Helping your breastfed baby to get all the milk he or she need

If you need to increase your milk supply:

• Be sure that baby is latched on well. If you are not sure baby is sucking well, or if you feel any nipple soreness when baby is nursing, ask your midwife, health visitor, breastfeeding counsellor or other breastfeeding specialist to help you. If the soreness is not improved by improving baby’s attachment, then keep asking for more help from that person or a different person until you are comfortable.
• Be sure that baby is actively swallowing. You should be able to hear or see swallowing, rather than just jaw movements. Expect a swallow after every suck once your milk starts to flow during that feed, but it is okay to swallow less often as the breast empties in the course of the feed. If you see few or no swallows, despite following all the ideas on this sheet, then seek help from a breastfeeding specialist.
• Nurse frequently for as long as your baby will nurse. The average baby feeds 8 to 12 times every 24 hours. The more often the breasts are stimulated the more milk they will produce. Follow baby’s feeding cues and do not try to schedule feedings. Crying is considered a late hunger cue so try to spot he/she needs feeding before he/she starts to cry.
• Offer both breasts at each feeding. This will ensure that your baby can get all the milk available and that both breasts are stimulated frequently. Allow your baby to indicate he/she is finished on the first breast and then offer the other breast to see if he/she wants it. Do not try to limit the length of feedings.
• Try breast compression to keep your baby interested in nursing and increase his/her fat consumption. Squeeze the breast firmly with your thumb on one side and fingers on the other to increase milk flow. Keep squeezing until baby is no longer actively sucking, then release. Rotate fingers around the breast and squeeze again. Then switch to the other breast, using both breasts twice at each feeding. Squeeze firmly but be careful not to cause injury to your breast tissue. **
• Try switch nursing to keep baby moving his/her jaw and swallowing. That means switching to the second breast for as long as he/she is actively feeding and then returning to the first again and then the second. This means he/she can nurse at each breast several times during the one feed so that he/she better empties each. The breasts make more milk and milk is higher in fat if the breasts are better emptied.
• All sucking should be at the breast where your baby will be getting food and stimulating your breasts to make milk. So do not put a dummy or a finger in baby’s mouth when he/she would otherwise go on the breast and feed.
• Use skin-to-skin to help to wake a sleepy baby and encourage him/her to nurse more frequently. Strip baby down to just a nappy and put him/her on mum’s bare chest.
• Kangaroo Mother Care (KMC) is an ideal way to combine all the ideas outlined above. Aim to spend as much of each day as possible holding and cuddling your baby with as little clothing as possible between the two of you. Just like the baby kangaroo in his/her mum’s pouch, your baby will have easy access to the smell, taste and feel of your body and milk so he will nurse better. You will be there to respond to your baby’s feeding cues and your body will actually produce more milk. Some baby carriers, slings or wraps are a great ‘hands free’ way to do KMC. ‘Wearing’ babies has become very fashionable!

How to know your baby is getting all the milk he/she needs:

• Your baby may lose up to 7% of his/her birth weight during the first three or four days. Once your milk supply becomes more plentiful on the third or fourth day, expect your baby to begin gaining weight. He/she should regain his birth weight by the time he/she is 10 to 14 days old. After that, most breastfed babies gain an average of six ounces (170 grams) per week or a pound and a half (680 grams) a month for the first four months.
• By the fifth day of your baby’s life if he/she is getting enough milk he/she should have at least five to six really wet nappies per day plus at least three bowel movements at least as big as a 50p piece. His poo should be runny yellow and no longer black/green as when he/she was newly born. When he/she reaches six weeks old he/she may poo much less often and still gain weight well but until then counting poos is a good way to check how much milk is going through.
• Your baby’s behaviour will tell you that he/she is satisfied and full. He/she will come off the breast spontaneously, telling you the feed is over by the ‘drunk’ look on his/her face.

There are other things a breastfeeding specialist can do to help:

• If you have tried all the ideas above and still your baby is not gaining weight as he/she needs then do not give up hope or abandon breastfeeding.
• There are other things that can be tried and there are breastfeeding specialists in your community who can tailor suggestions to suit you and your baby. Who to go to?
• You could ask your Midwife or Health Visitor to put you in touch with the member of her team who specialises in breastfeeding.
• You could attend a local breastfeeding clinic or drop-in. Remember to take your baby’s ‘Red Book’.
• You could call a breastfeeding counsellor, using one of the numbers on the sheet in your hospital discharge pack or in your ‘Red Book’.
• You could consult a private Lactation Consultant. Ask your breastfeeding counsellor, midwife or health visitor for a list or visit: www.lcgb.org/consultants_local.html.

** For VIDEOS showing these strategies:

http://www.breastfeedinginc.ca/content.php?pagename=videos

© Deborah Robertson. Revised Sept 2017. Permission granted to copy and use in accordance with the International Code of Marketing of Breast-milk substitutes on condition that original words are retained and authorship is acknowledged.

Breastfeeding helplines and websites

National Breastfeeding Helpline

Tel: 0300 100 0212

Association of Breastfeeding Mothers

Tel: 0300 330 5453              www.abm.me.uk

Breastfeeding Network

www.breastfeedingnetwork.org.uk

La Leche League

Tel: 0345 120 2918              www.laleche.org.uk

National Childbirth Trust

Tel: 0300 330 0700              www.nct.org.uk

Breastfeeding videos

** Dr Jack Newman Breastfeeding Video

www.youtube.com/watch?v=ObT5MELLqGA

Unicef UK Baby Friendly Initiative

www.unicef.org.uk/babyfriendly/baby-friendly-resources/video/

Contact details for 24 hour midwife advice

Pilgrim Hospital – Maternity Ward              01205 445429

Grantham Maternity Unit                            01476 464334

(available every day 8.00am to 4.00pm only)

Lincoln County – Nettleham Ward 01522 573134