Re: low milk supply


Genevieve writes that she has recently had several mothers that have not 
been able to build milk supplies past 250 ml.

I take it these moms are not breastfeeding? IE the total milk obtained 
is from pumping?

In Canada, most women have a years maternity leave so I see very few who 
are exclusively pumping.  Most are breastfeeding and pumping because of 
low supply due to poor start including tongue tie (they too delivered @ 
a BF hospital), poor latch (long stretchy nipples or lower lip tucked 
in) or baby inefficient at the breast because of difficult deliveries 
but usually because of poor positioning and the use of bottles and or 
pacifiers.

But in the last 3 or 4 years I too have seen moms whose supply seems 
stuck with the amount they can pump despite the good info and help 
available.  I have never done any advertising, (and cannot bill the 
health care system) so babies are often 7 - 10 weeks old, after the 
mother has exhausted all her free avenues, that she finds me.

What has changed over the last 3 or 4 years? I have found mothers are 
often using hands free pumping and are busy working on their electronic 
devices instead of thinking about their babies and visualizing they are 
Mother Venus.  Many of them too, stop pumping as soon as the milk stops 
flowing instead of continuing to pump an extra 5 - 10 min to send the 
message to increase the supply. Many do not realize they need to do a 
pump in the middle of the night. I also ask about what is going on in 
her life and her diet (usually have her add a protein snack each time 
she pumps).

Mothers always ask how long it will take to make sufficient milk for 
their babies. They would like me to wave a magic wand but I have found 
it usually takes about the same amount of time to fix the problem as it 
took to make the problem but I don't tell them that (7 -10 weeks is too 
much to hear for even a very motivated mother).  Instead I ask them to 
keep records and check in with me most days (free f/u phones calls is 
the volunteer part of my work).  We total up the daily pump amounts and 
within 3 - 4 days she can start to see small increases in output. As the 
milk increases to 35 or 40 ml per pump I tell her she is not a mother 
who can't make sufficient milk.

Making milk is such a confidence game. When she feels discouraged, we 
look back a week or so, at her numbers, and she can see dramatic 
increases. It takes such a long time to meet her goal to have enough 
milk because her supply was likely very low when I first saw her and her 
baby needs a little more each day but as she makes more, her baby needs 
more. I tell her the "gate post" keeps getting moved but she is getting 
closer to it all the time. She becomes much more patient when she 
understands what is happening. It is exciting for us both when supply 
meets demand.

After almost 30 years of private practice (approx 300 clients a month) I 
have also found that if for 4 days she pumps (properly as I suggest) for 
7x per 24 hours and can make more than 30 ml per pumping she will likely 
be able to build her supply.   (I tell her "likely" but in my experience 
it is "will").

Renee, in Vancouver, Canada







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