Many things can interfere with how your body makes breastmilk. Learn why your supply drops and how to address it.

When your little one is fussing and seems hungry a mere hour after you’ve nursed him, you fret that you aren’t actually producing enough sustenance for your baby’s needs.

Of course, you can’t tell how much milk you have and how much your baby is taking as your boobs, well, aren’t transparent. However, exclusively breastfed babies will show signs that they are growing well such as having adequate levels of pee (six to eight wet diapers) and poo. They also tend to be relaxed and content after a good feed and are less fussy.

A nursing mother is considered to have low milk supply when her milk production is insufficient to meet her infant’s growth needs, who won’t be putting on sufficient weight. Some causes of a low milk supply is that the mother isn’t paying attention to her diet or not drinking sufficient water. Other reasons are more complicated and may require professional advice.

Whatever the conditions leading to your low milk supply, it is important for mothers to keep up her breastfeeding efforts, as even small amounts of breastmilk will support baby’s nutrition and immune system.

In the meantime, if you feel your milk supply is dwindling (or low to begin with), here are possible conditions to address.

1) Insufficient breast glandular development

Breastmilk is made by small glands in the breast and reaches the baby via ducts. Some women may not have enough of these ducts to meet their baby’s feeding needs.
The solution Check with your doctor if there is any medication you can take to boost your milk production. Even if you supplement baby’s feeds with formula, don’t totally give up on the breastfeeding as every little bit of breastmilk will benefit your munchkin.

Painful nipples or engorgement can lead to a mother being unable to breastfeed or express her milk adequately. This eventually results in low milk supply.”

2) Difficulty in breastfeeding in the first week

According to Dr Yvonne Ng Peng Mei, senior consultant, Department of Neonatology, National University Hospital, one of the most common reasons for low milk supply is difficulty in breastfeeding in the first week after delivery.

“For instance, painful nipples or engorgement can lead to a mother being unable to breastfeed or express her milk adequately. This eventually results in low milk supply.” The solution Seek help and guidance early from medical staff knowledgeable about infant feeding. This will help you address difficulties in latching or engorgement.
“Get a doctor’s appointment to assess baby on days four or five of life, when baby should start gaining weight, and around day 14 of life, when baby should have regained his birthweight. Any deviation from these goals may indicate insufficient milk supply. Advice needs to be individualised to the mother-baby pair as circumstances are different,” adds Dr Ng, who is also a lactation consultant.

3) You’re exhausted

Giving birth is tiring, more so if yours was a difficult delivery. Recovering from the delivery as well as caring for a newborn is physically and mentally exhausting. Plus, if you have other children to attend to, it can all snowball into a bone-weary fatigue, which will affect your milk supply adversely.
The solution Make sure you get sufficient rest. Enlist the help of family members to attend to some chores while you get some precious shut-eye.

4) Poor health

Chronic medical illnesses such as hypothyroidism, polycystic ovarian disease and diabetes mellitus can cause your body to make less milk. Anaemia, too, can impose a similar effect.
The solution Check with your doctor about treatments suitable for breastfeeding mums.

5) You don’t breastfeed often

Maybe your nipples hurt, putting you off breastfeeding. Or perhaps you routinely skip those middle-of-the-night breastfeeding sessions, choosing instead to supplement with formula. Know that if you breastfeed less often, your milk supply may decrease. Your breasts are constantly making milk and are wired to make more milk when they’ve been adequately emptied. When your breasts are full, milk production slows.
The solution Breastfeed as soon as possible after delivery and breastfeed repeatedly in response to your baby’s cues. Aim to breastfeed at least eight to 12 times in 24 hours. The more baby takes, the more you make! If you have to skip a breastfeeding session, pump your milk to maintain a consistent milk supply.

If you’re rejoicing over another pregnancy, the resulting hormones of this new pregnancy can cause your milk supply to dip.

6) Mastitis

Mastitis, an inflammation of the breast, can be caused by an infection due to poor general health, delayed treatment of a blocked duct, or even an allergy. The condition can be painful, uncomfortable and bring on fever and flu-like symptoms.
The solution Seek treatment from your doctor immediately. While recovering from your bout of mastitis, it is normal for the milk supply from the affected breast to decrease. No matter how arduous, try not to let up on feeding or expressing. In time, your supply should return to normal.

7) Over-indulging in alcohol

Alcohol inhibits the let-down milk reflex and may reduce milk supply, notes Dr Ng. The let-down reflex is what releases the milk from your breasts. “As alcohol passes easily between the plasma compartment (mother’s blood) and milk compartment, mothers should avoid breastfeeding for two hours after consuming alcohol,” she advises. Alcohol may change the taste of your breastmilk, resulting in your baby breastfeeding less. The less you breastfeed, the less breastmilk you will produce.
The solution The occasional glass of wine is fine, but keep tabs on the number of alcoholic drinks you imbibe when you are breastfeeding.

8) Not kicking the nicotine habit

Smoking cigarettes can lower your milk supply by interfering with the release of oxytocin, the hormone responsible for the let-down reflex, an ejection mechanism that makes the milk in your breasts available to your baby. If your breastmilk is not released and drained, your breasts will not produce more milk, a cycle leading to a low milk supply.
The solution Smoke less or better yet, kick the filthy habit. Puffing less will also lower your and your baby’s health risks.

9) Stress

Are you worried about your finances? Anxious about job security? Are there unresolved relationship problems distressing you? Being constantly apprehensive and agitated can contribute to a low milk supply.
The solution If you suspect you are suffering from significant postpartum depression, seek help from a women’s emotional health service.

10) You’re pregnant again!

If you’re rejoicing over another pregnancy, the resulting hormones of this new pregnancy can cause your milk supply to dip.
The solution If your child is at least 6 months old and is ready for it, this could be the time to introduce or increase his solid food intake. Otherwise, supplement with formula.

Photos: iStock

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