Breastmilk Production 101: The Law of Supply and Demand

by Wendy Goodman
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As a Lactation Consultant, a large part of my nursing practice deals with mothers’ real or perceived concerns of their milk supply throughout their duration of breastfeeding their baby. Moms often worry if they have enough milk.

Breastmilk production is a very simple concept; it is based on supply and demand. The more the baby breastfeeds, the more milk the mother manufactures. A good sucking baby is the best breast pump in the world! That means that the baby has to know how to suck properly and the new mother has to be able to tell if the baby is sucking properly. Breastfeeding is a skill, and like any skill, it often takes time and patience to learn. This is why moms and babies need help in learning this skill. New moms are not Lactation Consultants, so there should be no shame in having the experts get you off to the right start.

Often the mother’s breastmilk supply is low simply because the baby is not properly latched and is only sucking on the nipple. This will cause cracks, pain and definitely will lead to low milk supply. Correct the mother’s technique, and voila, the milk is flowing!

However, if the baby is not sucking properly, despite mom doing the correct positioning, the mom will need to do other interventions to keep her milk supply up until their baby learns to suck properly. Babies born early are not always ready to breastfeed at birth. In these situations, the mother will need to pump her breasts to keep her breastmilk supply up. Only a hospital grade rented pump is appropriate or a store bought “double -pump”. Single pumps are not sufficient to use in these circumstances as the motors are not strong enough to mimic a good sucking at baby at the breast (refer to my article on “The Mysterious World of Pumps”).

Sometimes moms’ breastmilk supply will go down after a period of having no problems with breastfeeding. Often the mom has become very busy with her own life’s pressures, is running around, and not taking time to allow her baby to nurse. In these situations, mom can easily increase her milk supply by doing skin-to-skin breastfeeds, feeding in a quiet room with her baby and not rushing the baby while breastfeeding. I wouldn’t want to eat with you, if you were on your blackberry the whole time!

And finally, there is medication that will increase breastmilk production. This should only be used when the mother’s breastfeeding technique has been assessed, and/or breastpumping is still not producing sufficient supply. The medication is called Domperidone and must be prescribed by a physician. It is very helpful in increasing breastmilk supply (must be done in conjunction with breast pumping) and has relatively few side effects. As well, herbs, such as Fenugreek and Blessed Thistle – used together, may help increase milk supply. While the breastfeeding literatures states that there is no proof that these herbs work, anecdotally many moms find they do work, so it is worth noting.

Again, I re-iterate, probably the best thing you can do when you are having difficulties with breastfeeding, is get help fast from Lactation Consultants!

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