Hello all, it's been a long time since I've posted to lactnet, but since I
got this from Kathleen, how could I refuse?

Here is information I send to mothers why milk supply may decrease after the
first few months.

1. you have gone on the birth control pill.  If you have, best to stop it.
2. you are pregnant.
3. you have been trying to stretch out the feedings, or "train" the baby to
sleep through the night.  If this is the case, better to feed when the baby
needs to.
4. you are using bottles more than occasionally.  Even when the milk supply
is well established, frequent bottles teach the baby a poor latch, and they
expect rapid flow.  When the flow slows from the breast, they often become
impatient.
5. a combination of above factors.
6. although it must be relatively uncommon, a severe sudden emotional stress
can decrease milk supply.
7. sometimes an illness in the mother, mastitis or any febrile illness seems
to decrease the supply significantly.  This also only happens in a very
small minority of cases of illness.
8. sometimes mothers' milk decreases about 3 months after birth for no
obvious reason.

One more reason requires a little more explanation.  In the first few weeks,
a baby tends to fall asleep at the breast when the flow of milk is slow
(this slowing of the flow occurs more rapidly if the baby's latch is not
good).  He will suck and sleep and suck, without getting large quantities at
this point, but the mother may have letdown reflexes from time to time and
the baby will drink more.  When the mother's supply is abundant, the baby
usually gains very well, though he may spend long periods on the breast.
However, by the time they are 6 or 8 weeks old, younger for some, older for
others, many babies are pulling away at the breast when the flow slows down,
often within a few minutes of starting nursing.  The mother will then likely
put the baby to the other side, but then the baby will do the same thing.
He may seem hungry still, but may refuse the breast and simply suck his
hand.  He won't get those extra letdown reflexes that he would have if he
had stayed on the breast.  So he drinks less, and the supply also decreases
because he drinks less, and the baby then gets slower flow earlier in the
feeding (because there is less milk) and you see what may happen.

However, if you are not pregnant, it could be very useful to use domperidone
to increase your supply.

The above was a paste.

Jack Newman, MD, FRCPC

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