up to an hour or longer, but the mother and baby should be given this time together to start learning about each other. Babies who "self-attach" run into far fewer breastfeeding problems.

This process does not take any effort on the mother’s part, and the excuse that it cannot be done because the mother is tired after labor is nonsense, pure and simple. Incidentally, studies have also shown that skin-to-skin contact between mothers and babies keeps the baby as warm as an incubator.

2. The mother and baby should room in together.
There is absolutely no medial reason for healthy mothers and babies to be separated from each other, even for short periods. Health facilities which have routine separations of mothers and babies after birth are years behind the times, and the reasons for the separation often have to do with letting parents know who is in control (the hospital) and who is not (the parents). Often bogus reasons are given for separations. One example is the baby passed meconium before birth. A baby who passes meconium and is fine a few minutes after birth will be fine and does not need to be in an incubator for several hours’ "observation".

There is no evidence that mothers who are separated from their babies are better rested. On the contrary, they are more rested and less stressed when they are with their babies. Mothers and babies learn how to sleep in the same rhythm. Thus, when the baby starts waking for a feed, the mother is also starting to wake up naturally. This is not as tiring for the mother as being awakened from deep sleep, as she often is if the baby is elsewhere when he wakes up.

The baby shows long before he starts crying that he is ready to feed. His breathing may change, for example. Or he may start to stretch. The mother, being in light sleep, will awaken, her milk will start to flow, and the calm baby will be content to nurse. A baby who has been crying for some time before being tried on the breast may refuse to take the breast even if he is ravenous. Mothers and babies should be encouraged to sleep side by side in hospital. This is a great way for mothers to rest while the baby nurses. Breastfeeding should be a relaxing, not tiring or a difficult one.

3. Artificial nipples should not be given to the baby.
There seems to be some controversy about whether "nipple confusion" exists. Babies will take whatever method gives them a rapid flow of fluid and may refuse others that do not. Thus, in the first few days, when the mother is producing only a little milk (as nature intended), and the baby gets a bottle (as nature intended?) from which he gets rapid flow, he will tend to prefer the rapid flow method. You don’t have to be a rocket scientist to figure that one out, though many health professionals, who are supposed to be helping you, don’t seem to be able to manage it. Nipple confusion includes not just the baby refusing the breast, but also the baby not taking the breast as well as he could and thus not getting milk well and /or the mother getting sore nipples. Just because a baby will "take both" does not mean that the bottle is not having a negative effect. Since there are now alternatives available if the baby needs to be supplemented, why use an artificial nipple?

4. No restriction on length or frequency of breastfeedings.
A baby who drinks well will not be on the breast for hours at a time. Thus, if he is, it is usually because he is not latching on well and not getting the milk which is available. This, not a pacifier, not a bottle, not taking the baby to the nursery, will help.

5. Supplements of water, sugar water, or formula are rarely needed.
Most supplements could be avoided by getting the baby to take the breast properly and get the milk that is available. If you are being told you need to supplement without someone having observed you breastfeeding, ask for someone to help who knows what they are doing. There are rare indications for supplementation, but usually supplements are suggested for the convenience of the hospital staff. The best supplement is your own colostrum. Formula is hardly ever necessary in the first few days.

6. A proper latch is crucial to success.
This is the key to successful breastfeeding. Unfortunately, too many mothers are being "helped" by people who don’t know what a proper latch is. If you are being told your two day old’s latch is good despite your having very sore nipples, be skeptical, and ask for help from someone who knows. Before you leave the hospital, you should be shown that your baby is latched on properly, and that he is actually getting milk from the breast and that you know how to know he is getting milk from the breast (open— pause—close type of suck). If you and the baby are leaving hospital not knowing this, get help quickly.

7. Free formula samples and formula company literature are not gifts.
There is only one purpose for these "gifts" and that is to get you to use formula. It is very effective, and very unethical, marketing. If you get any from any health professional, you should be wondering about his/her knowledge of breastfeeding and his/her commitment to breastfeeding. "But I need formula because the baby is not getting enough!". Maybe, but, more likely, you weren’t given good help and the baby is simply not getting your milk well. Get good help. Formula samples are not help.

Hope you enjoyed this article and that it was helpful to you.

In Light, Love and health
Sincerely
Ana Sola, CLA, CHBE, BC

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