132. Your Top Milk Supply Questions: Pumping Output, Baby Getting Enough, Things That Lower Supply and How To Increase Supply
How much milk is normal to pump? How do I know if my baby is getting enough milk? What are things that may lower my milk supply? What are tips to increase my milk supply? Have you had one of these questions before? Or maybe them all? Listen in for the answers!
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This podcast is not "medical advice". Please consult with your Healthcare Provider about your specific situation.
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Welcome to the Breezy Babies podcast, where we talk about all things boobs, babies and breastfeeding. This is episode 132, your top milk questions. I'm Bree the IBCLC, and I made Breezy Babies with you in mind to help ease your transition into parenthood. Becoming a parent changes your life in every way imaginable. Bumps in the road are going to come up as you move into your new role, but my goal is to help smooth out those bumps and help you become the most confident parent you can be. With good education and support, I know you can meet your breastfeeding and parenting goals. Let's do this together. Hey there, friend. Welcome back to another episode of the podcast. I'm so glad to be back with you in 2023. It's not 2023 as I'm recording to this, but it is as you are listening to this. I am still back in crazy holiday season. I look forward to the time when this podcast does come out and it's just a fresh new start of the year. I went yesterday to two in person consultations and I love doing two back to back. By the way, when I do go for in person consultations, if I'm already out and about, I have all my stuff packed up, I might as well just go from one house to the next. And now that my baby is a little bit older, I can do that. When she was younger, it was hard enough to just get away for one consultation, even if they were really close by my house, that's kind of the best I could do before I needed to be back to feed her. But I have a little bit more flexibility now. Anyway, at my second consultation, she asked, how long have you been doing in home consultations for? And I thought and I was like, it's been about six years. And she said, wow, you must really like doing these if you've been doing it for that long. I was like, yeah, I guess that is absolutely true. And honestly, sometimes it's a little exhausting traveling to people's homes, especially when you have to go out and brave the weather or traffic or you never know what you're going to come upon. But it is always just so nice to go meet with someone in their home, in their space. They can sit where they normally nurse their baby. They have all the things that they need. They have their breast pump close by if we need that. They have whatever supplies on hand close by so we can look at that and make sure that it's working right. And those are my favorite. Honestly, most of my clients have their consultations covered by insurance. If you're wondering if insurance will cover your consultations as well, you can always just click the link in the show notes or go to Breezybabies.com and you can have them covered under telehealth or in person. Either one is totally covered and it's worth a shot. You never know. Sometimes my clients will say, oh, I have this insurance. I don't know if it will be covered. We run it. And it turns out they do have six free consults, so you never know. Anyway, I am excited to chat with you today about the top milk supply questions that you are asking. I'm sure that you've Googled these before I want to talk to you today about, number one, how much milk is normal to pump? Number two, how do I know if my baby is getting enough milk? Number three, things that lower your milk supply. And number four, tips to increase your milk supply. So, have you had one of these questions before? Maybe even all of them? I know that at all different points in my own personal nursing journey, I have had one of these questions myself. And you may have even done a middle of the night Google search asking something very similar to one of these questions or even one of these questions word for word. I bet you have. I bet money on it, in fact, because as an IBCLC, I get asked the same questions over and over again, which I love, because isn't it so cool that no matter where you live in the entire world, you're not alone in your lactation struggles? I promise there is someone else going through something very similar. In fact, one of my favorite parts of my job is meeting with clients all over the world. I've met via telehealth, which just means secure video, with clients all over the United States. And you might not even believe this, but I've even met with a handful of moms from the Middle East. Seriously, it's happened more than once. And while their societal circumstances might be a little bit different or some of the specifics, such as what supplies and breast pumps they have available, well, that might all be a little bit different when it comes to the basics. The breastfeeding basics, such as the questions that I started with asking on this podcast episode. Those are the same answers no matter where you live, anywhere in the world. And you will find something helpful in this podcast episode today. So that's what we have to look forward to today. But before we get into that, I want to tell you that today's podcast episode is brought to you by Amara, a baby food company that does things differently. Amara is what I stock personally in my kitchen for when I need a grab and go quick meal for my 13 month old. Amara's baby food is organic. It looks, smells, and tastes homemade. Plus, one cool thing is that you can rehydrate the powder with water or your own breast milk. I love that option. If you could peek into my pantry right now, you'd see packets of black beans and sweet corn and also oats and berries. Mila loves them both, but her absolute favorite is the mango carrot smoothie milks. I throw them in my diaper bag for an on the go snack. No added sugar, just good clean ingredients. If you and your little one would like some amar in your life, then before you order, let me share a discount code with you. Go to Amaraorganicsfoods.com and use my affiliate discount code, Breezy. 20 for 20% off. That's BRZ y 20 for 20% off. I'll have that link and code in the show notes for you as well. All right, my friend, I have one other thing I want to tell you before we get back to your most Googled milk questions. Milk supply questions. I want to just read you a quick Google review that was left for Breezy Babies and this was left by SB. It's all the information I have. So they said Holly has been absolutely amazing. The first visit I had with her was very educational. She is kind, patient, and professional. She takes time answering any questions or concerns I may have. I have been so grateful for her help and always look forward to my sessions with her. Isn't that so great? If you don't already know, Breezy Babies is a team of three IBCLCs at this time, and I absolutely love having other IBC LCS on my team that can go out and give amazing care, whether in person or telehealth. And it just makes my day every time I get one of these amazing reviews that come back for one of the consultants on my team. So good job, Holly. If you left this Google review and you are listening to this podcast episode, you can just send me an email firstname.lastname@example.org. I will send you one of my digital downloads totally free from my Breezy Babies website. And if you would like one of my digital downloads for free as well, either one of my workshops or my ebook, all you have to do is just leave a review. And leaving a review is so simple to do. It just takes a minute or two of your time, and it means so much to a small business like us. All right, let's get into your top milk supply questions. I know you've been waiting for the answers. Let's break each of these down. This episode is going to be a little bit different than my classic top three tips. Instead, I'm just going to break down every single one of these top questions and give you a little bit more insight. All right? So first of all, let's take the question, how much milk is normal to pump? Now, the answer to this question is going to be a little bit different depending on if you're exclusively pumping, exclusively breastfeeding, or somewhere in between. Because, by the way, remember, it's not all or nothing when it comes to breastfeeding. You can combo feed. You could bottle feed. You could only feed out the breast. You could do any combination in between as well. So depending on where you land on that spectrum will change my answer on how much milk is normal to pump. Another important thing to consider is how old your baby is. You can probably guess that a one day old would take far less milk than a one month old, right? Because a baby's stomach changes and grows so much just in that first month. If you've ever seen me on Instagram or on my YouTube channel showing my belly balls, you'll see the drastic difference between a baby who is one day old and a baby who's one month old. The drastic difference in the size of their stomach is huge. So obviously your supply and how much you would pump and how much you would give to your baby would be very different depending on the age of your baby. Now, after one month, it's pretty consistent all the way through the first year of your baby's life. But still, I just wanted to point out that don't compare your supply to someone with a one month old if you have a one or two day old, okay? So since you would pump out such different amounts depending on the age of your baby, I just want to make it really clear that if you have a one day old and you hooked up a breast pump, you would probably pump out nothing. Especially with an electric breast pump, it would be totally normal for you to pump out absolutely nothing. Now, does that mean that your baby is getting nothing? Most likely, no. In fact, if you were to hand express, you would probably get out more than with your electric pump if your baby is just a day or two old. Okay, that's a little besides the point, but it's definitely something I talk a lot of my clients through. I teach all of my clients, especially when we meet prenatally, to know how to hand express because oftentimes that's much more effective at getting out milk in those beginning days. So let's just say, for example, that we're talking about a one month old only, okay? So let's take a one month old and let's start with how much milk a baby needs in 24 hours. An easy way to remember this is about an ounce to an ounce and a half for every hour of the day. So just as an estimation, that could land us at about 24 to 36oz of milk in 24 hours. Again, this is not a one size fits all. I'm just giving you an example here. So let's say for this example that you exclusively breastfeed, you exclusively nurse, and you only hook up your baby, latch them on. You don't really use a breast pump much, but for one time after you fed your baby, you did use a breast pump and you only pumped out a half ounce, maybe 2oz tops total, from both breasts, I would say. Hey, that is completely normal. Now, let's say that you exclusively pump. You only use your breast pump. You may be skipped over a feed or you just don't nurse at the breast. And let's say that you pumped the same, a half to 2oz total from both breasts. Well, while that might be your personal normal, you would likely need to supplement with formula or donor milk to fill those gaps for a full feeding for your baby. So I would say that that might not be a total amount that your baby would need. So that might be considered a low supply. So you can see this is very personalized. This is no one size fits all. And for that purpose, don't compare your output or your freezer stash to anyone else. A little pro tip here as well is that you want to use breast compressions while you pump to really maximize your output. Okay? If you're just like, man, I'm pumping. I'm not getting a whole lot out. I'd really like some more. One thing you can do is breast compressions. If you don't know how to do that, work one on one with your Ivclc. I believe I have a bubble on my Instagram where you can go and watch me show you how to do breast compressions. So again, there's no one size fits all when it comes to how much you should be pumping out. And the main thing I want you to remember here is the sweetest place to be with your supply is just enough for your baby with a little bit to spare. Seriously, a little bit to spare. If you think it's normal to breastfeed your baby and then pump out 8oz total, I'm here to tell you that that is actually considered more oversupply. And while that might work well for some people, that can lead to clogged ducks and mastitis and feeling so full and so uncomfortable and just honestly having more milk than you would ever even know what to do with. So again, the sweet place to be is just enough for your baby with a little bit to spare. Okay, let's move on to question two. How do I know if my baby is getting enough milk? One thing you can do is watch your baby's hands. When your baby is hungry, notice that her fists are tight. She's saying, Feed me. She's ready to come to the dinner table. After you relax your baby, you're going to hear some swallows. It sounds like a little. And you're going to notice as you hear those swallows, that your baby's hands are going to start to relax and they're going to start to open up. And by the end of the feed, we like to call this the milk drunk look, so baby's fists are tight. They're coming to the breast like, feed me, feed me. I'm here. I'm so hungry. And then as the feed goes on, the fists slowly start to open. They start to relax. They start to lean back a little bit more. Their head rolls back, their eyes close. This is called milk drunk. Okay? So that's one thing to watch for. Watch the fist to know that your baby is getting enough milk. That's one sign. Some other things that you can watch for are your breasts feeling softer or drained after a feed. You could again, listen for swallows during feeds. You also want to watch for enough wet and poopy diapers. You want to watch that your baby is meeting developmental milestones. You want to watch that your baby is following their growth curve. You want to watch also that your baby is having times of being alert and active throughout the day. Now let's kind of break down a couple of those. How many wet and poopy diapers your baby should be having is, again, dependent on how old they are. So work with your IBCLC and your pediatrician to talk about that specifically for your baby. When it comes to developmental milestones, this is things like rolling over and being able to sit up and doing the pincer grab and all these developmental things that we expect your baby to do as they grow up, they're getting more interested in the world around them. Those are signs that your baby is getting enough at the breast. Also following their own growth curve. Again, this looks very different from baby to baby. We don't expect all babies to be in the 75th percentile or even the 40th percentile. Every baby is so different. The important part is that your baby is following his or her own personal growth curve. Okay? So again, work with your Ivclc, your pediatrician, to help you look at these things. We can really help you put together the puzzle pieces and help decide if your baby is truly getting enough at the breast. All right, number three. Question number three things that may lower your milk supply. Now, there's a lot. I actually recently posted this list on my Instagram, and someone left a comment and said, wow, that's a very long list. Is there anything we don't have to avoid? And I responded with, yeah, sometimes it can feel like that. But the truth is, just remember that as I'm reading off this list, this is not an all inclusive list, and it doesn't apply to everyone. I have honestly had some clients that are so far into oversupply that even when they do go through these things that would normally cause someone to have a dip in supply, it hardly even touches anything for them. Okay, and then I also have some clients who are just enoughers. They're kind of scraping by, and just a tiny little bump in the road can totally just cause a huge decrease in their milk supply. And it takes a lot of work to get their supply back to where it was before. Okay, so keep that in mind as I'm reading off this list. It's a little bit long, but stick with me. Okay? So these are some things that can lower your milk supply. Waiting too long to start breastfeeding, nursing or pumping. What I mean is waiting too long after giving birth and sometimes that's uncontrollable. Maybe you had an unexpected hemorrhage after giving birth. Your baby went to the NICU. Sometimes things don't go exactly as planned. But whenever possible, always try and latch your baby within the first couple of hours after birth. And if that's not possible, if you have to be separated from your baby for some reason, then hand expression and or an electric breast pump, or a hand pump, anything to keep the milk moving. Tell your body, hey, we're making milk, we're removing milk is so important. And then later on down the road, you don't want to go long stretches without nursing or pumping. That's the second one. If you're going very long stretches without nursing or pumping, you're trying to stretch out feeds or you're away from your baby and you're not pumping or hand expressing milk while you're away, then guess what? A full breast tells your body to make less milk. That's just how bodies work. Okay, so we have waiting too long to start breastfeeding. We have going long stretches without nursing or pumping. And then we also have not offering the breast frequently, especially in the first weeks. Okay, the first twelve weeks especially, remember that you're putting in your order for your milk supply for the whole time you're going to be breastfeeding. So you just want to offer the breast frequently. Especially in those first days and weeks. You cannot offer the breast too much. Anytime your baby is interested, just offer the breast and that will put in a great order for milk supply. Okay? The next one is supplementing with formula or donor milk when it's not needed. Okay, now I'm not saying that formula or donor milk is never not needed. There are times when it can be so helpful and even life saving. But there also are many times when formula or donor milk are introduced and given when breast milk is there and available for a baby and it's not used. And then since baby is spending more time away from mom with the bottle, then mom's supply continues to go down and then baby has to spend more time with the bottle. And I see this downward spiral all the time when it's not even necessary. I'm telling you guys, I have helped clients with oversupply. They are feeding their baby at the breast. Their baby isn't quite efficient at removing milk yet for whatever reason. Maybe there's restriction in the mouth or there was a traumatic delivery and baby just didn't get a lot of time at the breast, whatever reason. But mom has so much milk, she's even having to pump and catch milk after feeds because she's just so full and so uncomfortable and she already has just so much milk in her fridge and her freezer. And I've literally had their pediatrician tell them, oh, you need to give formula to help your baby to gain weight. Instead of that mom using her own breast milk that she already has on hand. That's a different story for a different day. Anyway, supplementing can be great, but doing it when it's not necessary can be very problematic for a mom's milk supply. Okay, the next one on my list is peppermint or sage, and even some medications, such as birth control. So when I talk with a client, we talk through why they're having a dip in supply. I always want to know recent medications that they've started, and sometimes it is that they've recently gone back on birth control. And that's not true for everyone. It's not a cause of low supply for everyone, but it absolutely can be. Even if your healthcare provider says, oh, this one is breastfeeding friendly and it won't cause a dip in supply, well, guess what? It's not a one size fits all, and I have seen it cause a dip in supply for some of my clients. Peppermint and sage. Now, you would have to have this in a little bit higher doses. Usually it's more of like an essential oil or a tea where you're getting a lot of it at one sitting. That can cause a dip. But again, for some people, they could have peppermint all day. They'd never notice anything. The next one on my list is a poor latch. Your baby is not removing milk, then your breasts are staying full, and that tells your body to make less milk. That's just how bodies work. The next one on my list is high stress and anxiety and no sleep. Isn't it horrible that that's like the perfect storm for a low supply, and yet that's such a commonplace that so many new parents find themselves in after having a baby, especially if it's your first baby. It's like, oh, yeah, stress, check. Anxiety, yes. And no. Sleep, yes. All three. So sometimes it definitely takes a good plan to figure out, okay, how can we take a little bit off of our plate? What is the plan for us to just get one good stretch of sleep at night? Maybe you're taking turns back and forth with your significant other, but that is a perfect storm for low supply. And I even see this a lot with the families that I work with who are returning back to work. Returning back to work can be a very stressful, high anxiety time. And I really noticed that a lot of my moms, they will start pumping out less milk as they get into their work schedule, and they're feeling some of that stress and anxiety from work and from leaving their baby at daycare or whatever it is. So that's something to keep in mind. The next one is your medical and surgical history, such as poor gut health that's a huge one. Or low thyroid or breast surgery. Those are all things that can cause low milk supply. The next on list is giving too many solids or solids too soon. Sickness is a huge one, especially we're still in cold and flu season at the time of this recording. If you get sick, that totally can cause a temporary dip in your supply. Another one that can is starting your period that can as well. A huge one that causes a really big dip in supply that I find the absolute hardest, near to impossible to improve is actually pregnancy. And there's not a whole lot we can do about that. That definitely takes working one on one with an IBCLC and possibly figuring out some other supplementing methods, especially if you have a very young baby because pregnancy can cause a huge dip in supply. Now, if you have an older baby baby, then you may not even find any problem at all. Maybe your baby will just nurse for comfort throughout your pregnancy and then start nursing a little bit more after your baby is born and you can get through a little bit easier. The last one on my list is if you pump a flange that doesn't fit and I find that it's usually a flange that is too big. Okay, so this is an exhaustive list and of course I do recommend working one on one with an Ivclc if you are battling a supply that is just dropping, no matter your best efforts. Okay, last question, tips to increase your milk supply. Number one is breastfeed every time your baby is hungry. Now, I know you've heard this before, but I'm still going to repeat it. Removing more milk sends a signal to your body to make more milk. So take a warm bath with your baby or take the day off to Netflix and chill loads of skin to skin time. Plus, offering the breast is a great way to increase your milk supply. It really is that simple. Now, I do want to start by telling you that this list is especially helpful for those struggling with secondary low milk supply. That just means that your body is needing a signal for more milk. If you're dealing with primary low milk supply, such as insufficient glandular tissue, then your journey is going to look a little bit different. Okay? So this really is going to be helpful if you're dealing with secondary low milk supply. So again, tip number one was breastfeed every time your baby is hungry. Tip number two is check the latch. Things like a tongue tie or a lip tie can make it tricky for your baby to remove milk, which lowers your supply over time. I can't tell you how many times I see babies compensate getting through, and then all of a sudden at the three month mark, I hear from families and they say, oh my gosh, my supply just disappeared. We just don't know what happened. Things were going fine and then I just had no milk at three months. Okay, guess what? That actually is often an undiagnosed tongue and or lip tie. Not saying that's for sure what's going on with you if you're listening to this, but that's a really common thing that I see. Tip number three is get plenty of sleep and eat a healthy diet. I want you to think protein and whole foods like fruits and vegetables. Also drink water with electrolytes to stay hydrated. Tip number four, pump or express your milk power. Pumping, hand expressing even just for a few days, that can be a great way to boost your supply. Also, again, be sure you have the right flange size. You may need to size down. All right, the last one. Tip number five is relax and massage. Because guess what? Oxytocin is needed for let down aka for the milk to come out. Stress blocks oxytocin. So relax, take some deep breaths, and for a bonus, you can even gently massage your breasts. That's a great way to boost the play. One last pro tip for you. If you are pumping, I am going to suggest that you cover your containers with socks so that you aren't stressing over every drop that is falling down. And do you know what? A lot of people who try this, they cover up their containers with socks. They actually end up pumping out way more milk. Try it out. Let me know how it goes. So there you have it. Those are your top milk supply questions. Again today we talked about how much milk is normal to pump, how you know if your baby is getting enough milk, and things that may lower your milk supply. Oh, and last tips to increase your milk supply as well. Thank you so much for listening in today. You know, I'm going to be back next Tuesday for more tips and tricks for you. You, I hope to see you then. And of course, I'm going to leave you with. You are strong, you are smart, you are beautiful, you are a good friend to all. Bye.