How to maintain a healthy breastmilk supply


Breastmilk is unarguably your baby’s most important food for the first six months of their life. It contains a valuable mix of nutrients and antibodies that no artificial food can match or mimic. The act of breastfeeding is an important part of bonding between you and your baby, from the moment of birth and beyond. 

For some mums, breastfeeding comes easy. But others may encounter certain challenges, including concerns around if they are producing enough breast milk. In this article, we’re going to give you information on the following matters related to breastfeeding: 

  • What is a healthy breastmilk supply?
  • Signs that your baby is getting enough breastmilk
  • Signs that your baby might not be getting enough breastmilk
  • Ways of ensuring a healthy breastmilk supply

What is a Healthy Breastmilk Supply?

The first breast milk you make is called colostrum.1 Colostrum is sticky and thick and can be clear, white, yellow or brown in color. It is produced in very small quantities but packs a powerful punch2 in micronutrients your newborn needs, and antibodies that will help boost their immunity. 

Your  baby usually takes in only  about half to one teaspoon3  of colostrum at each feeding during the first several days of life. The colostrum changes to a more liquid substance within a few days after delivery. This first breastmilk will still contain some of the yellow colostrum for the first two weeks, but after that your breastmilk will look whiter in color. 

How much milk should you produce? 

First, keep in mind that the amount of milk you might express is not a good indication of how much breastmilk you actually produce. In fact, it’s difficult to calculate the exact amount of breastmilk a nursing mum produces, simply because of how milk is made. Human milk is produced on a “supply and demand” model: the more your baby is at your breast, nursing, the more milk you will produce. So, different babies will take in different amounts of milk. 

However, according to research,4 an exclusively breastfed baby will drink an average of 750ml (25oz) each day, between the ages of one to six months. International Board Certified Lactation Consultant Kelly Bonyata5 says that a typical range of breastmilk intake is between 570-900ml (19-30oz) per day. 

She also provides a formula that may give you an indication of how much milk your baby might drink in one feeding: 

  1. Estimate the number of times that baby nurses per day (24 hours).
  2. Then divide 25 oz by the number of nursings.
  3. This gives you a “ballpark” figure for the amount of expressed milk your exclusively breastfed baby will need at one feeding

Even though it’s difficult to know exactly how much milk you produce, there are some signs that indicate that your exclusively breast-fed baby is getting enough milk, according to La Leche League International.6 

  • Frequent nursing by your baby, around eight to 12 times in a 24-hour period. 
  • Your baby seems happy and content after a feed, and latches off your breast on their own. 
  • Weight gain as expected, which is around, “155-240 grams or 5.5-8.5 ounces per week until four months of age.”
  • You can see your baby swallowing your milk as they nurse, with your little one gulping down milk during “letdown” at the beginning of a nursing session. The let-down reflex7 is responsible for that tingling sensation in your breast that occurs just before a rush of milk is released. 
  • Baby’s stools look seedy, and are mustard-yellow in colour by around day five.  
  • Your little one has the right number of wet and dirty diapers per day. 
  • Your baby is active and alert, and is meeting their developmental milestones. 

You could also refer to this guide on approximately how many wet and dirty diapers your baby should be producing: 

  • Day 1 = one wet and one black meconium stool. (more is fine).
  • Day 2 = two wets and one or more black stools.
  • Day 3 = three wets and one or more black or green stools.
  • Day 4 = four wets (no longer dark) and one or more green stools.
  • Day 5 = five wets and one or more green to yellow stools.
  • Day 6 on = six to eight wets a day and one or more yellow stools a day.

Now that you know approximately how much breastmilk is produced on average, how do you know if your baby is not getting enough? 

Signs your baby may not be getting enough breastmilk

If you notice the following signs, it could indicate that your little one might not be getting enough of your breastmilk. You should seek the opinion of a paediatrician or lactation consultant, if so. 

  • Your baby is at your breast for very long, or very little time. According to La Leche League International,8 a baby who isn’t feeding well may fall asleep shortly after latching on, or might suckle for over 40 minutes. 
  • You experience pain when your baby latches on. A poor latch could mean your little one isn’t getting milk efficiently. A lactation consultant can help you fix your baby’s latch, if so. 
  • Brick-dust colored urine (uric acid crystals9), no urine for six hours, or dark colored urine after day three of life.
  • Fewer than four urinations a day after day five of life.
  • Still passing black meconium stool after day five of life. 
  • Noticeably sunken fontanelles10 (soft spot on the top of the head) when your baby is held upright. This could indicate dehydration. 
  • Baby is still below their birth weight by two weeks of age. 

Best Strategies for a Healthy Breastmilk Supply

Frequent breast stimulation 

Both breasts should be "stimulated" at least eight to 12 times a day (in the beginning and when you are trying to increase your breastmilk supply). Whether from the baby sucking or from a pump or both, your breasts MUST have that frequent removal of milk to make more milk (remember – supply and demand). And the best “milk remover” in the world is your baby.  

Enough rest, fluids, and a balanced diet 

Stay well-hydrated through the day with at least eight glasses of water. Try to get adequate rest, too. Eat three balanced meals and two to three snacks of fruit and/or protein, every day.  

Avoid artificial nipples 

All sucking should be at the breast in the beginning, as this will help bring your breastmilk in quicker and prevent any nipple confusion.11 If your baby requires supplementation while you work on increasing your breastmilk supply, you have several options available for you. You might want to look into a supplemental nursing system12 that allows you to feed the baby at the breast while giving formula through a tube taped to your breast. If you would prefer to use a bottle, look up "paced bottle feeding."13  If you are first feeding the baby at the breast and then "topping off with a little formula", be sure to pump after each bottle given so that your body understands that it needs to make more breastmilk. Before you give your baby formula, please check with a paediatrician.  

Avoid the following

Diuretics14 and cold medications that contain pseudoephedrine15 or phenylephrine,16 estrogen containing oral contraceptives17 and excess stress. All these can hinder your breastmilk supply.  

Seek help from a lactation consultant: 

There are multiple reasons for supply issues and a visit to a lactation consultant could help you find and correct any underlying causes. Some common issues18 are poor latch,  tongue tie in your baby, PCOS, retained placenta, thyroid disorders, and insufficient glandular tissue in your breasts.  

Try a breastmilk booster, or galactagogue

A galactagogue19 is a food or herb considered to improve breast milk production. Some popular breastmilk boosters are durian, oatmeal, fatty fish (like salmon), coconut milk, red date tea, and fenugreek.  

Fenugreek, in fact, has been used for centuries as a galactagogue20 and is very popular among Singaporean mummies, too. However, in its raw form, it can be bitter and hard to ingest. This is why UpSpring brings you the benefits of fenugreek, along with a blend of blessed thistle and anise (also galactagogues), in their Milkflow capsules.   

Milkflow Fenugreek + Blessed Thistle Capsules

milkflow blessed thistle

The capsules  contain a proprietary blend of three herbs known to help with milk supply: fenugreek, blessed thistle, and anise. Fenugreek, blessed thistle, and anise are all known galactagogues. The herbs are naturally sourced, are non-GMO and the capsules contain no added fillers.

 Each capsule has 1,800 mg of concentrated fenugreek seed extract, that could help improve your milk production*. Because of this high concentration, you only need to take one to three Milkflow capsules a day, unlike some other brands where you may need to take up to six (or more) capsules daily.

To find out more about these Milkflow capsules and purchase them, click here.

Milkflow Blessed Thistle Capsules 

UpSpring also presents another galactagogue—Blessed Thistle22—in capsule form.  

Each serving contains 1,000mg of concentrated Blessed Thistle extract, and could help promote a healthy breast milk supply. lt also contains a proprietary botanical blend to help digestive health for both mum and baby.  

Both the Milkflow (Fenugreek) and Blessed Thistle supplements could be taken whenever you want to boost your milk supply, whether this is to cope with the demands of your baby’s growth spurt/s, or in preparation for heading back to work. 

For more information on both products, click here.

*Before you try a galactagogue, it’s important to speak to a lactation consultant who could give you some tips on how to improve production.

 

References

1. ​​​Breastfeeding: Health Benefits for Your Baby. HealthXchange Singapore. Retrieved on 6 June, 2021 from Breastfeeding: Health Benefits for Your Baby - HealthXchange

2. ​​​Breastfeeding: Health Benefits for Your Baby. HealthXchange Singapore. Retrieved on 6 June, 2021 from Breastfeeding: Health Benefits for Your Baby - HealthXchange

3. Breastfeeding - the first days. The Better Health Channel. Retrieved on 6 June, 2021 from Breastfeeding - the first days - Better Health Channel

4. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation. American Journal of Clinical Nutrition. Published in December 1988. Retrieved on 6 June, 2021 from Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation - PubMed (nih.gov).

5. How much expressed milk will my baby need? Kelly Bonyata. Updated in January 2018. Retrieved on June 6, 2021 from How much expressed milk will my baby need? • KellyMom.com

6. Is my baby getting enough milk? La Leche League International. Retrieved on 6 June, 2021 from Is my baby getting enough milk? | La Leche League International (llli.org)

7. Let-down reflex (milk ejection reflex). The Australian Breastfeeding Association. Reviewed in August 2020. Retrieved on June 6, 2021 from Let-down reflex (milk ejection reflex) | Australian Breastfeeding Association

8. Is my baby getting enough milk? La Leche League International. Retrieved on 6 June, 2021 from Is my baby getting enough milk? | La Leche League International (llli.org)

9. Appearance of Urate Crystals in a Baby's Diaper. Vincent Iannelli, MD. Updated on December 01, 2020. Retrieved on 6 June, 2021 from Appearance of Urate Crystals in a Baby's Diaper (verywellfamily.com)

10. What Causes Sunken Fontanel? Healthline Parenthood. Medically reviewed in December 2016. Retrieved on 6 June, 2021 from Sunken Fontanelles: Causes, Diagnosis and Treatments (healthline.com)

11. Nipple Confusion. La Leche League International. Retrieved on 6 June, 2021 from Nipple Confusion | La Leche League International (llli.org)

12. What Is a Supplemental Nursing System? WebMD. Retrieved on 6 June, 2021 from What Is a Supplemental Nursing System? (webmd.com)

13. Paced Bottle Feeding. YouTube video by Stacy Kucharczk. Retrieved on 6 June, 2021 from Paced Bottle Feeding - YouTube

14. Safety in Lactation: Diuretics. Sarah Fenner. Published on October 10, 2020. Retrieved on 6 June, 2021 from Safety in Lactation: Diuretics – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice

15. Breast-feeding and OTC Medications. Kelly Masters and Jessica Trompeter. Published July 13, 2007. Retrieved on 6 June, 2021 from Breast-feeding and OTC Medications (uspharmacist.com)

16. Phenylephrine. Drugs and Lactation Database (LactMed). Last reviewed in October 2018. Retrieved on 6 June, 2021 from Phenylephrine - Drugs and Lactation Database (LactMed) - NCBI Bookshelf (nih.gov)

17. Combined Oral Contraceptives for Mothers Who Are Breastfeeding. American Family Physician. Published in October 2005. Retrieved on 6 June, 2021 from Combined Oral Contraceptives for Mothers Who Are Breastfeeding - FPIN's Clinical Inquiries - American Family Physician (aafp.org)

18. Common breastfeeding problems. NHS. Last reviewed on July 17, 2018. Retrieved on June 6, 2021 from Breastfeeding problems - NHS (www.nhs.uk)

19. Galactagogues: 23 Foods That Increase Breast Milk. Healthline ParentHood. Last reviewed on December 14, 2018. Retrieved on 6 June, 2021 from Galactagogue Foods: 23 That Increase Breast Milk, Herbs to Try, and M (healthline.com)

20. Fenugreek Seed for Increasing Milk Supply. Kelly Bonyata. Retrieved on June 6, 2021 from Fenugreek Seed for Increasing Milk Supply • KellyMom.com

21. A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding. The Ochsner Journal. Published Winter 2016. Retrieved on June 6, 2021 from A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding (nih.gov)