Advice for second time mom who had low supply with LO 1

[Louisep]

I'm writing for my friend. She had supply issues with her first baby (emergency cs), supplemented, and did not end up breastfeeding for long. This time round she wants to exclusively breastfeed for as long as possible but is worried about having supply problems again. I've given her all the advice I know of for when a mom starts bfing and needs to increase supply (water, oatmeal, fenugreek), but is there anything she can do from day 1, or during pregnancy even? Can supply issues always be overcome, or are there sometimes hormonal imbalances in the mother that need addressing?

Thanks for any advice.

[jessica_s]

It's hard to say without knowing more but it sounds like if she can just nurse her baby early and often there wouldn't be any reason she couldn't breastfeed with a full supply. A lot of Dr/Nurses/Hospitals undermine mothers when it comes to those first few days in the hospital. Mom and baby come home supplementing when often it wasn't needed in the first place and then the downward spiral begins. Sort of like the very first intervention in birth, you can come back but you've gotta fight hard for it. 

I would say a support network and learning all that she can about breast-feeding would be her best move. The new Womanly Art of Breastfeeding (the green and orange one) and Breastfeeding Made Simple are good books. She should try to get to a couple of LLL meetings *before* the baby comes as well. 

[lactatinggirl]

Biggest thing with supply issues is remembering that breastfeeding is a supply and demand system. If you're low, breastfeed more. Never, ever try to schedule. Never try to hold off a feeding with a LO that's young. I've had issues with my supply in the past and usually just nursing DD more often helped, but occasionally I resorted to taking More Milk Plus (it's better than fenugreek because it's a combination of herbs and you don't have to take it as often, it is spendy though). It also helps to drink lots of water or at least did in my case.

[Asiago]

As previous poster said, never schedule, never restrict feedings.

If mom is delivering in hospital bring baby to breast as soon as possible after the birth. Baby can be examined while on the mom, bathing can be delayed. Most important is to let mom and baby bond and let baby find her nipple.

Request hospital lactation consultant visit mom and baby. Also bring along phone number of the local Le Leche League leader.

Leave the not so free gift of artificial milk. These formula promos often undermine the confidence of mothers. Basically it's planting the seed "here have some artificial milk in the event you are unable to breastfeed". It is estimated that 80% of mothers with intentions of exclusively breastfeeding are 'gifted' these kits before they leave the hospital.

As posted earlier, resist that 'one bottle of formula' to supplement until milk comes in. Colostrum is all that is needed. I spoke with a hospital lactation consultant the other day and she said often well meaninng doctors will request that 'one bottle of artifical milk' not realizing they are effecting the establishment of a new mother's milk supply.

Best wishes to your friend, she is lucky to have you for support!

[averlee]

The book Bestfeeding was a wonderful resource for me during pregnancy.

I have heard many moms say that establishing breastfeeding is much more difficult after a cesarean birth. I have always urged moms not to feel guilty about this, because we don't fully understand the connections between the birth process and lactation. Maybe a milk switch gets flipped on while the baby is crowning or something. Also the hard recovery from the surgery may contribute to the difficulties.

I also recently have heard about "laid back breastfeeding", which is new ideas about more relaxed positioning and relying more on instinct and less on the breastfeeding "rules". 

I think in addition to feeding on demand- whenever baby wants and for as long as baby wants- a new mom can increase her supply by making sure she's pretty much constantly available to nurse. For me, that meant keeping baby as close as possible, as much as possible. Keeping her actually in my arms seemed best, I'd start to drip just moments before she stirred or woke for a feed. Sleeping with her at night, maybe because I was breathing in her smell all night, seemed to really keep my supply high and also encourage her to nurse more often. I tried really hard to avoid removing her from the breast, even if she was asleep or seemed to have had enough- I think even those last few dream sucks before they fall off can keep your breasts in production mode. Avoiding pacifiers, and letting baby nurse for comfort instead, also seems to keep supplies up. (While formula feeding, you have to be careful not to overfeed, so letting baby have a pacifier might be ok between bottles.)