Most weeks I find myself speaking with mother’s who are struggling to produce enough breast milk for their infants.
Especially if they desperately want to breastfeed, and if these mothers have been told by a professional that their newborn is losing weight! *Shudder*
Can I suggest pausing briefly before acting, and consider that it’s possible that your baby may be losing weight due to a breastfeeding issue versus a breast milk supply issue?
Both scenarios, in my experience, are workable as along as your baby hasn’t lost significant weight already. If your baby is grossly underweight and your carers are deeply concerned, then as a priority do whatever you need to do to help your baby gain weight. If concerns about weight loss are just being flagged, however, then the following information may assist you with building your supply.
Remember that babies are born with an excess of fluids, which is one reason why they lose weight after they are born.
It is normal for a newborn to lose weight in the first few weeks. A fully breastfed baby will then generally gain weight rapidly, often doubling or tripling their birth weight in the first four to five months. After this, their weight gain will slow markedly. By contrast, formula feed babies tend to steadily gain weight.
As I discuss in “Well Adjusted Babies”, breastfeeding is not for all mother- baby- duo’s. This discussion is for mothers looking to pursue breastfeeding as far as they can.
A good place to start is to try and ascertain if your baby is getting enough milk. From here you will obviously need to get a second opinion. While health and maternal nursing can assist, lactation consultants and midwives tend to be a wise and often calming resource for mothers. The Australian Breastfeeding Association outline some of the signs to look for in order to assess if a baby is receiving enough milk:
- Does your baby appear healthy?
- Are they feeding unrestricted and at least six times per day?
- Does your baby have six to eight pale yellow, wet cloth nappies, or five heavily wet, disposable nappies per day?
- Does your baby have soft bowel motions?
- Is your baby’s weight trend positive?
Is it a Breastfeeding Issue or a Breast Milk Supply Issue?
To help determine this it’s important to consider the following:
- Does your baby come on and off the nipple consistently?
- Does your breastfeeding technique feel awkward?
- Does your baby clearly like feeding off one breast as opposed to the other?
- Do you hear a clicking noise when your baby feeds?
- Does your baby fuss and seems to have reflux or colic?
- Do you feel like your baby drains your breast fully?
- Do your breasts regularly feel full and engorged?
If some of the above check points are evident for you or your baby, then it’s possible that your low supply is due more to a breast feeding issue than an inability to produce enough breast milk.
For most mother-baby-duo’s, the amount of breast milk a mother can produce is a direct result of supply and demand. While some anatomical issues can make breastfeeding challenging, our body’s are typically designed and geared to nourish our babies. For example our baby’s suckling stimulates our anterior pituitary gland to release prolactin, which then instructs our mammary glands (breasts) to produce more milk and replace the amount lost from our baby’s drinking. The long standing view held by midwives and lactation consultants is – the more frequently we feed and the longer the feed lasts, the more breast milk our body will produce.
It makes sense, then, that if our baby’s are not draining the breast and creating the demand for more milk to consider if perhaps, there may be an underlying issue.
Here are a few possibilities:
1. Does your feeding technique need some tweaking?
Breastfeeding can be incredibly hard. I can remember with our first son thinking, “My goodness this is crazy! How on earth will we master this?” His arms were flailing around and there were hands everywhere, people coaching me from the sidelines, my boobs were the size of my actual head, and they were full and sore. Some women quickly develop grazed, bleeding nipples, which look and feel as though they have been dragged along a dirt road, known as ‘nipple trauma’. What a nightmare. Fortunately, I had some great midwives who guided me repeatedly over the first few days. This guidance made the world of difference. I learnt how to make sure our baby was attached correctly, or ‘latched’, how to protect my nipples and what a drained breast felt like (think flat, lifeless pancake). Then, almost miraculously, as is often the case, with time, breastfeeding became an unconscious task, requiring little to no thought!
Breastfeeding was even easy with our second son! With our fourth son Quin I had nipple thrush that I attribute to the general anesthetic and antibiotics associated with Abe, our 3rd son, being stillborn. Nipple thrush is agony, and as a result I found myself stuggling to feed Quin. Again, I sought help, requiring technique advice. Finally, feeding Arlo our last son seemed like a welcomed ‘walk in the park’. The salient point here is that both Mum and baby are being taught how to breastfeed. New baby, new lesson. They are all different.
Lactation consultants and most midwives are experts in feeding. Seek out one or moreof these ladies to guide you on your technique until you feel like you’ve nailed it. You may find that one expert reaches you, and another does not. That’s okay too, persist and you and your baby will most likely get there.
2.Could your baby be in pain?
As a practitioner, I know that sometimes newborn babies experience trauma in birth. It’s not intended and it is often the result of necessary intervention – due to babies having to undergo an accelerated birth to help avoid hypoxia (lack of oxygen to the brain) or a fatality. This may result in the baby be bruised from the use of forceps, or have swelling from suction cups. These babies may have difficulty turning or lifting their heads due to strain and pressure placed on the cervical spine, and the cranium or skull. While unfortunate, obviously this type of delivery is better than a more sombre outcome.
Some baby’s experience trauma from birth in other ways for example if they are wedged down deep in the birth canal and become stuck and then have to be pulled back out through the abdomen. These babies may not have physical markings but they, too, may have discomfort through their necks and jaws that may impeded breastfeeding. Other babies may have their heads twisted to one side during delivery that may also create some pain on turning to feed.
Constraint in the womb during pregnancy, where the baby’s ability to move around freely is hindered, maybe another reason your little one finds breastfeeding difficult.
At this point in time, there has not been a lot of research done on the benefits of chiropractic adjustments for newborns. We are a growing profession, and without the financial backing seen with drug companies for medical research, we need to publish more case studies and complete more clinical trials. Additionally like any drug or procedure, chiropractic may not assist all children, particularly if there are other underlying issues.
As a chiropractor who has seen how quickly these babies typically respond to gentle adjustments that work to ease tension around the spine, jaw and skull, however, I would encourage you to find a recommended family wellness chiropractor and have your baby assessed. Find a recommended practitioner who works regularly with babies and families. Ask around, Mum’s are your best resource for finding great practitioners.
3. Do you need to slow down and let your baby feed more often?
Get some rest. Fatigue can affect your body’s capacity to produce milk, and unfortunately will often lead to mastitis. Allocate certain sections of your day to lie down somewhere quiet with your new- born and rest, whilst your baby feeds and suckles. When mothers have created this time, or arranged additional help (with older children, for example) and have focused one-on-one quiet time with their newborn, most have found that their milk supply builds dramatically.
Just as some women have big breasts and others small, it is my opinion that sustaining breast milk may physically tax some women more than others – often more than they realise. If you feel that you produce small amounts of breast milk, it may be worth considering whether you need to slow down your daily haste—at least for this point of your life. Easier said than done, I know, but important nonetheless.
Let your baby suckle and feed frequently through the day to stimulate your supply. Worry about routines later. Do not try to establish a strict three- to-four-hourly routine in the first few months, rather let yourselves get used to feeding and allow your baby to be guided by its instincts. You can establish a routine, together, later.
If you are wanting your baby to gain weight, keep in mind that the fat content of hind milk increases as the interval between feeds decreases. A consistent pattern of 8 – to -12 effective breastfeeds every 24 hours should produce noticeable weight gains.
Remember, there are great benefits for your baby when breastfed for at least six months, so prioritize quiet time for this period.
4. Is your body taxed?
Aside from fatigue, perhaps you need some body work? Don’t be alarmed, I’m not suggesting you go to a workshop and get your dents bashed out, here. Even the most structurally ‘balanced’ body has to adapt to hormonal influences and gravitational changes in pregnancy.
As your pregnancy progresses, the weight of your baby can become a major load to bear and hormonal changes begin to relax the supporting tissues of the spine. To accommodate the increased loading, a pregnant female will usually widen her stance and develop an increased lumbar lordosis (“pride of pregnancy”). Maintaining the integrity of the spine may help alleviate mid back pain (due to an increase in breast size), and perhaps even shortness of breath and heartburn. Chiropractic adjustments, massage and yoga are all positive self-care steps in pregnancy.
Post birth, as a mothers breasts increase in size and we are lugging our newborns around and sitting for hours arched with feeding, it makes sense that we may strain our spine and nervous system with poor postures. Maintaining the integrity of the mid back with chiropractic adjustments post-birth may help facilitate a smoother transition to breastfeeding.
An article in the scientific periodical, the Journal of Clinical Chiropractic Pediatrics 1, presented three documented case studies of chiropractic care helping new mothers who were unable to produce adequate mother`s milk. A reduction in mothers milk, known as “Hypolactation” can be a serious problem that can create health issues for both the mother and child.
The first case was a woman who went to the chiropractor on the referral of her midwife. She had given birth 10 days earlier to her second child, and unlike her first, she was unable to establish a milk supply for her second baby. The patient had no other medical issues other than difficulty in swallowing a glass of water. An examination determined that she had a subluxation, and specific chiropractic care was initiated to correct that issue. After her second visit the patient commented that she found it much easier to swallow. By the third visit she noticed visible changes in her breast size and the production of milk. This improvement resulted in a positive weight gain for the infant who was forced to depend of formula until the mothers milk issues were resolved.
The second patient went to the chiropractor for upper back pain but was also unable to produce sufficient milk to feed her one month old infant. Her examination showed no medical history for her problems, however, the chiropractic portion of her exam showed subluxations. She began a series of specific chiropractic adjustments for subluxation correction. By the forth visit the patient was noticing breast enlargement and the production of milk. She also became pain free from the upper back pain she had been experiencing.
The third case was a women who came into the chiropractor`s office with her six day old daughter. She was sent there on the recommendation of the hospital lactation consultant. As in the previous cases, subluxations were found and care was initiated to correct them. In this case it took only 24 hours for the positive results to show, and for this mother to be able to feed her infant naturally.
Based on their case studies and other studies, these researchers concluded that subluxations and the neurological interference they may play a major role in Hypolactation. The researchers suggest, “Chiropractic evaluation for subluxations would be a key element in the holistic assessment of the failure to establish milk supply in the post partum patient.”
Ensure that you are drinking plenty of water, ideally three liters. Dehydration can certainly affect your supply. For example, I always found flying and traveling in the dry atmosphere of a plane would affect my quantity of milk for a couple of days.
Utilise the various herbs and herbal teas known to boost milk supply. These herbs can be drunk or used in cooking.
- Herbs that can be taken as a tea include Milk Thistle, Vervain, Alfalfa, Aniseed, Nettle and Fennel (use as a vegetable or as tea), Red Clover and Raspberry Leaf.
- There are also specific pre-made breastfeeding teas you can purchase at some health food stores.
- Fenugreek (can be used as a spice in cooking or as a tea)
- Parsley (can be eaten fresh or utilised in cooking)
There may also be Naturopathic herbal liquids that may help build milk supplies.
Not feeling like yourself? Aside from physical challenges that may result in a mother being unable to breastfeed, sometimes there may be unconscious resistance that contributes to a traumatic breastfeeding experience. If breastfeeding seems particularly stressful, you might like to contemplate whether there is a deeper anchor for your anxiety and uneasiness before swapping to a formula.
For some women, breastfeeding can bring to the surface a gamut of unidentified or unresolved issues. Interestingly, a number of midwives have commented that during the first months post-birth, women tend to ‘mother’ as they themselves have been mothered. Life can be particularly chaotic with a newborn, and in times of stress we often revert to deep subconscious patterns of behaviour.
Remember there are some wonderful support options available. Seeing a Kinesiologist may help with any mixed emotions you may have around your capacity to mother. A skilled Kinesiologist can be such an asset to your family over the years. Mothering can offer great healing and learning (for us all) when we allow it. Be gentle with yourself, still your mind and trust that you’ll be divinely guided.
Hopefully this has given you some ideas on how you may be able to boost your milk supply for your baby.
If your infant is older, it is important to establish if there are other factors at play that may be decreasing your supply, and assess if the desire to continue feeding is still strong. Sometimes the novelty has worn off and a Mother will need to weigh up the pro’s and con’s of continued feeding.
Yours in Health,
Dr Jennifer Barham-Floreani
For further information and advice please also see Chapter 16, “Breastfeeding” in Well Adjusted Babies