Newborn babies eat frequently to meet their growth needs and help establish milk supply, but that doesn’t always guarantee lots of milk. Infant, parent and birth factors may all impact milk production.
For example, infant issues include a poor latch, prematurity, oral issues such as oral ties or cleft lip/palate and other infant disorders. Infants who are fed on a schedule rather than when they show signs of hunger can potentially lower milk production.
Maternal conditions such as thyroid dysfunction, polycystic ovary syndrome, diabetes and obesity or previous breast surgery or injury may influence milk supply. Maternal birth control containing estrogen may also lower milk production.
Birth issues may include excessive blood loss during delivery, retained placenta and even a C-Section may temporarily delay milk production.
How much milk does a newborn need?
The body starts to make early milk called colostrum around the 20th week of pregnancy. That early milk is produced in very small volumes, perfect for a newborn stomach which is only about the size of a cherry. In cases cleared by the patient’s medical term, it’s safe to start hand expressing colostrum around the 37th week of pregnancy and patients can bring it to the hospital to give their baby.
The first few feedings only measure about a teaspoon and increase gradually. By about four weeks, the average feeding is three to four ounces of milk, resulting in 24 to 30 ounces in 24 hours.
Warning signs that a baby isn’t eating enough includes:
- Signs of dehydration: Not having enough wet or dirty diapers based on their age
- Being sleepy at the breast and never seeming full at the breast
- Dropping more weight than expected in the first few days of life
How often should I feed to increase milk supply?
Robin Murtha, APRN and International Board-Certified Lactation Consultant at Yale New Haven Hospital says the key to increasing supply is to remove milk from the body often and effectively.
“Each time your baby breastfeeds, or you pump, you’re telling your body to make more milk. Frequent feedings and pumping tell your body to make milk faster,” Murtha said.
Newborn babies typically need to feed eight to 12 times in 24 hours, but parents shouldn’t get obsessed with watching the clock. Instead, follow their baby’s cues. Feed when baby is hungry and look to see if the baby is latching well and removing milk well. Lots of skin to skin can help too. However, if a baby is not feeding effectively or has a poor latch, an assessment by a lactation consultant is suggested to develop a plan to help parent and baby.
Supplements to increase milk supply
Most new parents have seen ads for lactation cookies, supplements and drinks all designed to boost milk supply. For generations moms were told to eat oats, barley and other herbs.
However, Advanced Practice Provider Kate Manuel, international board-certified lactation consultant and manager of the Yale New Haven Hospital Lactation Program says there’s no scientific evidence to support the idea that any specific food can increase supply.
“I think that's important for parents to hear because sometimes I think they forget the basics and they think a pill or a supplement or a cookie can be the quick fix to increase the milk supply. And really, all those other things we recommend will be more helpful,” said Manuel.
In some cases, supplements can be harmful if they interfere with other medications or if someone has an underlying medical condition. That’s why Manuel recommends patients always talk with their healthcare provider before taking one, even if they think it’s safe because it’s an herb.
Sudden drop in milk supply
It can be hard work to establish a robust milk supply, which is why it can be especially frustrating when a cold or flu causes supply to decrease. If milk supply drops off, Murtha encourages families not to give up.
“Years ago, before a lot of moms were pumping, they didn’t really know that their milk supply was lower when they were sick,” said Murtha. “If that happens, breastfeed a little more often if it’s just a temporary dip.”
If that happens, baby will seem hungry more often and families should follow their baby’s cues of hunger and can feed more often which will help rebuild supply. If the patient is pumping, they could add in another pumping session while production increases.
However, pumping constantly to boost supply can lead to issues down the road, such as an oversupply which can be associated with problems such as clogged ducts, mastitis and feeling engorged.
“I think there’s a lot of social pressure. Parents see pictures of freezers full of milk and that’s unrealistic,” Murtha said. “You’ll be beholden to your pump.”
“Your journey could be very different from someone else’s journey,” Manuel added. “It’s hard to look and compare yourself because everybody’s journey is unique.”
If anyone is struggling with low supply or an oversupply, they can get help from a certified lactation consultant. Learn more about the Yale New Haven Hospital Lactation Program or call 203-688-MILK to schedule an appointment.
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