Tips to get your breastmilk flowing

Many experts, from the World Health Organization to the La Leche League South Africa, agree that “human milk is the only food that healthy, full-term babies need for about the first six months of life”. After that, you can start introducing solids, but while continuing to breastfeed “up to age two or beyond”, says Jane Maasdorp, Durban representative of the league, which supports women who want to breastfeed. 

Research by the Centers of Disease Control and Prevention shows 60% of mothers don’t feed as long as they intend to, and the reasons include issues with lactation and latching, and worries about their baby’s nutrition and weight.

Your milk is flowing and baby is being well-nourished if: 

• They nurse at least 8-16 times in 24 hours, or every 2-3 hours. “Follow their cues, let them tell you when it’s time to feed,” says Hermanus paediatrician Dr Susan Annandale.
• They wet at least six cloth or five disposable nappies and have at least one bowel movement in 24 hours by week one. “Normal bowel movements may be one stool every 2-3 days,” she says. “Take note of what your baby’s stool pattern is, and if your baby is happy not passing a stool daily.”
• You can hear them swallow or feel it when you lightly touch their throat.
• Your breasts feel softer after you’ve nursed.
• Your baby gains weight. They tend to gain quickly, then slow down. In the first few months they gain about 28g a day, slowing around four months to about 20g a day. As they turn six months, many are gaining about 10g a day or less.

Take note and see your health provider/baby clinic if:

• Your baby feeds less and gains less weight than they should.
• They have a weak suck or battle to latch.
• You are on medication (such as birth control pills), which can affect your milk supply.
• You smoke – this can decrease milk supply, among other ill-effects for you and your baby.
• You are exhausted. 

To get your milk going:

• Nurse your baby often – the more they feed, the more milk you produce, says Annandale.
• Offer both breasts at each feed; let them finish the first, then offer the other side.
• Consciously relax – sit comfortably, breathe deeply and slowly, listen to soothing music.
• Make sure your baby is well-positioned and latched.
• Give baby “skin time”  – UNICEF reports that, “Skin-to-skin contact can take place any time a baby needs comforting and calming, and can boost a mother’s milk supply”. It increases your levels of milk-making hormone oxytocin and primes your baby to nurse – they can smell your milk, feel your skin, and increased demand results in increased supply. “Skin time is totally under-utilised and can make an amazing difference in an unhappy baby,” Annandale says. “It’s also something fathers can do to give mom time to relax and rest, and improves bonding between father and child.”
• Aim to empty your breast with each feed – use a pump or your hand to express milk afterwards, to draw it all out and signal to your body to make more. Expressed breast milk can be frozen for up to six months, Annandale says. “Ziplock bags dated with the period of collection work well.”
• Don’t give your baby bottles and pacifiers until breastfeeding has been established.
• Eat a healthy diet to fuel your milk production – protein-rich foods such as lean meat, eggs, dairy, beans, lentils, and seafood low in mercury, along with a variety of whole grains and plenty of vegetables and fruit. 
• Breastfeeding mothers can consider taking an iron supplement, says Annandale.
• It’s also extremely important to maintain good fluid intake.
• Take good care of yourself – get plenty of sleep and let others help you. “The worst thing for breastfeeding is stress and not allowing yourself time to rest,” says Annandale.

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