Ok so I’ve broken my own rule in the title of this post; because a bug-bear of mine is that we start looking at things all wrong when our starting point is ‘feeding’; this over-looks the fact that before we can breastfeed our baby, we need to produce some breastmilk (to lactate) in the first place. This is one of the reasons I love that Lactation Consultants are called just that.
Let’s look at the physiology of lactation:
- Once the placenta is birthed, your body produces a rush of breastfeeding hormones (prolactin and more oxytocin).
- Having your baby in skin-to-skin-contact immediately after the birth helps to boost your production of breastfeeding hormones and start to ‘switch-on’ the milk producing cells in your breast (the cells of acini). Without this stimulation some cells may never ‘switch on’ and produce milk.
- Your baby doesn’t just suckle on your nipple to get the milk out. They need to have your nipple right at the back of their throat (where it won’t get sore) and have a mouthful of breast tissue for your breast to get the right stimulation for it to produce milk (not just for that feed but for the whole time you will breastfeed which may be months or years).
- If your baby is not brought to your breast to feed frequently or is not latched properly in the first two weeks, your breasts won’t get enough stimulation and your body will assume that your baby isn’t very hungry; it will start to halt or reduce milk production using a specially designed inhibitor hormone.
When lactation is our starting point it is easy to see where, for some women, breastfeeding problems might stem (things like low milk production). There are situations that can occur immediately after birth or in the first two weeks which may mean that our milk supply never gets up to full steam.
Armed with this knowledge, it is easier to work around these issues should they arise or avoid them altogether. Here are some suggestions:
- Keep your need to lactate in mind as much as your baby’s need to feed.
- Have your baby in skin-to-skin contact after the birth. Even if your baby doesn’t take a feed in the first hour of life, just having them in close proximity, nuzzling your breasts will start to switch on the milk-producing cells in your breasts.
- Offer your breast or bring your baby to your breast with their head in a position which makes it easy for them to get a good latch (nipple at the back of their throat and a good mouthful of breast tissue).
- If you can’t hold your baby in skin-to-skin contact immediately after birth for any reason, mimic the stimulation that your baby would have given your breasts. Learn how to hand express before your baby is born (a machine or a gadget is no good at this early stage).
- If you need to mimic the stimulation in the place of your baby (hand express) do it frequently (every two hours at least, even throughout the night if you can). The aim is not so much to get any milk out (you will never be as efficient at getting milk out as your baby is) so don’t worry if it seems like nothing is coming out; that’s not what’s important at this stage, it’s just about stimulating lactation at this point; although of course it’s a bonus for your baby if you do get one or two mls out and manage to catch it.
- Hold your baby in skin-to-skin contact as soon as you can; even if it’s a matter of hours later it will still help to boost your lactation.
- Bring your baby to your breast to feed frequently, especially in the first two weeks to establish your milk supply. Learn to recognise your baby’s early hunger cues and respond to these by offering your breast.
- Make sure your home environment allows you to engage in lactation stimulating behaviour – keep your baby close by where you can see and respond to their early hunger cues, avoid or limit visitors who are going to make breastfeeding difficult. If you can’t get your breasts out in front of them, their visits should be limited to a half hour max! If these kinds of visitors can’t be avoided, then every time your baby needs to feed they should leave the room rather than you and your baby having to get up and relocate. You should be firmly embedded in your nest with everything you need to hand!
- Visitors that do come should make you food and drink and not expect to hold the baby while you wait on them.
- Explain to people that you are not hogging your baby; they have a life time to get to know your baby, what your baby really needs right now is a good food supply and they can only get that if they are allowed to feed frequently (uninterrupted access to their food supply!). It won’t always be like this, just while everything gets established.
- Keep a sports bottle of drink topped-up and nearby. A sports lid on a bottle is really useful as the bottle can lie down in the bed sheets if needed and not spill.
- If you get the chance before your baby is born and you have enough room in your freezer, cook and freeze some single portion meals that you can re-heat easily.
- If you don’t have a freezer, stock up on soups, pasta and oat-based foods like porridge or muesli. Oats are considered to be lactogenic (good for boosting milk supply) and all of these suggestions can be prepared super quick and eaten with one hand.
Take a look at my video course Preparing for Successful Breastfeeding to learn all about how to help your baby latch at your breast (getting your nipple in the right place in their mouth), about early hunger cues, how to hand express and much more. It’s a video course so you can watch it now and then as many times as you like, even after your baby is born.
Foot note: there is emerging evidence that a couple of things we may be exposed to around birth have the potential to reduce our milk supply. I am in no way saying that you should decline them or not have them if they are right for you, but I think it’s important that you are aware of their potential so you are making a fully informed choice:
Syntometrine is an injection that is offered to women immediately after their baby is born to help the placenta come away. Most women don’t actually need this routinely but it can be helpful for women who have an increased risk of bleeding. Visit my free birth planning video to learn more about this.
Syntometrine has the potential to reduce our milk supply. There is limited evidence that one dose at birth will have this effect, but it all depends on how sensitive to it you and your milk supply are; we are all different.
Syntocinon is also worth considering. It is often given as a ‘drip’ during labour as part of a labour induction or to speed up a labour that the hospital obstetric team feels has slowed down (that’s a WHOLE other subject for another day!). Research has suggested that this and other ‘routinely’ administered drugs in labour are associated with lower breastfeeding rates but it’s not clear if this is due to a reduction in milk supply or others issues.
Placental encapsulation / eating your placenta
There are more and more women turning to this due to its growing reputation for maintaining health (especially mood related health) after the birth. There is a cautionary note though as the placenta is high in estrogen which can inhibit lactation. If you have had your placenta encapsulated and are taking it regularly and you then find that your milk supply is low, you can just stop taking it unlike drugs which are injected into you; once they are in they can’t be stopped.