Understanding and maintaining milk production
The first few days after your baby’s birth is a period of changes in your life. Remember breastfeeding is a connection between you and your baby and it connects the three B’s namely the brain, the baby and the breast. Breastfeeding starts in the mind, you think or believe that you will produce lots of milk and this will signal your body to produce and it will happen in your breast. The baby latches and sucking will trigger the nerves which will send a message to the brain to secrete Prolactin, the hormone which stimulates milk production. Oxytocin is the other hormone which plays an important role, oxytocin helps the mammary glands to contract and the breast milk is then squeezed into the ducts which flow towards the nipple openings. This process starts when the placenta is expelled and the baby starts to suck on the breast.
An important rule of breastfeeding is that the more milk is removed from the breast, the more milk will be produced and also the more you breastfeed in the beginning the more milk you will have later.
The first feed needs to be as soon as possible after birth, this is referred to as the golden hour. Place the baby skin-to-skin on your body. Skin-to-skin stabilizes the baby’s blood sugar, breathing, heart rate and temperature. The mother’s body temperature can rise or drop according to the baby’s temperature. The baby will go through 9 instinctive stages when the baby is in skin-to-skin and these are very essential for breastfeeding. (An article on the importance of skin-to-skin will follow)
The baby will feel hungry for the first time after birth. To make the transition easier, start with small frequent feeds. The baby's stomach is small with birth and gradually increases over the first few days and this is the reason why you need to feed more often.
The stomach capacity is as follows:
Day 1: 5 - 7ml
Day 3: 22 - 27 ml
Day 7: 46 -60 ml
Day 30: 80 - 150 ml
Milk volume increases as the stomach capacity increases. The milk present in the breast when a baby is born is called colostrum. Colostrum is packed with antibodies and 5 ml of colostrum's nutritional value is equal to 30 ml of mature milk. Mature milk is from 6 days onwards.
These are all important to keep in mind to understand milk production and maintain milk production. Feed frequently and respond to early feeding cues. Small amounts digest quickly. Do not rush a feed and do not watch the clock.
Increase milk production:
Breastfeed on cue, regular sessions, feeding often
Drain breast thoroughly, the more milk out - the more milk in
No long periods without milk removals, if you stretch too long between feeds the breast will get too full and that makes it difficult for milk flow and the baby can not remove adequate milk from the breast.
Massage breasts gently and try doing breast compression
Correct latch if needed to, insure deep latch, try the different latch
Switch the nursing side if the baby gets fussy on the breast you are feeding on; for example, feed on the left side, change to the right side and back to the left side.
Try to express after each feed if needed
Discuss the use of medicine, and herbs with your lactation consultant
Power pumping
Let your baby be examined for a tongue tie because a tie influences the latch and that might influence the removal of milk out the breast which influences the milk production.
See if there is any interference with your supply and eliminate it; for example smoking, top-ups, herbs like sage and mint, starting hormonal contraceptives, using antihistamines, alcohol, overtiredness, eating disorders, thyroid problems, and low iron levels.
Indications of an adequate milk supply:
The baby is relaxed and sucking well
See and feel your baby sucking rhythmically and swallowing audibly
The breast softens as fed continuously and feels softer after feeds
Baby gains weight adequately
6 wet nappies in 24 hours
4 - 6 stool nappies in 24 hours
The baby is drinking regularly
Your baby comes off the breast on their own at the end of feeds
Your baby’s mouth looks moist after feeds
Your baby appears content and satisfied after most feeds
You as a mother may feel sleepy and relaxed after feeds
Contact a lactation consultant if you experience any difficulty with milk production.
The follow-up article will focus on latching the bay and feeding positions.
For more information on breastfeeding preparation classes or a breastfeeding consultation contact Sr Elna 072 124 7455.
REFERENCES:
Breastfeeding and Human Lactation; Jan Riordan and Karen Wambach;
Breastfeeding Made Simple; Nancy Mohrbacher and Kathleen Kendall-Tackett
Born to breastfeed, born to be breastfed; Hettie Grove
Borsvoed jou baba; Marie-Louise Steyn
Hold your baby; Jill Bergman
The womanly art of breastfeeding; Diane Wiessinger, Diana West, Teresa Pitman
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