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A Few Tips to Increase Your Breast Milk Supply

9/25/2024

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First of all, the most important step is to figure out if your breast milk supply really low.  Remember if your baby is gaining weight properly and producing enough wet diapers, your milk supply is probably just fine.  However, if your baby is fussy after feedings or drinks an entire bottle after nursing there may be a problem.  Here are some tips on what you can to do to increase your supply.

1.  Nurse nurse nurse: Your breasts will try to meet the demand of your baby.  Nursing more frequently will help augment your production.  Supplementing with formula especially during a growth spurt will negatively impact your breasts ability to meet the demand of your baby.  That being said, sometimes you still may have to supplement in order to meet your baby’s needs.

2.  When you are done nursing, pump, pump, pump.   If you are going back to work, this is not easy!  It essentially means you are either nursing or pumping every couple of hours.  However, pumping regularly will allow you to produce plenty of milk for storage when you go back to work.  

3.  Hydrate!!  About 2/3 of Americans are chronically dehydrated.  You do not need to overdo it.  Just make sure you are drinking fluids and staying hydrated throughout the day!  If you are properly hydrated, your urine will have a clear, light yellow appearance.  If it’s dark and yellow, then drink more! 
4.  Herbal options
     A.  
Fenugreek: Fenugreek is an herb similar to clover and the herb most commonly recommended to help increase breast milk supply.  Fenugreek is used as an herbal remedy to help with diabetes, painful menstrual cycles, exercise performance, male infertility, breastfeeding and many more indications as well.  Studies have not shown a significant impact on breast milk production.  However, anecdotally many mothers find that fenugreek (whether in capsules, seeds or tincture) can help increase supply.  Side effect include sweat and urine smelling like maple syrup.  Fenugreek is most commonly discontinued for causing loose stools.  The amount of fenugreek transferred to breast milk is unknown.  If your baby develops fussiness or loose stools, you may want to discontinue it and speak with your pediatrician.  Please do not use fenugreek when pregnant as it can be a uterine stimulant.  
     B.  Milk thistle: Milk thistle is a tall flowering plant from the Mediterranean.  It is a common ingredient found in lactation teas and supplements to help increase breast milk supply.  This herb is also commonly used in patients with liver disease or gallbladder issues.  While there are no good studies showing increased breast milk production, it has been linked to breastfeeding historically.  

5.  Oatmeal?  While there are also no good studies that show that oatmeal directly impacts breast milk production, many lactation consultants will encourage moms to eat oatmeal for breakfast.  Its a good source of iron and nutrition, so why not?

6.  Prescription medications
     A.  Reglan: Reglan increases milk supply work by blocking dopamine, which results in an increase in prolactin levels.  This does not work for all women, and unfortunately reglan has lots of side effects.  The most common is severe depression; other side effects include diarrhea, sedation, gastric upset, nausea, seizures and extrapyramidal effects (twitching, etc.).  Even though it may be helpful in increasing production, because of all the side effects, especially in women susceptible to postpartum depression, it is generally prescribed very cautiously by providers.  
     B.  Domperidone: This medication is associated with increased production and fewer side effects than reglan. However, it is available in Canada and not in the US as it has not been approved by the FDA.  The FDA actually issued a statement against its use in 2004 as there was concern about its transfer into breast milk.

7.  Lactation consultants!  There are lactation consultants online (la leche leaugue), or you can meet with one of the lactation consultants at the hospital.  If you call the hospital where you delivered, they should be able to help you make an appointment with one their consultants, even after you have been discharged from the hospital.  Sometimes something as simple as poor latch can contribute to supply issues.  

For those moms who are working hard to breastfeeding and are struggling with their supply, hopefully the tips listed above will help get you over the hump.  If not, remember that breastfeeding isn’t always possible for everyone.  While there certainly are some health benefits for baby, even if it doesn’t work out for you, that doesn’t make you a bad mother.  Many healthy babies have been raised on formula, too  :)  

Dr Pam
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What happens to your hormones after delivery and while you breastfeed

8/10/2020

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Just like hormonal changes that can occur during pregnancy, there are also big changes that go on in a woman after delivery.  These changes generally last at least a few months, and hormone levels can be affected in some women for as long as they choose to breastfeed.  These fluctuations can influence everything from hair loss to libido to irregular bleeding, and for some women, the effects can be quite dramatic.  Here’s a quick overview of what goes up and what comes down:
  1. Prolactin – prolactin is the hormone responsible for milk production, so for moms who elect to breastfeed, this hormone remains persistently elevated.  Prolactin generally leads to feelings of relaxation and calm, but it directly counteracts dopamine, which plays a big role in sexual arousal and gratification.  Thus, you can feel pretty serene while you’re breastfeeding, but you might be so content that you don’t care about having sex.
  2. Oxytocin – during breastfeeding, this hormone increases and causes milk letdown and release.  It’s also associated with bonding both with breastfeeding and sex.  During intercourse, it’s released during orgasm, so it’s not uncommon for milk leakage to happen during sex.  Depending on the amount of leakage that happens, some women can become a bit self-conscious, and in turn, this can decrease desire for intercourse.
  3. Estrogen – estrogen will be low for at least the first several months after delivery, and it may continue to be low throughout breastfeeding.  Low estrogen can cause menopausal-type changes within the vagina, leading to decreased lubrication and elasticity with increased tightness, which, in turn, can cause painful intercourse.  That drop in estrogen after delivery also plays a big role in postpartum hair loss.  While this should resolve in few months to year and typically only involves catching up with the normal loss that doesn’t happen during pregnancy, for some women the sudden large amounts of hair loss can be pretty traumatic.  Be sure to continue prenatal vitamins, use gentle brushing and hair car techniques, and remember that this change should be temporary.
  4. Testosterone – this hormone plays a role in libido/desire, and it is suppressed in the postpartum period and with breastfeeding.
  5. FSH – this hormone is responsible for menstrual cycle regulation, and while levels don’t change much during the postpartum period and breastfeeding, it’s level of activity can.  Change in FSH activity may contribute to anovulation (not releasing an egg).  While change in FSH activity can be helpful in preventing pregnancy for some women (some women can still get pregnant while breastfeeding), it can also be a culprit for some pretty erratic bleeding.  Both menstrual and nonmenstrual bleeding can be very unpredictable for women while breastfeeding, with cycles ranging from completely absent to dysfunctional bleeding nearly every day.  The same irregularity can be present with fertility while breastfeeding as well, with some women who don’t ovulate and can’t get pregnant to those with resumption of normal cycles and fertility to those who become pregnant even before they have their first menstrual cycle after their baby is born.
In short, hormones in the postpartum period and while breastfeeding can vary dramatically from woman to woman and have a variety of effects on their health.  Lack of sleep, a fussy newborn, stress of being a new (or repeat) parent and adjustment to the amount of time needed by your new baby can wreak havoc on everything from mood to uterine bleeding to libido, and the hormonal changes during the postpartum period can add a bit of fuel to this fire.  Sometimes the fix can be as simple as starting a birth control pill to regulate your cycle; other times medical intervention or counseling may be needed for postpartum depression.  While it may feel like your newborn is sucking the life right out of you, these symptoms are common, so be sure to discuss your concerns with your provider, and remember that all of these changes should be temporary, so there is a light at the end of the tunnel 😊

​Dr. Nick
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Breastfeeding: Mind Your Own **** Business!

11/15/2016

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So now that you are pregnant and approaching the end of your pregnancy, you have to decide how you are going to feed your baby: breast milk or formula.  I promise you that everyone you know will have an opinion: friends, grandparents, neighbors, 4th cousins, and even the cashier at the grocery store. 

What are the advantages of breastfeeding for your baby?  For baby, breast milk provides them with mom’s antibodies and protects them from lots of infections that can make them sick.    Breastfeeding also decreases the chances that the baby will develop obesity, diabetes, asthma, and SIDS (Sudden Infant Death Syndrome) later in life. 

What are the advantages of breastfeeding for mom?  Breastfeeding burns more than 500 calories a day and helps you drop that baby weight.  It decreases your future chance of developing breast and ovarian cancer.  It can be a form of birth control for the first six months, but I would still talk to your provider about a back-up option.  The most enticing feature of breastfeeding is probably that it is free!  Formula can cost upwards of $1,000.00 for the first year.

The American Academy of Pediatrics recommends that mothers breastfeed for the first year of life.  However, less than half of moms are breastfeeding at the 6-month mark.  So if breastfeeding is so great, why are so few moms breastfeeding after the first 6 months? 

1.       For lots of moms breastfeeding and pumping are painful.  For some women and babies, latching on comes naturally, and for others it does not. 
2.       The emotional rollercoaster: for some women breastfeeding affects their emotions in a not so pleasant way.
3.       Moms are exhausted: between feeding your baby, pumping and all of life’s other chores, moms are not getting any sleep.
4.      Some women don’t produce enough milk, and watching a baby scream because of hunger is not a pleasant scenario. 
5.       Some babies do not tolerate breast milk or have bad reflux, and this can make breastfeeding difficult. 
6.        I just don't want to breastfeed.  And this is totally acceptable!

So many first- time moms complain to me about how their decision to not breastfeed is met with hostility and cruelty.  They even describe how complete strangers accuse them of being a “bad mother”.  Frankly, it probably isn't anyone else’s business.  The decision to breastfeed or not is a personal one.  You should discuss it with your provider if you feel like you need help.  Just because you breastfeed does not mean that your baby will not get sick, and there are plenty of babies that are exclusively formula fed that do just fine.  The most important thing is to have a happy, healthy and comfortable mom and baby! 

​Pam

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