The Boob Group
Do I Really Have Low Milk Supply?

[00:00:00]

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: There are times when a mother is breastfeeding where she may question: “If she is making enough milk for her baby.” Sometimes a mom may truly have a low milk supply and another time something may have changed that froze her for a loop.

Today, I’m excited to welcome to the show Elizabeth Myler. Elizabeth is an RN, an International Board Certified Lactation Consultant with Mahala Lactation and Perinatal Services in New Jersey in Pennsylvania.

Today, we’re talking about: “Whether a mom has of low milk supply or not.” This is The Boob Group Episode 106.

[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.

Today, we have two lovely panellists in the studio. Ladies, will you please introduce yourselves?

MELISSA LANG LYTLE: My name is Melissa Lang Lytle. I’m 43 years old. I’m a birth doula and birth choices advocate. I have three children: Benjamin 5, Joseph 3 and Milo 3 months.

ROBIN KAPLAN: Milo is in the studio today.

ELIZABETH MYLER: Hi Milo. Hi Melissa.

MELISSA LANG LYTLE: Hi.

ROBIN KAPLAN: Tess, would you like to introduce yourself?

TESS DE LA GARMA: My name is Tess De La Garma. I am 35 this month. I work for the National University and I have one son and he is nine months old.

ROBIN KAPLAN: All right, welcome to the show.

TESS DE LA GARMA: Thank you.

ROBIN KAPLAN: Mj, will you please introduce yourself as our awesome producer. As well as, talk a little bit about our Virtual Panellists Program.

MJ FISHER: Well, thank you for that intro. So, I’m Mj. I have a son who’s almost going to be three in June. Besides taking care of him because I am a stay-at-home mom, I get to do this wonderful job. One of my job description is: “The Virtual Panellists Program.”

So, it is really just a way to get you out there online to join our conversation and here in studio if you can’t be a part of the show or if you can’t be on the studio with us. Because we post the same questions that our in-studio panellists are answering. So, you can share your experiences; give your opinions or tips.

A lot of the moms are just engaging and supporting each other because there are lots of questions besides just giving their answers or opinions and comments. It’s kind of a sneak preview of our show before it releases because we’ll post tips and info as we record. Everybody’s just supporting each other. So, it’s really great.

You can check out more about this program on at website – www.TheBoobGroup.com under the community tab and there are perks for participation.

ROBIN KAPLAN: All right, thanks Mj.

MJ FISHER: Yes.

[Theme Music]

ROBIN KAPLAN: So, here’s a question from one of our listeners. This is from Miranda.

She wrote:

Help. My twin girls wean themselves about three weeks ago. I have had painful period like cramping ever since but no period. It’s getting super annoying being in pain all the time. Is this normal? Did anyone else experience this cramping post-weaning and how long did it last?

-Miranda

ASHLEY TREADWELL: My name is Ashley Treadwell. I’m an International Board Certified Lactation Consultant in San Diego California. I work as a private lactation consultant for the San Diego Breastfeeding Centre. Hi Miranda. Thank you so much for your question.

Short answer is: “It’s totally normal to experience what you are currently experiencing after weaning your baby. Chances are: “Your body is starting to ovulate and the cramping that you’re feeling could be related to that.”

While we are breastfeeding, the Estrogen hormone is lower. So, when you stop breastfeeding, your Estrogen levels increase which can cause menstrual-like symptoms. It could take as you’ve mentioned a few weeks to actually see a cycle. Sometimes a little bit longer.

It could be ovulation. It could be the increase in Estrogen. But, I would expect that you probably see your cycle in the next month or so. Thanks so much for the question and I wish you good luck.

[Theme Music]

ROBIN KAPLAN: Today on The Boob Group, we are: “Discussing signs for whether a mom may or may not have a low milk supply.” Our expert Elizabeth Myler is an RN, an International Board Certified Lactation Consultant with Mahala Lactation and Perinatal Services in New Jersey in Pennsylvania. Welcome back to the show Beth.

ELIZABETH MYLER: Thanks so much Robin. It’s great to be with you guys.

ROBIN KAPLAN: Awesome. So Beth, what is the average weight gain we are looking for in a baby during that first year of life and how is that change month-to-month base on baby’s age?

ELIZABETH MYLER: Well, there is a couple of different ways that we can look at that. I think what everybody needs to keep in mind some basic benchmarks. So, we’re going to expect the average breastfeeding baby to double their birth weight by about 5 to 6 months. By a year, they are going to be about 2 ½ times their birth weight. But, other indicators are important too.

Their length is going to increase by 50% and their head’s going to grow by about 33%. When we break it down into the 3-month kind of mark, we’re looking for that for the first three months being like our highest growth rate so babies going to gain about 8 ounces a week; sometimes we say about an ounce a day.

Boys gain slightly faster than girls in most cases. As we move to the 3 to 6 month period we should all be aware that rate of growth for breastfed babies slows. That’s going to be an average or about five ounces per week. Then, for the 6 to 12 month we’re looking at a gain of about 2 to 4 ounces a week; so, significant changes during that first year for the breastfed baby.

ROBIN KAPLAN: Okay and that helps so that way we all don’t end up with 35-pound one year olds.

ELIZABETH MYLER: Exactly! Can you imagine if we’d continue the rate of growth from 0 to 3 months? Yes, we’d be adult in five.

ROBIN KAPLAN: So, with this weight-gain as well as height and head circumference; how much milk does an average baby consume in that 24-hour period to maintain this and how does that change month-to-month base on baby’s age?

ELIZABETH MYLER: So, of course the biggest change is going to be between the periods of time before a mother’s milk transitions to-or-what-we-say: “The milk has come in. So, that her mature milk is fully in.” So, if we say that: “On average, that’s going to be about Day Four.”

Moms at that point in time are usually making about 19 ounces a day. Again, these are all averages. We should remember that the 50th percentile when especially when we talk about baby’s weight is the average. So, some healthy babies are going to be a little above and a little below.

When we talk about average milk productions, for moms – we should realize that some moms are going to be above and some moms are going to be below and that’s it. We usually end up okay for the most part. So between Day 4 and Day 7 – by Day 7, the average mom is up to about 21 ounces total in 24 hours.

She continues to increase until she usually maxes about by about Week 5. That’s going to be anywhere between and this is crazy. This is a big differential here. But, between 25 and 35 ounces a day and I like to use the 30 ounce benchmark because it’s just right in the middle between 25 and 35.

As far as baby’s taking that, taking the amount of milk that mom’s making – the in-take by baby after Day 4 is going to be about so when we’re talking about the first week, it’s going to be about 1 ½ to 2 ounces per feed in general. After about that first month and until solids are introduced, we’re going to say the average feeding is around 3 ounces. But, that the range is anywhere from 2 ½ to 5, 5 ½ per feeding.

ROBIN KAPLAN: Okay and that also depends on how the frequency of the feeds as well. Babies who are feeding more frequently would eat less.

ELIZABETH MYLER: Absolutely.

ROBIN KAPLAN: Okay.

ELIZABETH MYLER: Absolutely. It’s a great time to bring that up because there are so many different things that drives how much milk the baby gets and again, how much milk a mom is going to make day-to-day and week-to-week.

ROBIN KAPLAN: Okay and so when we’re looking at low supply, what are common causes for a mom to have a lowered supply than what you have just talked about as being the average?

ELIZABETH MYLER: So again, it really depends in what stage of lactation that we’re talking about. I think it maybe helped if we’ll just think about: “The milk supply is having three sort of broad causes.”

But the first and the most common and the biggest over arching one is: “Ineffective and insufficient milk removal at the breast, milk removal and breast stimulation I’m sorry in the early days postpartum.” So, this is really big and they’re can be many reasons why there is ineffective and insufficient milk removal or breast stimulation.

But, we know that maybe one in three moms are going to experience delay in their mature milk coming in the United States. So, lots of reasons why this can happen and a lot of it has to do with our common accepted birth practices – and sort of mismanagement of our breastfeeding.

So, if there’s a delay in her milk coming in the beginning, this maybe predictive of her long-term outcomes. If we don’t play catch up and make sure that we have really good breast stimulation and milk removal once her milk does come in.

ROBIN KAPLAN: Okay.

ELIZABETH MYLER: So if that make sense, the two are not the same but they are connected. There’s a researcher named Camellia Hill who’s done a lot of great work about this. A lot of her work is with NICU moms. But, she actually did determine that: “The amount of milk that a mom makes on Day 4 is highly correlated by how much milk she’s going to end up making at 2-weeks and again at 4 weeks.” So, what we do in those early days is really, really crucial.

ROBIN KAPLAN: Okay.

ELIZABETH MYLER: So, that’s our first bullet point. Then, the next things that we need to think about are: “The other mother-driven reasons.” So, I’m talking about hormonal causes for a low milk production. That could be anything from retained placenta to ovarian tumours; to insulin resistance, hypertension, thyroid disorders, metabolic disorders, Prolactin resistance, things like that – so, the hormonal aspect on the mother side.

Then, we can have breast tissue or structure causes of lower milk supply. So, that would be: “Our mothers who have a history of breast surgery whether it’s reduction or augmentation surgery or chest surgery – anytime in their life.”

Then, also our mothers who have insufficient glandular tissue; so that would be a breast tissue structure and then, we have a low milk supply that’s baby driven possibility. That can be related to the oral anatomy of the baby like tongue tie and lip tie.

The baby could also have suck-swallow-breathe dis-coordination – there are several genetic disorders where the baby just really can’t remove the milk well, cardio-respiratory disorders, muscular disorders, certain week prematurity can be something so the baby-driven and other causes for baby-driven side later can be that baby’s sleeping longer stretches at night.

Again, milk just isn’t being removed from mom. Mom’s period can return or she could be on medications that are reducing her supply.

ROBIN KAPLAN: Okay, all right. Thank you Beth, that’s incredibly extensive list but super helpful. Thank you. No, I appreciate it. I don’t think you left anything else. So, that is really, really helpful.

All right, so I love to open it up to our panellists now to kind of talk about: “Low milk supply or baby-perceive low milk supply as well.” So, ladies, have you felt like your milk supply was ever low and were you ever concerned? Tess?

TESS DE LA GARMA: I was little bit concerned when my baby was four months. I had returned to work and my girlfriend suggested that I actually get my pump checked out. I was pumping about 10 ounces a day and it was going down to about 8.

I went to Mary Birch Hospital and they checked my pump and they said that: “The pressure this is the suction wasn’t working towards full capacity.” So, they actually fixed it. I had a little part that I was able to replace for about $5 and I was pumping 15 ounces a day at work.

You could probably check your pump if you’re a working mom or if you’re pumping during the day just make sure that-that pump is working to its full capacity. Then, I also decided to pump one boob; the other boob then I would go back to the other one and the other one. That’s what really made me get some more milk.

ROBIN KAPLAN: Okay.

ELIZABETH MYLER: That is such a great point. I loved that you said that because I mustered all these really complicated reasons and you just hit on this very simple thing and it’s the first thing that I always tell mom who are pump-dependent. Check out your pump. Check out your parts. Make sure everything’s functioning well because it’s so important.

ROBIN KAPLAN: Absolutely. Melissa, how about you?

MELISSA LANG LYTLE: I have two times that I can think of with my first-born. It’s a little easier with the second and third just because you kind of get in your groove faster. So, you identify issues quickly as well.

But with my first-born, I know that my babies are long and lean. I was a little nervous at first based on weight. It looked like a more of a genetic issue. So, I didn’t turn out to really base low supply. Then the second was: “When my menstrual cycle came back around nine months postpartum.”

It just takes a dip a little bit when that started and I was concerned that I was losing milk but then it came right back. So, then I get a new rhythm on a monthly basis. So, it didn’t turned out to be a low supply.

ROBIN KAPLAN: Okay, we’ll definitely be talking about: “The return of menstrual cycle as well because that’s something that I think really can trip moms a little bit” which is you mentioned: “It’s just a matter of getting a new rhythm.”

MELISSA LANG LYTLE: Growth spurts too but I didn’t want to name like all of what that named.

ROBIN KAPLAN: No. So, Beth the first thing that you’ve mentioned when talking about low milk supply was that: “Sometimes it’s just the birth and getting that kind of delayed Lactogenesis—the delay of that fuller milk coming in.”

So, when a baby needs supplementation in the early weeks, does that always indicate that a mom has a low supply?

ELIZABETH MYLER: No, not at all. Not at all, again we’ve got to determine if the milk supply is down regulated. Why is it down-regulated? That’s really the first step to try to figure these things out. So, the baby-driven problems might require supplementation not because mom doesn’t have milk but because the baby can’t effectively access the milk that she has.

Sometimes baby is actually expanding more calories to get the milk than they should. That’s a tricky one to try and figure out what’s going on. But again, we need to look at, transfer this individual baby and how much time they’re spending at breasts, milk transfer and all of these complicated things that we can do with when you’re working with an IBCLC. But, the overall answer to you is: “No, not at all.”

ROBIN KAPLAN: Okay and I often hear mothers either in my support group or I see them posting on Facebook. For example that: “The concern that their milk supply has dropped because their breast no longer feel full.” That initial engorgement stage is gone.

Now, their breasts feel a little bit more: “They’re not as full.” So, they’re concerned about their supply. Is this an indicator?

ELIZABETH MYLER: No, absolutely it is not. There is actually one study though that did show that moms’ perception of sort of feelings of fullness in her breasts or that initial milk increase is really quite reliable. That most moms can tell when their milk has transitioned initially; so that’s something to keep in mind.

But, those feelings of fullness or that typical initial feeling of fullness goes away after the first few weeks. Even though milk supply stays the same or it may even still be increasing. Our milk production it’s not static. It doesn’t stay the same. It varies hour-to-hour and it varies day-to-day, month-to-month.

So, some of the things that contribute to this are – the degree of breast emptying that mom has. When a baby breastfeeds or when she thumps. Also, her milk storage capacity which is not the same as the size of her breast but it really has to do with the amount of milk-making tissue inside her breast and that varies mom-to-mom.

So, a mom with less milk storage capacity; she may start to feel thaw a lot sooner than the other moms. The amount of milk that’s just in there could be identical. So on average, babies only remove like 2/3 of the milk that is in the breast.

So, this is why when we’re trying to increase milk supply – in true cases of needing more milk or lower supply. When we try to remove that extra 1/3 that’s left behind, we can almost always help a mom increase her production within 72 hours. So, that’s kind of nature’s protective mechanism in most cases.

ROBIN KAPLAN: Also, one of the reasons why if mom’s feel like baby just fed an hour before but they put the baby back on again. They actually do have milk. It’s not like you’re ever fully drained; although sometimes we definitely feel that.

ELIZABETH MYLER: Exactly.

ROBIN KAPLAN: All right, fantastic. Well, when we come back, we will continue our discussion about: “Signs about a mom may or may not a low milk supply.” We’ll be right back.

[Theme Music]

ROBIN KAPLAN: Well, welcome back to the show. We’re talking about Elizabeth Myler about: “Milk supply.”

So, Beth, how does a mom’s milk supply change throughout the day? We’ve kind of alluded to this a little bit throughout the discussion already. Why do moms often feel like their supply is low during evenings and like late afternoons and evenings?

ELIZABETH MYLER: Well, cause moms are really smart. Typically, milk production does go down in the afternoon and in the evenings; not for all moms but for a lot of moms. Although, our milk volumes maybe lower than, we have to remember that the fat-content and the calorie-content or the calorie account of that milk is going to change throughout the day as well – so the emptier the breast, actually the higher the fat content of the milk.

So, sometimes even though baby maybe getting smaller volumes. The overall calorie intake is going to be the same. So, that’s important to remember. Fat content of milk is something that varies mother-to-mother as well as just hour-to-hour during the day. But in general, moms are alike. Our milk supply does get to its lowest point in the afternoons and early evenings.

ROBIN KAPLAN: Okay. Ladies, have you ever felt like your supply is lower in the afternoons and in the evenings and what did you do during this time if you were feeling like it did take in a little bit of a dip? Melissa, how about you?

MELISSA LANG LYTLE: I do feel that it’s lower in the afternoon and in the evenings. Then, especially when there’s a growth spurt or like cluster feedings. I would swear my baby wearing because if you can in fact have things you must do outside or sitting in your chair and just nursing all day or all night. It really saved me.

So, that’s kind of how I worked through some of those what feels like lower supply – or maybe that baby wants to be at the breast what feels like longer because they were really working at getting the milk. Baby wearing saved me.

ROBIN KAPLAN: Okay, cool. How about you Tess?

TESS DE LA GARMA: I did feel that especially going back to work. So, I would pump before I would leave. So, I probably would feel that the boob wasn’t full enough when I got home to feed. So then, what I’ve done is: “I’ve made the last pump earlier about 2-3:00 rather than 4-5 when I’m about to live.”

So, in that way when I do get home at about 5:30 and if I feed about 6:00 I’ve got really full boobs ready for a good feed. So, I think that’s helped me a little bit.

ROBIN KAPLAN: Nice and how does your baby reacted during this time? Have you noticed, been more appreciative?

TESS DE LA GARMA: Yes and he sees me and it’s exciting because I lift up my top and he’s like: “Daddy’s hands.”

ELIZABETH MYLER: There it is.

ROBIN KAPLAN: Awesome, very cool. Beth, if a baby seems a little grumpy while breastfeeding in as popping on and off of the breast kind of like little Milo’s doing right here. Can this indicate a little milk supply?

ELIZABETH MYLER: Sometimes it can but I think it’s truly important to know that: “Babies respond to decrease the true low milk supply in lots of different ways.” Some of them actually will just chuck down and go to sleep. Other babies or mothers who have true low supply seemed kind of content to just accept less than adequate milk intake. So, coming on and off the breast can have lots of different reasons.

Teething, it actually can be an indication of an overactive or really strong milk let down which may be related to oversupply. A baby could just have just they’re could be a latching difficulties like some of the things that we talked about before tongue-tie or Hypertonia or something like that.

But, we can’t rely just on the baby’s behaviour as an indicator in any way of maternal supply. It’s not accurate.

ROBIN KAPLAN: Sure.

ELIZABETH MYLER: Especially the older baby, this is a relationship and there’s sort of talking to you as they’re coming on and off in many cases.

ROBIN KAPLAN: Absolutely and I would say for in our studio as well: “I think it was done.” He was like: “I need to burp and I think I’m full and now he’s smiling.”

ELIZABETH MYLER: Yes. Yes.

ROBIN KAPLAN: It kind of alluding to what Melissa was mentioning with the growth spurt. What if babies starts to eat much more frequently like going from every 3 hours to every hour to an hour and a half? Not necessarily a low milk supply, right? It could be just a growth spurt?

ELIZABETH MYLER: It could totally be a growth spurt. I mean I think it’s really important to put the cultural feeding norms out there. So, when I was a peace volunteer in West Africa, I learned that mothers nourished according to baby’s cues like for a couple of minutes up to 20 times a day.

I mean they were just constantly feeding their babies small amounts of milk. So, in our country; when I’m asking my client to do 10 to 12, I’m really like: “Kind of cut them some slack.” I’m like: “Hey, listen. I’m not telling you to do it 20 times a day.” But, really I think in the US, our cultural norms are sort of more based on the bottle-feeding and the formula-feeding model so we are expecting our babies to eat larger volumes and to space their feedings out.”

So, I guess what I’m trying to say that: “There are other ways of feeding a baby that fully meet their needs but don’t have anything to do with these more rigid clock-based norms.” Did that make sense?

ROBIN KAPLAN: Absolutely.

ELIZABETH MYLER: Even though growth spurts, we never even noticed growth spurts in Africa – that’s what I’m saying because baby’s just had total access all the time for short little first.

ROBIN KAPLAN: Very good point. Then, something that Tess had mentioned. So, going back to work, what if a mom is pumping at work? What is the average amount of express milk that she should leave per hour when she’s gone from her baby and how does this defer depending on the age of the baby?

ELIZABETH MYLER: So, Tess was really spot-on when she said: “She started at about 10 ounces daily.” It really depends how long you’re going to be separated from the baby. Of course, how much milk you need to have prepared for the baby each day. But, somewhere between 10 and 15 ounces daily, it’s going to cover a mom who works anywhere from 6 to 12 hours – or that’s the period of time that she’s away from the baby.

So, if a mom went back to work before her baby was 6-weeks old then we may be talking about needing less. But after 6 weeks, she’s going to be needing about 3-5 ounces per feed. It really just depends how frequently this baby is going to feed when their apart. But for most moms, 15 ounces total for a full work day is about what she needs to feel comfortable. Did that make sense?

ROBIN KAPLAN: Yes.

ELIZABETH MYLER: Tess, was that about what you figured out?

TESS DE LA GARMA: Yes. Yes.

ROBIN KAPLAN: Then, with what Tess has mentioned: “The pumping output was decreasing while she was at work.” With Tess’s case, it had nothing to do with her milk supply decreasing.

ELIZABETH MYLER: Absolutely.

ROBIN KAPLAN: It was the pump that was failing you. Do you find that this is most often the case?

ELIZABETH MYLER: Yes. I mean that’s why that it is the most important thing to check the pump part to know. Sometimes there has been a change in breastfeeding rhythm or again we talked about: “If a mom gets her period back often she’ll see that dip happen right before bleeding starts. Then into the first couple of days of menstruation.”

It’s really an acute stress, any changes – big changes and sleeping. These things can have a minor and temporary affect in a mom’s milk supply that we can almost go with remedy with some of the things that both Melissa and Tess talked about. She’s really nursing a lot more when we are together with our babies.

Babies who bed-share and share time with their moms at night can often get a third or more of their caloric intake during the night. So, and then we know that night nursing can help boost overall supply throughout the day. So, lots of these things are really modifiable and temporary and that’s I guess the really the big point.

Babies obtain the calories they need in a 24-hour period. So, we shouldn’t be panicked if all of a sudden our pumping output at work is down a little bit – because when mom and baby are together, most babies can make up for any decreases.

ROBIN KAPLAN: Okay. So Tess, you’ve kind of already shared your story about fixing the remedy in the pump situation. Melissa, did you pump at all or you just mostly start from the tap-type mom?

MELISSA LANG LYTLE: Mostly straight from the tap. In fact, it’s kind of funny because my parents are in town right now. My dad said: “Is it against your beliefs to pump?” I’m like: “No, not at all.” I just: “I really haven’t needed too.” My baby is that nurse or with me all the time.

So, if I could find a way to take them with me to birth, that would be amazing. But so far, no; I’m just kind of working for the most part from home or out of my home.

ROBIN KAPLAN: So, pumping is not necessary something that you have to incorporate. Okay. Beth, what are some key indicators that a mom actually does have a low milk supply or that her supply has in fact decrease? So, maybe it’s not able to remedied by fixing pump pieces or increasing frequency that baby’s feeding. What are these signs that a mom should be looking for?

ELIZABETH MYLER: This is where it really helps to work with the skilled helping person because we want to have somebody who can really evaluate the difference between: “Primary low milk supply and secondary milk supply.” So, we want to know: “Did the moms’ breast grow?” Did she have what we called: “Positive breast changes during pregnancy?” This is the norms.

So, we would expect her breasts to grow a little bit. Some moms are going to experience tenderness in the first trimester. Did her Areola get darker? Some moms will even notice a little bit of leaking of colostrums. These are all really good; positive signs that for her to look for. So, if these things didn’t occur, these can be indicators for us that she may truly have the some of those the breast tissue structural problems that can be indicators of low milk supply.

If her breasts don’t ever get heavier or fuller, by even with a really awful, horrendous start and bad birth, typically milk will come in by Day 7, Day 5 to 7. If that doesn’t happen, she never notices the change and that feeling of fullness that we’ve talked about. That could be a sign.

If the baby really continues to need supplementation in order to gain weight. So, she tries stopping supplementation and the baby stops gaining. Again, there could be other reasons but this could definitely be a sign especially if she’s not doing this. She’s not supplementing with her own milk.

But really in adequate weight gain, at any point in the first year could be a sign that her supply has decreased at some point. We can do test weights if she’s working with an IBCLC; so we can see how does the baby transfer during what we’d hope to be a typical feed. One test weight is not going to be enough to show us if this mom truly has a little milk supply. But multiple test weights can often give us good information about a mother’s supply.

When we’re looking for good milk transfer, most baby mother dyad who or doing well – that baby should get about 2 ½ ounces in less than 15 minutes once full milk supply comes in. This is less than 15 minutes of good active suckling, flowing – so if that doesn’t happen, we may be looking at what else maybe going on. But, suckiness at the breast is unlikely to be a strong key indicator for it.

ROBIN KAPLAN: I like that you brought that the test weight is not to just do one because I think sometimes – one of the things that mom’s will do is go to a support groups once a week. It’s hard to see if that was actually a good feeding.

I have a mom that I was working with whose baby always took about 1 ounce 1 ½ maybe 2. Then she ran to the scale and we did test weights overnight and the baby took in like 5 ounces to 7 ounces during a couple of feedings in the middle of the night and just snack the whole rest of the day.

ELIZABETH MYLER: Absolutely.

ROBIN KAPLAN: Though, she was concern because every time she went to support group, he was taking so little. But again, we were looking at the whole picture as well. But, that was really illuminating to her.

It also helped her to not do many type of sleep training as well because she realize that he tanked up so much overnight; that he really actually did need in the middle of the night – which I think was equally important aspect for her to see if that whole process as well.

ELIZABETH MYLER: That’s why I really loved to tell moms all the time that: “Your baby is going to obtain the calories that they need in the 24-hour period not in 1snapshot.” We cannot multiply that by 8 feedings and get in a good indicator.

Some moms who are really concerned will do just what you recommended. They will rent a scale for a full 24 hours and do multiple test weights; at least twice in the morning, maybe twice in the afternoon, twice at night. That will give us a much better idea.

ROBIN KAPLAN: All right, well thank you so much Beth and to our panellists for joining in this conversation about: “Signs for whether old mom has a little low milk supply or not.” It was so great to have you on the show again Beth.

ELIZABETH MYLER: Thanks so much Robin. Good luck to you moms.

TESS DE LA GARMA: Thank you.

ROBIN KAPLAN: For our Boob Group Club Members, our conversation will continue after the end of the show. As we will discuss: “How babies nursing distractibility and how it affects milk supply.” So, for more information about our Boob Group Club, please visit our website at www.TheBoobGroup.com .

[Theme Music]

DENISE ALTMAN: Hey there Boob Group. My name is Denise Altman and I am a private practice IBCLC otherwise known as the Registered Lactation Consultant. Private practice means: “I have my own business and I specialize in prenatal education and breastfeeding support.” This session is about: “Prenatal breast-to-breastfeeding” something I definitely have an opinion about.

One thing you as an expectant mama and your partner should be considering is: “Where are your resources in the hospital or birth centre or out?” Your professional resources are your lactation consultant or breastfeeding specialist; typically beginning in the hospital or as I’ve said birth centre.

In many cases, most hospitals or birth facilities don’t’ have an excess of breastfeeding support staff. So to best utilize your lactation consultant: “When she comes to visit you, ask her to watch a full feeding.” If the baby is already nursing when she walks in the door, remove the baby from the breast and ask her for to watch you latch and observe the full feeding.

Your staff nurse and caregivers that are at your bed-side for at least a full shift are also an excellent resource while you’re immediately postpartum. Staff nurses are often trained and expected to assist with feeding. While they may not have a same level of knowledge as a lactation consultant, most of them are very willing and able to help you at least to get through the basics.

After discharge, it’s helpful to know what your resources are on the community. While you’re pregnant, contact your local [inaudible] or peer counsellors support network with if you were with eligible but also find out where your outpatient resources are. Sometimes a hospital offers outpatient breastfeeding support services; sometimes a support groups and most communities have a private practice lactation consultant like myself.

Private practice also means: “Often do home visits which is very convenient if you have a C Section or a difficult birth or if the baby has to be on [inaudible]. You spending a lot of time back and forth to the Paedia’s Office.”

Let’s not discount the paediatrician’s office. Many now are hiring lactation consultants to function as staff members. When you’re choosing your paediatrician, this is something to ask about as well.

I hope the information in this session can get you started on exploring your options. For additional tips on choosing a breastfeeding task, please visit my website – www.feedyourbaby.com and keep listening to The Boob Group.

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 shows:

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

SUNNY GAULT: New Mommy Media is expanding our line-up of shows for new and expecting parents. If you have an idea for a new series or if you’re a business or organization interested in joining our network of shows through a co-branded podcasts, visit www.NewMommyMedia.com .

End of Audio
[00:38:44]