Hi all, Coach Smith here again.

I'm not surprised that so many moms claim "insufficient milk" when there is
so much misinformation about "how to make milk" around. Many of the current
books (parent books and professional sources alike) have gaping holes in
this topic. Here is a very quick summary of the current research on this
subject (and YES, I can document these statements!). Most of the
breastfeeding books around assume that the baby can suck well, and all mom
has to do is get her breast into the baby's mouth enough times a day, and
presto! - plenty of milk moves from her to the baby. Not quite. Getting the
baby "in the restaurant" is not the same thing as "the baby is actually
eating." I am not referring to those moms who will not get the baby TO the
breast enough - that's another discussion.

What MATTERS for sustaining a milk supply is:
1. Frequent and thorough draining of the breasts (removal of most of the
milk), at least 8 times per 24 hours, for a total of at least 140 minutes
per day - preferably by the baby.
2. Intact breasts (no surgery)
3. No hormonal medications (especially estrogen)
4. No large blood loss following birth

What DOES NOT MATTER for sustaining adequate milk synthesis is:
1. mother's diet (quantity or quality)
2. mother's fluid intake
3. mother's "stress" level, state of relaxation, or amount of sleep.

The second set of things matter to the mother, of course. BUT NOT FOR MAKING
MILK. There are VERY RARE other reasons why breasts don't initiate and
sustain lactation - including insufficient growth of glandular tissue,
hormonal aberrations, and a very few other conditions.

One cannot look at the baby to determine the mother's milk-making capacity,
because a baby's ability to actually GET mom's milk is often compromised by
birth medications, events and practices. If the baby does not remove a lot
of milk from the breast, and no other method of milk removal is used, the
normal involution process quickly gets underway - within days. By two weeks
postbirth, milk synthesis is either sailing along in high gear or mostly
shut down.

Bottom line: USE IT OR LOSE IT. If you're NOT SURE the baby is taking milk
effectively, use something else to collect milk (pump, hand-express) while
the situation is carefully investigated. And meanwhile, be sure to follow
Rule #1: FEED THE BABY.

The "breastfeeding relationship" means nothing if "FEEDING" isn't happening
at breast.

Climbing down now, not even short of breath....

Linda J. Smith, BSE, FACCE, IBCLC
Bright Future Lactation Resource Centre
Dayton, OH USA where the leaves are a blazing mix of red, yellow and orange
this crisp autumn day
http://www.bflrc.com