The Boob Group
Myths and Misconceptions: Milk Supply

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Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

Robin Kaplan: With so many myths and misconceptions out there about breastfeeding, how’s a new mom or even a seasoned mom to know: “What is evidence-based breastfeeding information or just completely misguided fabrication?” Today, we continue our series: “Breastfeeding myths and misconceptions with this episode focusing on supply.”

Since this is one of my favorite topics. I will be your expert on this series because I just couldn’t pass it up. So, this is The Boob Group Episode 101.” We’re talking about: “Breastfeeding myths and misconceptions about supply.”

[Theme Music/ Intro]

Robin Kaplan: Welcome to The Boob Group broadcasting from the Birth Education Centre of San Diego. The Boob Group is your weekly online on-the-go support group for all things related to breastfeeding. I’m your host Robin Kaplan. I’m also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Centre.

Have you signed up for our weekly newsletter yet? Best thing about it: “You can have each new Boob Group Episode delivered straight to your inbox every week.” That way you will never miss your next favourite episodes so sign up today on our website.

Today, I’m joined by three lovely panellists in the studio. Ladies, will you please introduce yourselves.

Stacy Spensley: I’m Stacy Spensley. I’m 31 years old. I am a certified holistic health coach and I have one son who is 14 months old.

Robin Kaplan: All right.

Chelsea Powell: I’m Chelsea Powell and I am 27. Sorry, I have to think I’m used to saying being based on months. I work as an administrator and I have one son who is 11 months.

Robin Kaplan: I was just thinking: “I can’t believe it’s going to be a year old.” Holy cow.

Chelsea Powell: It’s crazy.

Robin Kaplan: My gosh. Our next lovely panellist

Angela Kabel: My name is Angela Kabel. I’m 31. I’m a Montessori teacher. I have twins who are six month old – Reed and Abby.

Robin Kaplan: Awesome. All right and Mj would you like to introduce yourself as well as our Virtual Panellist Program.

Mj Fisher: Yes, I’m Mj. I am 37. My son is going to be three in June. We are still nursing and besides being a staying-at-home mom, I get to have the honour of being producing this show and helping other moms. One of my jobs is the Virtual Panellists Program.

So, while we’re recording, there’s a way for you out there to join our conversation and be a part of the show – even if you can’t be in the studio because we post the same questions as our in-studio panellists are answering. So, it’s a way to share your experience, your opinions or give tips; moms who are engaging and supporting each other with tips and advice and just empathy. It’s just nice to know that you’re not alone.

We may even read your comment while we record. It’s kind of a sneak preview of our show before it releases. We’ll post that tips and info as our experts give it. It’s really just an extension of our show supporting each other. So, check out www.TheBoobGroup.com under the community tab for more info on the VP Program and possible perks for participation.

Robin Kaplan: All right, thanks Mj.

Mj Fisher: Yes.

[Theme Music]

Robin Kaplan: So, before we get started, we’re going talk about an article that’s been going around the internet recently. This one was titled: “Breastfeeding at infant sleep: Our babies who wake to breastfeed at night trying to delay the birth of a sibling.” So apparently, there was a new article published online today or a couple of days ago in the journal called: “Evolution, medicine and public health.”

Where Professor Haig argues that: “Infants that wake frequently at night to breastfeed or delaying the resumption of the mom’s ovulation in therefore preventing the birth of a sibling with whom they have to compete with.” So, it has been documented that smaller gaps between the births of siblings are associated with increased mortality of infants and toddlers; especially in environments where resources are scarce and where infectious diseases are high.

So, this professor believes that the benefits of delaying this or such the selective forces are strong enough to have en gendered a significant evolutionary response. So, ladies who still breastfeed in the middle of the night with many of you are – do you think that your child is trying to delay the birth of a sibling? Stacy, what’s Iver doing?

Stacy Spensley: He wakes up an awful lot at night. I think my friend was complaining about a four month sleep regression saying: “Her daughter was waking up three times.” I was like: “Only three? He is still waking up more than that.” So, I think definitely: “Resources are not scarce at our house that is for sure.” He probably knows that I can only keep up with him right now.

Robin Kaplan: That’s so funny. How about you Chelsea?

Chelsea Powell: I think there are so many factors in all of that and to say like something just so blatantly. I don’t personally adhere to that because I’m like: “Well, there are so many factors for the mom, for the baby and the environment – like they were talking about where resources are.” Obviously, we live in a place where resources tend to be abundant.

I just think it kind of how it depends on the baby and what the baby’s going through and the mom. I know something – we’ve talked about before and probably talked about today in regards to breastfeeding is: “It has to do with the storage capacity for moms too which would definitely affect that and might not be the baby thinking – I’m trying to keep a sibling.”

The baby is just like: “I want milk.” So, I think there are a lot of factors.

Robin Kaplan: Angela, you were saying: “Growing babies.”

Angela Kabel: Yes, Abby and Reed don’t wake out too much in the middle of the night. So, there’ve been a really great night sleepers. My night feedings haven’t been too much for me.

Robin Kaplan: They still are nursing a lot though otherwise. Cool, well thanks ladies. I felt that was an interesting article and I would be very curious to read the research that was behind it because I kind of just think: “Baby’s likes to eat in the middle of the night as well.”

Chelsea Powell: So, won’t their moms?

Stacy Spensley: I was just to say that: “My son is really concern that he’s been left angora bush for mountain lions. So, he wakes up a lot to double check that we haven’t left him behind.

Chelsea Powell: Yes, exactly.

Stacy Spensley: He’s very concerned about that.

Robin Kaplan: Yes, they just need some snuggles in the middle of the night.

Angela Kabel: We do, exactly.

Robin Kaplan: All right, thanks ladies. So, today on The Boob Group, we’re discussing: “Breastfeeding myths and misconceptions with a special focus on milk supply.” So, for months we have been collecting all of the misinformation and bad advice you have received since you started breastfeeding.

So, let’s just say: “The list was staggering so much that we really had to make an entire series because we couldn’t fit it all into one episode.” So, one thing just to kind of plug is that: “If you feel like you’ve heard a very interesting breastfeeding myth or misconception that you would like us to bust on another episode, please post it on our Facebook Page and we will add it to our ongoing list.”

So, Myth Number One was from Sheena. Sheena said that the myths that she would like to bust was that:

Big breast equal lots of milk and small breasts equal low or no supply.

-Sheena

So if any of you could have a vision, a view into this room today, you would see that there are multitudes of breast sizes in this room. That clearly is not the case. So, according to Nancy Mohrbacher who has been an expert on our show multiple times, she has this amazing info graphic on her website.

It says that: “Breast sizes determine by the amount of fatty tissue in your breast and storage capacities determine by the amount of room in your milk making glands.” So, moms who have very large breasts can actually have a low milk supply and some moms with small breast can produce enough to feed a small village.

So, if the storage capacity is small meaning: “For example, a breast can hold maybe 1 1/2 ounces per side – that might mean that a baby needs to feed more frequently over a 24-hour period compared to a mom whose storage capacity is higher.” Then, both babies are able to get all that they need as long as they’re breastfeeding a demand.

So, you had mentioned, Chelsea that: “Kiddo feeds throughout the night.” What do you think? I think that is Stacy actually but Chelsea, you were saying though also that: “Your little kiddo was feeding quite frequently as well?”

Chelsea Powell: He basically for the first to six months, we were – Stacy and I came in the same car and we were kind of talking about it on the way over is that: “The other day for the first time in his entire life when I offered him milk, he like decided he wanted to play instead.”

I was like: “This is weird because literally his entire left up until now, all he’s ever wanted to do was to eat.” You offer it; even if you were just nurse he’s like: “Give me more.”

Robin Kaplan: All right, Myth Number Two is from Jennifer on Facebook.

She wanted to bust:

Pumping output is equal to the same amount that your baby can get directly from the breast. -Jennifer

So, ladies before I kind of bust this myth, when you compare with your baby can take at say like a support group if you’ve ever measured how much your baby is taking and you compared that to pumping, do you find the discrepancy at all? Angela, do you?

Angela Kabel: Well, actually I’m not a big pumper.

Robin Kaplan: That’s okay.

Angela Kabel: We’re just completely exclusive breastfeeding.

Robin Kaplan: That’s awesome.

Angela Kabel: But for the few times that I’ve had a lactation consultant out to the house, it’s like 5 or 6 ounces pretty regular. So, that’s it.

Robin Kaplan: That’s awesome. How about you Stacy, have you noticed the discrepancy in pumping compared to what your kiddo can take?

Stacy Spensley: Yes but the opposite way is: “I actually have a raging over-supply.” So, in fact pumped, I have been pumping, feeding, nursing all day – and then pumping an extra 18 ounces a day for most of the year. So, he’s definitely not eating that much.

There was one growth spurt where I didn’t have to pump for three days and I was like: “Holy crap kid. You’re eating a lot of milk.” But I mean, if he takes a bottle, he only takes five ounces max and I’m pumping way more than five ounces at once.

Robin Kaplan: So, definitely a discrepancy.

Stacy Spensley: Absolutely.

Robin Kaplan: Have you noticed a discrepancy in all of your pumping output?

Angela Kabel: For me, I think kind of what’s going on with my life reflects more of what I can get pumping versus like: “If you’re sitting there with your kid, it’s a little bit different; your stress level kind of changes.

Robin Kaplan: Absolutely.

Angela Kabel: Usually when I pump, I pump about the exact amount that he would need. If I was away from him for that period of time for a bottle, but I do know for sure if I only try to pump one side, not a drop. I have to double pump or nothing and obviously he can only eat from one side at a time. So, it’s not the same.

Robin Kaplan: Yes, absolutely. So, to kind of bust that myth – so most moms will actually pump less than what their babies can take out while breastfeeding. Other moms will find that they actually can’t even let-down for the pump. So, like you’re imagining Chelsea, if you’re not pumping both sides, your body almost get stage fright. I don’t know what to do with these things.

Chelsea Powell: It’s literally like one drop comes down like seriously.

Robin Kaplan: Yes, absolutely. So, that can really affect the mom’s output as well. Sometimes the body doesn’t respond to the pump. Sometimes the pump’s uncomfortable, the suction can also not be as strong as the baby’s and we don’t want to jam up that suction super high on the pump but with the baby’s suction, it’s not as uncomfortable oftentimes. So, it shouldn’t be definitely.

Also pump malfunction, a lot of times moms will think: “We’ll not pumping as much all of the sudden. There must be something wrong with my supply and actually, it’s just you needed to replace maybe the little membrane or the tubing got a little funky and so you need to replace the tubing.

So, definitely the pump is not an indicator of a mom’s supply and sometimes can pump more than a baby’s taking because she has an oversupply and her example. I probably would never need 10 ounces out of feeding.

Stacy Spensley: It probably drink it but

Robin Kaplan: You’ll probably drink it but you’ll be very sick. Yes, exactly.

Stacy Spensley: I love the Jay Gordon quote of: “Pumping doesn’t tell you how much milk you have, it tells you how much milk you can pump.”

Robin Kaplan: Yes, exactly. That’s such a good quote, absolutely.

Myth Three was from Laura on Facebook and her myth was that she wanted us to bust was:

When babies frequently nurse, it means you have a low supply. -Laura

So, again I know everyone’s shaking their heads – absolutely not. So, this goes back to kind of the Nancy Mohrbacher info graph actually or info graphic about storage capacity. So, when a mom has a smaller storage capacity, her baby might need to feed more frequently throughout the day or night. So, no night weaning for this little one and this little one probably needs to feed in the middle of the night.

When a mom has a larger storage capacity, her baby may only need to take one breast per feeding and may actually sleep longer stretches at night. Both babies still have that same chance of gaining the same amount of weight per week as long as mom is feeding on demand and baby is effectively breastfeeding.

So, for those little babies that frequently nurse definitely does not equal low milk supply. For all of you who have ever been through a growth spurt, you know that-that is definitely not the case.

All right, so Myth Number Four is from Sandy on Facebook and she posted:

It is difficult to know if your baby is getting enough from breastfeeding because you can’t measure the milk like you would in a bottle. -Sandy

So, panelists, how many have you ever felt insecure about how much your baby is getting since you actually can’t measure every time and what did you do to maybe help yourself feel more secure? Have you ever felt insecure about your supply at all?

Angela Kabel: I guess a little bit but it’s more just their behaviors and their response that they’ve gotten enough or if not and also, how full I feel.

Robin Kaplan: Tell us about your twins. So, when they’re taking a good feeding, what’s their behavior looking like?

Angela Kabel: Well, now you know their bigger, they still kind of space-out a little bit after they’ve eaten. So, we always just eat, play and then sleep later so they just kind of sit there and maybe sit on their little lounge that they have and just kind of relax for a while after they have eaten and it always shows me that they’ve gotten a really good meal.

Robin Kaplan: Cool. How about you ladies? Stacy, have you ever been worried about your supply at all?

Stacy Spensley: Well, I was actually the first week that’s why I came to see you Robin because all the information I was getting was: “Everybody’s worried about their supply and so, I thought he wasn’t eating long enough so I thought he wasn’t getting enough while he was actually getting plenty very quickly.”

Robin Kaplan: That’s a good point.

Stacy Spensley: So, everything I looked up online, I thought he was a sleepy baby; he was just done eating. So, what help – we were going to see you and we weighed him and then you can see how much he ate least approximately. So, then, that was really helpful.

Then, I also went to your breastfeeding support group for a very long time and he didn’t nurse at it after he was four months old because he was too distracted. But then, I could at least see about how much he was taking in.

Robin Kaplan: Yes, absolutely. How about you Chelsea?

Chelsea Powell: I think for me early on, I was kind of concerned about it because I was just concerned about it all in general because we had a rough start. He had problem not he wasn’t losing weight but he had that like period of time they were – he kind of mystified you and the fact that he was like when we weighed him after he nursed, he had gotten enough.

He had the diapers like the things that you’re suppose to have but he just wasn’t quite like gaining. He wasn’t working quite hard enough to get past a certain point. So, at that time, I was kind of worried about it because I’m like: “What’s happening?”

You’re just trying to figure it all out and you’re looking at the signs that you’re supposed to be looking for. But, I think once that just kind of whom you were just working on things and we would go to the support group and we could weigh before and after – just kind of helped ease my mind.

Okay, this is all starting to go as it should and to be able to relax and know like: “Okay, we’re doing this. It’s going good now. Okay, I don’t need to stress about this anymore.”

Robin Kaplan: Awesome. Well, you mentioned – I mean bringing up, it can be very, very stressful. Absolutely, so kind of all of the signs that you all were talking about; knowing what those signs are can be super helpful. So, I think the most important thing for moms to know is: “What normal weight gain looks like.”

So, Stacy you were mentioning: “Your kiddo was feeding maybe five or 10 minutes and so he would like the sleepy baby. But, then when we weighed him, you could see he was actually getting enough.” So, weight gain for a zero like a two-week old to a four-month old; you’re really looking at about 4 to 7 ounces a week to kind of let us know that your baby is usually getting enough of a feeding.

Then it actually drops from 4 to 6 months to about 3 to 5 ounces per week. Then, it drops down even lower once they got to six months and we’re early six months and beyond. We’re looking at 2 to 4 ounces a week and that’s because we don’t want 30 pound one year olds; babies eventually need to slow-down a little bit.

So, when you know that they’re gaining weight and even if whether you’re going to a support group or you’re popping by your paediatrician’s office maybe just once a month if you’re feeling a little insecure – that can be really helpful.

We’re also looking for lots of pees and poops and granted poops can sometimes be kind of hard because after a couple of – no pun intended but a couple of months into it, some babies actually stop pooping so frequently. So, that doesn’t necessarily mean: “Well, when they don’t put

Chelsea Powell: I heard on these babies

Robin Kaplan: I know except they get really gassy though. So, I actually would prefer as a lactation consultant, I would prefer babies to poop much more frequently than once every couple of days because they can get really uncomfortable when it’s kind of backed up in there. But, lots of pees and poops especially in the first couple of weeks is what we’re looking for.

But, like you all mentioned, heading to a support group and weighing before and after feedings can be really helpful to help kind of reduce your stress to know what your babies taking in. However, Stacy brings up a very important point that once your baby hits about four months old, support groups aren’t always the most accurate way to find out – because babies are very interested in everything else that’s going on at the group.

So, but you can use them to track them week-to-week or month by month – that will kind of help give you that confidence as well. Then, if you’re feeling really, really nervous about it, you could always rent a scale for a few days and weigh your baby before and after feeding. The scale that places like Babies R’ Us and Target that you can purchase yourself are not really accurate enough to do the weigh, feed and weigh again.

You really need something that like the consultation would have or most paediatricians’ offices would have these more digital ones. But, they can be helpful for trending week-to-week if you wanted to purchase one. So, again if you’re not near a support group or you don’t have the time to go to one. You could use these to kind of trend and see how babies doing.

Then, if breastfeeding hasn’t been going well – I’m sorry, if breastfeeding has been going well, you can look at your baby’s behaviour just like Angela was saying. A well fed baby who suddenly isn’t eating enough will often protest and get frustrated. So, if you’re getting those really calm babies, still kind of milk-drunk at six months old, there’s a good chance that baby’s taking enough.

So, all right and our last myth before we jump to a break – Myth Number Five is from Ashley on Facebook and this is what she wanted busted:

If you have an inefficiently nursing baby, your supply should always meet his/her need. -Ashley

So, this is a really difficult one. For moms who have a low supply due to for example Insufficient Glandular Tissue or Hypoplasia, Thyroid Conditions, Endocrine Conditions, [inaudible] disorders, history of breast surgery – just to name a few. Sometimes moms’ supply it has a really difficult time reaching baby’s need even if the baby has the most effective suck ever.

So, obviously if the more effective a baby’s suck – the better moms’ supply will regardless of any situation. So, it’s always worth it to make an attempt to help baby to become more effective if possible. But, we also have to take a look at moms’ medical history, physical anatomy to see whether she has the capability to bring in that full supply to meet her absolute baby’s need.

We also have a ton of Boob Group episodes about this topic where moms describe doing everything possible ranging from taking herbs. Some moms will take prescription medication, pumping and supplementing at the breast, those who are still unable to bring enough full milk supply.

So, you can always check out our other episodes on this topic. But, the main thing I’d like to focus on is that: “Every drop of breast milk is hugely significant to a baby’s well-being and immune system.” So, even if a mom is needing to supplement; every bit that she’s able to give her baby is super important.

So, all right when we come back, we will continue to discuss: “All of these myths and misconceptions.” So, we will be right back.

[Theme Music]

Robin Kaplan: All right, well welcome back to the show. We’re talking about: “Breastfeeding myths and misconceptions about milk supply.”

So, our Myth Number Six is from Andrea on Facebook. This is what she posted:

When breasts are no longer engorged does it means that I am not making enough milk? -Andrea

Ladies, have you ever felt that you were not engorged or not full and you put your baby on or baby’s on and also the gulping is just crazy incessant. So, yes Angela, when have you notice this before?

Angela Kabel: All the time. Every day, I mean usually that early afternoon feeding I’m like: “Are you sure it’s time to eat? Okay.” Then, I put him on; it’s a huge let-down.

Robin Kaplan: I know. I just love that. I mean sometimes you just have no idea what your breasts are capable of doing. Chelsea, how about you? Have you noticed that?

Chelsea Powell: Yes, all of the time. I think I only get engorged now really if he’s slept a lot longer at night than he normally does and I wake up and I’m kind of like: “Oh.” But otherwise throughout the day it’s like: “Okay.”

Robin Kaplan: Yes, how about you Stacy?

Stacy Spensley: I think when he was about three or four months old, I mean I knew I had enough milk but it was just weird because it’s like: “Are you hungry? I can’t tell. You ever tell me that you are hungry so because I would have to wake him up at night to feed him because I’d be so engorged. So, when I didn’t get engorged all the time – it was just weird.

Robin Kaplan: Yes, like something was wrong.

Stacy Spensley: He was gaining okay – so I wasn’t super nervous. But, it’s still was just a weird feeling.

Robin Kaplan: Yes, absolutely. Mj, one of our virtual panellists want to share something?

Mj Fisher: Yes, so I didn’t post all of the myths but I picked I think about six of them.

So, this one Vana Castro said:

I didn’t know this was false. I’m glad I got posted. Past two days, mine have not been big or hard like they have been in the beginning. She’s going on three months now exclusively breastfeeding. She’s not stressing over it anymore. -Vana

Also, Jamie I’m going to put your name. I’m sorry. Kadalafu – she said

I’m going on three weeks and I don’t feel engorged anymore. I thought I was drying up. -Jamie

Robin Kaplan: That’s a huge myth. We get moms in support group all the time who will come in and say like: “I’m nervous because we went to that growth spurt and now all of the sudden, my breasts don’t feel full anymore. I’m like: “Well, your body doesn’t really want – nature doesn’t want your body in a permanent state of engorgement.” So, the time period – it can’t be longer.

Most moms will feel engorgement really like 3 to 7 days postpartum where they feel heavy and full. But, a lot of the engorgement has to do with excess fluids. Your body just like: “Why all of the sudden do I have all these extra fluids and what do I do with it?”

So, one of the things I tell moms in the beginning too is: “Well, check your ankles and your wrist too because if they’re swollen and your breasts are swollen too – it’s probably Edema fluid.” So, one solution that swelling has gone down, most moms will just find that they get engorged if their kids sleep a little bit longer.

I remember going to a concert when my son was – I think he was like three months old and I didn’t obviously bring a pump with me to the concert. So, when I get home I was like: “My gosh, these things are up to my neck.” They had not been that big in a while and it was just because he was regularly draining them. So, they didn’t really have the chance to really fill up.

Babies feeding frequently and efficiently then that fullness should subside unless you go for that longer stretch. So, it doesn’t mean you’re losing milk; it just means your body is working like a well-oiled machine – exactly.

So, Myth Number Seven is from Selena. She posted:

When babies choke and sputter while breastfeeding it means that mom has an oversupply and should start block-feeding. -Selena

So, this is a really important myth that I wanted to really bust as well did as many of my lactation consultant friends who saw that post as well. Sometimes that can be the case. For example, if the baby is gaining a pound a week and when feeding from both sides and have green poops and lots of gas then possibly.

But, it’s always really good to check with a lactation consultant first and why? It’s because coughing and choking can be due to either an overactive milk ejection reflex. Often times that coincides with an oversupply but sometimes it doesn’t. It could also be an indication of a tongue-tie which both of those are not an indication to start block-feeding.

Block-feeding when a mom just has an overactive let-down or if a baby has a tongue-tie could actually cause a baby to slow down in weight gain and could actually tank a moms’ milk supply. So, with overactive let-down which AKA forceful let-down, you’re often have spraying, gushing and can often be associated with an oversupply but not always.

So, first we try to accommodate the baby to help manage the flow – so mom can lean back. We can try side lying and baby just lets the milk just drip out the side of his mouth. You can have the baby sit more upright. One of my favourites is actually pressing down on the top of moms’ breast to kind of block the upper docks and just let the lower docks – the underside part let-down. So, we’re just telling half the breast: “Okay, just wait your turn.”

So, we kind of put the yellow light on the top docks and the green light on the bottom docks. Then, after about a minute, you let go. The top part of your breasts now gets the green light and it can let-down. So, it shouldn’t cause plug docks but what it does is just: “It helps kind of slow down the flow a little bit.”

Then, also having baby pause to burp and stuff like that. Tongue-ties can often sound like a mom has an oversupply with all that coughing and sputtering and choking. But, really babies having a challenging time keeping up with the flow even if it’s not that fast.

So, these babies taking the ton of air seem super gassy, puff up frequently while feeding, and drop milk maybe at the sides of their mouths sometimes. But, that’s not usually because of there’s an excessive amount of milk because babies actually not gaining an excessive amount of weight either. So, block-feeding would actually crush this moms’ milk supply.

So, it’s always good to know: “What’s the cause of all that coughing and sputtering and not just to immediately assume it’s an oversupply.” So, all right – Myth Number Eight is from Tasha and what she posted was that:

A mom doesn’t have enough milk for her baby in the first few days before that fuller milk comes in. -Tasha

So, did any of you that those first couple of days and Stacy, you actually are kind of eluded to it that maybe you didn’t have enough milk in the beginning?

Stacy Spensley: I will say: “This is not to be [inaudible] but I want my entire pregnancy with no stretch marks and I got stretch marks on my boob with my milk came in.” So, the first and then they came on – I think it was day 3 or 4. So, the first couple of days – I was a B Cup.

Well, they were bigger from being pregnant. It’s like: “It was kind of just normal pregnancy boobs and then suddenly my milk came in mass quantity.” But that didn’t mean you know. It’s their tummies are tiny the first couple of days. They don’t need very much.

Robin Kaplan: Exactly. How about you Angela with two – were you worried at all?

Angela Kabel: My milk came in probably within the first 10 to 15 hours after.

Robin Kaplan: Holy cow.

Angela Kabel: Yes. The lactation consultants at USC were wonderful of course. They said: “Do not pump anymore. Don’t do it.”

Robin Kaplan: Did you start pumping initially then?

Angela Kabel: Yes, my son unfortunately had to go to the NICU. So, just as sure to say: “So, I did pump just of ahead something that stuff if he was hungry, they did.” Right away, I had to switch to – they have the smaller bottles and the bigger bottles for the pump. I had to switch to it right away – so the bigger ounces of supply.

Robin Kaplan: Your body was ready to make it work.

Angela Kabel: Yes.

Robin Kaplan: All right. Chelsea, were you nervous at all in the first couple of days before fuller milk came in?

Chelsea Powell: No because I think – I just wasn’t something I was that concerned about because I knew that they didn’t really need much in the beginning and that they were gone and just be nursing all the time anyway. So, that wasn’t something I was really concerned about.

Plus, I think probably within the first 24 hours, I had already started to really feel like my mouth was coming in. So, it just wasn’t something that I was worried about. It just didn’t occur to me like: “No.” He didn’t really like lose.

Anyway in the hospital, I had only loss like a couple of ounces – that it’s like four-day appointment. He literally had lost like two ounces since he was born. So, there wasn’t really any discrepancies there like a massive weight loss or anything that might indicate that he’s not quite getting enough.

Robin Kaplan: Sure. I think the thing that you point out too – the education behind it. Angela as well, you were prepared like you knew like your little kiddo was going to be in the NICU for a little bit. So, let’s get this pump going just to help initiate supply.

So, I think the hard part with moms thinking that: “They don’t have enough milk in the first couple of days – is just not knowing exactly what’s expected of their body at that time.” So, moms’ milk is actually on the lower side in the beginning for several reasons.

First, babies born full in Meconium that lovely, dark, tarry poop that needs like 15 wipes to come out of their bottom. Wipe them clean and so, they need to pass this Meconium. So, they need to suck a ton to cause Peristalsis to get rid of it.

So, if you have [inaudible] amounts of milk, it would actually make them quite uncomfortable. So, and like Stacy had mentioned: “Tummies are super small.”

Stacy Spensley: Like a size of a marble when they’re born.

Robin Kaplan: They are. They’re super small. So, the colostrums which is mom’s first milk is really low in quantity but super high in quality. So, it’s jam packed with nutrients and anti-bodies and just a right amount of diuretic to count pass that Meconium.

So, it’s helpful for moms to kind of understand that-that first day, babies actually only need about five Millilitres per feeding but in the first 24 hours. That’s tiny. That’s barely covers the bottom of a bottle, if you were going to measure it in a bottle. Then, each day it kind of goes up a little bit.

So, by Day Two – we’re looking at about 10 to 15 Millilitres per feeding and then by Day Three up to about 20-25. Then, by Day Four about 30 Millilitres but still 30 Millilitres is only an ounce per feeding. So, kind of keeping in that frame of mind like: “Okay, this is actually all my body is expected to give.” So, it kind of relieves the stress.

I think the other thing to point out too is that: “Until that fuller milk comes in-in the first couple of days unless you’re Angela and it comes in about 12 hours. Colostrums doesn’t really leak that much. I mean or I should say: “It doesn’t drip.” So, when we think of milk, we think of liquidly stuff that we like pour out of a carton and colostrums is thick like maple syrup. It might bead up a little bit. But, it doesn’t actually drip.

I remember when I knew when my milk came in when we just gotten home for the paediatricians’ office and I was leaning over to get something – my mom was holding our son. So, I leaned over and I had those little cups on because my nipples were hurting really badly and I didn’t want anything touching them. So, there was nothing between. There’s just like: “Breast and then those cups and then the shirt.”

I leaned over and my mom was like: “I think your milk is in.” I’m like: “How did you know?” She’s like: “Because you just dripped all over my shoe.” I was like: “There you go. The fuller milk is in.” It was true like: “It’s switched over from that kind of that sticky stuff to full on drippage. So, all right.

Okay, Myth Nine is from Stacy on Facebook and what she wrote was:

When a baby is under weight, just keep latching the baby and feed more often and don’t supplement because it will hurt your supply. -Stacy

So, this is actually really important myth to bust as well because usually, if baby is underweight – it means that actually something is going on with either mom’s supply, baby’s suck effectiveness or sometimes both. So, latching the baby and feeding more often isn’t always the best or only solution to the situation.

So, a baby ineffectively feeding 14 times a day or for an hour long at a time isn’t going to solve anything. It’s not going to get baby’s weight up. So, really a baby that’s underweight needs to meet with a lactation consultant to assess what the cause is. One part of the statement though is super important and that supplementation can hurt your milk supply.

Supplementation sometimes can and that’s only if moms not taking measures to protect her milk supply. So if a mom is needing to supplement with something other than her own milk, she’s going to want to stimulate when the baby is not feeding – either using a pump or a hand expression to help kind of phone-in the order to her brain to help increase supply.

So, that’s really the only time that supplementation is going to negatively impact a moms’ milk supply is that: “If there’s no excess simulation just what the baby is giving.” So, and then sometimes, making sure that babies suck is effective. Positively, doing some extra pumping, do some herbs. Sometimes a medication is necessary.

But again, when a baby is underweight, we got both mom and baby to see what the cause is because not just pop in the baby on multiple times is going to always solve the issue.

Chelsea Powell: Now, you throw in away something to say. It is just something I’ve come across on the internet kind of the breastfeeding groups were in and just come across the people I meet on the supplementing and hurting supply side is I know a lot of moms or I’ve seen them where there’s just like: “They’re not getting enough.”

So, they give them just a bottle of something like you were saying: “They don’t do other side of the stimulation and they’re so concerned about their supply but they don’t really understand how it works.” So, I just like: “It’s just something I’m always like because you need to keep you breasts I think is the best possible way.”

We met with you and we’re having that struggle. You’re like: “Here’s the syringe. Try to supplement him with your own milk like pumped make the supplement for him and then keep it at your breast so that you’re getting that stimulation.” So, yes they need to get check to see if it’s like tongue-tie or whatever.

But, keeping it there versus just being like: “Here’s a bottle because if you’re giving them something but then you’re not telling your body they had something, it’s your body is not kind of keep making more.”

Robin Kaplan: Exactly.

Chelsea Powell: Because they don’t need it.

Robin Kaplan: Absolutely and that’s the key right there is that: “If you’re giving something else, you need your body to know that something else was given.” In the beginning, moms may not be able to – if the baby needs an ounce of supplement, mom may not actually be able to pump out an ounce but the pumping is what’s so crucial to say like: “Okay, babies getting milk from somewhere else. So, we need your body to do it again and increase it.”

Stacy Spensley: I just come across that so much that I’m like: “Please I need people to know this.”

Robin Kaplan: Yes, absolutely.

Stacy Spensley: The other one I would say is that: “You kind of gloss over it because you are a lactation consultant. As you need to see a lactation consultant because I see it the same thing on the Facebook groups all the time.” I’d be like: “Well, my doctor just said that I should supplement with formula.”

Robin Kaplan: Yes.

Stacy Spensley: Paediatricians are doctor for your baby; they’re not a lactation consultant for baby and mom.

Robin Kaplan: It’s a great point. Absolutely and again, one of the things I’ve mentioned to moms’ as well is just exact you nailed it on the head that: “Paediatricians – they have to be concerned for the baby.” They want to make sure babies gaining weight and getting healthy and stuff. But, sometimes they forget the component that: “The mom is the one who is trying to make the baby healthy.” If we don’t protect them

Stacy Spensley: If we usually just kind of bulldoze the mom like think a lot of times when you’re like

Robin Kaplan: So, mom needs that support to make sure that: “Her supply doesn’t plummet while baby is turned getting laid up.”

Mj Fisher: The doctor’s job is to make sure the baby’s gaining weight. They don’t care how as much and the lactation consultant’s job is to make sure that moms milk supply is providing what they need.

Robin Kaplan: Yes. All right and our last myth – Myth Number 10 is that:

“A mom cannot increase her milk supply after the first two weeks.”

This one is absolutely not true. Yes, the first 10 days are super critical. That’s when Prolactin which is a hormone that is released from the Anterior Pituitary Gland. It stimulates milk supply production. It spikes after the placentas delivered and those levels with a highest between Day 10.

So, if you’re a numbers person we’re looking at 200 Nano Grams per millilitre. So, between 10 to 90 days that Prolactin can actually fluctuate from about 60 to a 110 Nano Grams per millilitre and then it drops below 60.

So, you can see that the highest point is in those first 10 days but then between 10 and 90 days, we have a lot of room to work with. Then, other hormones such as progesterone, estrogens, insulin, cortisol and Thyroxine can play a huge role in this as well. So, and then another thing is that: “A huge component is milk removal.” So, the fuller the breast, the slower the milk production – so, the more frequently the breast is empty, the faster that milk production occurs.

So, if a mom needs to increase her supply after babies two weeks old, she should really meet with a knowledgeable lactation consultant. Again, to asses’ babies suck effectiveness and mom’s medical history. We had several episodes on The Boob Group that talk about the topic of low milk supply and tests that can be done to check hormone levels as a way to increase mom’s supply as well as with extra stimulation herbs and medication if necessary.

So, again, first two weeks are important but they are not the end all be all to increasing a mom’s supply. So, it’s a great myth I love to bust all the time. So, that is the end of our show. Thank you so much for our panellists for joining in on this conversation about: “Breastfeeding myths and misconceptions about supply.” It’s always fun being answering with you guys and hearing about all of your advice as well.

For our Boob Group Club Members, our conversation will continue after the end of the show as we will discuss Myth Number 11 from Melanie which is:

If I am not making enough milk in the beginning and need to supplement that I won’t ever make enough milk. -Melanie

So, we will be busting that myth. For our Boob Group Club Members and for more information about our Boob Group Club, please visit our website at www.newmommymedia.com . Here is a question from one of our listeners.

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Robin Kaplan: This is from Jessie and this is what she wrote:

I’m concerned I’m not making enough milk for my two-week old daughter. I’ve heard Fenugreek can produce milk, any advice? -Jessie

Veronica Tingzon: Hey Boob Group listeners! This is Veronica Tingzon, an International Board Certified Lactation Consultant and owner of the Original Comfort Food in San Diego California. Jessie, first of all I don’t treat you as a patient so I don’t know if you truly do not have enough milk for what maybe going on.

So, first of all, the first thing I wanted to tell you is that: “You should be seeing a lactation consultant whether it’s at a breastfeeding support group, at [inaudible] meeting or if you hire a lactation consultant personally or if your doctor, paediatrician or your hospital offers some type of lactation’s clinic services – you should take advantage of that.

Fenugreek is a great herb that enhances milk production. It doesn’t actually produce milk. The only thing that produces milk is: “The baby latching on or comfortable into your breasts and making that stimulation send a signal to your brain which then tells your brain to make milk and send it to your breasts.” That is what produces milk. Nothing else produces milk.

A lot of people have this misconception that: “Doing this or doing that, eating the food, drinking good supplement, drinking more water produces milk and that is a very, very erroneous assumption. So, with that said. There are foods, herbs and things that do help with the production much like if you were dieting and you are exercising and eating right, you can take pills that could perhaps help you share that weight faster. It’s the same thing.

If you’re doing all those steps to make the milk like pumping and breastfeeding well, then the next step is to add on top of that an herbal supplement like Fenugreek. There’s a lots of different herbs that you can take and you can take herbs and combination. There’s an even supplement products out there that actually have all those herbs wondered into them.

Fenugreek is kind of the lower man on the totem pole – first try or first line of defence when it comes to the herbal supplements. There’s also the Blessed Thistle. There’s also Marshmallow Root. There is also Goat’s Rue. Something called [inaudible].

There’s even the prescription drug like Reglan and Domperidone which also have the by-product of making more milk or enhancing that production as well.

So, yes; go ahead and try the Fenugreek and what you can do is: “There’s a couple of great websites that have some wonderful information about herbal [inaudible 00:41:27] which are the herbal supplements that support lactation.”

The first is MobiMotherhood.org that’s www.MOBIMOTHERHOOD.ORG and www.LowMilkSupply.org – www.LOWMILKSUPPLY.ORG These are two really great websites that can help you kind of decide for your ways through which supplements using my help you with that.

It gives you some typical dosaging amount. It gives you a place to start on maybe kind of figuring out why it might be that you got some lowered milk supply. But, I really having you encourage you see a lactation consultant because that’s going to get you the best information faster than anything else.

The other thing, I do suggest that: “You do pump after you breastfeed during those waking hours and to do some more stimulation to you breast.” That is really going to give you a bigger kick. Don’t worry about how much you’re collecting. You’re pumping for simulation not volume. I hope this helps. Thanks for calling.

Robin Kaplan: That wraps up our show for today. We appreciate you listening to The Boob Group.

Don’t forget to check out our sister show:

• Preggie Pals for expecting parents
• Our show Parent Savers for moms and dads with newborns, infants and toddlers
• Our show Twin Talks for parents of multiples.

Thanks for listening to The Boob Group, your judgement-free breastfeeding resource.

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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