Understanding milk supply and healthy growth

Evidence suggests that very few women are unable to breastfeed. However, many women believe that they do not have enough milk for their baby.

Contrary to what some may think, if you’re not supplementing your baby’s feeding, low milk supply is actually very unusual. In fact, it’s estimated that just five per cent of women do not produce enough milk for their baby’s needs.

Generally, women will be making enough milk if their baby:

• uses 5+ wet disposable nappies, or at least 6–8 pale, wet cloth/reusable nappies over 24 hours
• has soft poos
• has good skin colour and muscle tone
• is generally content
• is gaining weight and growing in length and head circumference (your midwife or local health nurse will guide you).

Some background

As background to this investigation, there are two important things we need to get our heads around:

1. New mothers will produce enough milk for their baby to grow healthily. However, their ability to do this depends on not introducing other drinks or foods to their baby’s diet.

2. A mother’s milk production is all about demand and supply. The more the baby suckles on the breasts, the more milk a mother will make. It’s therefore very important for mothers to fully establish their milk supply, which can take 6–8 weeks, before introducing dummies or bottles. This will help ensure mothers are feeding often enough to build their milk supply.

Understanding the feedback loop between the amount a baby suckles at the breast and the amount of milk produced is important when you consider one of the key reasons women say they’ve reduced or ceased breastfeeding.

What are the issues?

When researching barriers to breastfeeding, we frequently hear that mothers believe that they ‘don’t make enough milk’ or have a ‘low milk supply’. This belief is often fuelled by misinterpreting the infant growth charts.

For example, some cultures believe that a heavier baby is a healthier baby. Our own research with Chinese immigrant families in Australia shows that family members may push parents to add infant formula to the baby’s diet if they feel the child is not growing quickly enough.

Many people believe that their child’s weight (or length, or both) should be crossing the percentile lines on the growth chart (see our diagram) as proof that their baby is healthy and doing well.

However, the ideal situation is for your baby’s weight and length to stay on about the same line as it has previously been, not heading up or down to the next line on the chart.

In this diagram, we see a baby whose weight was sitting around the 50th percentile until they were about three months old, then began to move upwards. The ideal would be for this baby’s weight to stay close to the 50th percentile line.

What are the facts?

Contrary to what some may think, if you’re not supplementing the baby’s feeding, low milk supply is actually very unusual. In fact, it’s estimated that just five per cent of women do not produce enough milk for their baby’s needs.

As we’ve noted, providing infant formula in response to feeling you’re not producing enough milk is likely to reduce breastmilk supply further because your baby’s time at the breast will have been reduced (another reason why introducing infant formula isn’t recommended).

What can I do?

If you or someone you know is concerned that they’re not producing enough milk, it’s important to seek advice from your nurse or other health professional as soon as possible.

That said, take comfort in knowing that there are many useful resources available to help you. For example, this Enough milk, too much milk, expressing video provides some great practical advice.

Your task

Reflect on the growth chart and consider the following questions before posting your thoughts in the comments.

• Are you concerned that you don’t/won’t produce enough breastmilk for your baby’s healthy growth?
• How important do you think growth charts are in terms of assessing healthy weights for babies?
• Do other people in your life comment on or try to influence your feeding regimen because they are worried about your baby’s growth?

Reference

World Health Organization, undated. Child growth standards: Weight-for-age, Geneva: WHO. Retrieved from http://www.who.int/childgrowth/standards/chts_wfa_girls_p/en/