Coping with low milk supply: A guide for first time moms
Certified Lactation Counselor and La Leche League leader Abbie Yabot gives new moms tips on boosting milk supply and beginning their breastfeeding journey
"I still have my own set of problems," confides certified Lactation counselor and La Leche League leader Abbie Yabot, which is surprising and quite refreshing to hear form someone who has breastfed five kids and has worked with many breastfeeding moms over the years. Who better than to help struggling moms than someone who's gone through the same things?
"Now, I feel I have low milk supply, my youngest is turning two. I’m scared na I won’t be able to stretch until two," she said in an interview with theAsianparent Philippines. "My fourth daughter breastfeed until she was 6. My third breastfed until 4. I’m a breastfeeding counselor, so I have to walk the talk."
The top three concerns of moms struggling with low milk supply
She went on to share the top three concerns of moms who struggle with low milk supply: improper latching, not being able to pump regularly after returning to work, and when their baby gets used to feeding through a bottle. All of these concerns are rooted upon the principle of supply and demand.
Elaborating on her experiences with new moms who've sought her help, she said: "Yung low milk supply na concern, it happens during the first week because breastmilk happens in 3 stages. The first is colostrum, and the second stage transition milk, you don’t really produce a lot. You only produce about 1 teaspoon per feed. This can usually be taken out by your baby. And so when some moms try to squeeze their nipples or they try to pump, nothing comes out they feel that it’s low milk supply when, in fact, if baby can latch well it’s not low milk supply because baby can take it."
Breast milk supply is connected to how well your baby latches
"I’ll get a call, they’ll say they don’t have milk and then I’ll come to them and apparently, they’ll have milk only if the baby latches well. The thing with that is, if you’re not able to catch it that week, of course they’ll supplement and if baby knows they can get milk from somewhere else, of course they won’t exert proper effort anymore on the breast and then it becomes a cycle the breast don’t feel a demand, so they won’t produce a lot until such time that it lessens and lessens and it eventually dries out," she clarifies.
"When a mom returns to work, her advice is to express at least two weeks before returning to work. Why? Because a mom needs a stash and it can’t be a one-day stash, it needs to be days' worth because when baby is away from their mom the first time, they consume a little bit more than usual. Because that’s their way of coping," she shares. "Also, if milk is given through a bottle or cup, they consume it faster."
When the baby gets used to the bottle, the breast becomes a "pacifier"
Humans need about 20 minutes for their brain to signal that their tummies are full.
"So babies, if they consume 2 ounces in like 5 minutes, they’re still hungry! So they need to suckle for 20 minutes to know that they’re full na. Some moms they have a hard time catching up with pumping and they feel na they have low milk supply when, in fact, the one that’s being given to babies sobra na."
Continuing she shared. "The third common problem is, like I said, when a mom returns to work, and the baby is fed through a bottle and not through a cup, they baby gets used to sucking from a bottle. The way they suckle is different from breastfeeding if the baby gets attuned to that, the baby doesn’t suckle anymore from the breast, they just pacify."
"So they’re not able to take the milk out and there’s no stimulation," explains Abbie, "the milk supply becomes less and less and less and baby gets more and more frustrated, baby will prefer the bottle, and eventually mommy will dry out."
Read on for more of our interview with Abbie.
What would you say to moms who believe low milk supply is a myth?
There’s truth to that because there’s less than 1% of women who don’t have milk or have low milk supply, you know, if it’s a medical indication. If the baby is able to latch correctly and efficiently during the first 6 weeks, then there’s no possibility that you’ll have low milk supply. Our bodies work on supply and demand, so the body is like a computer, it’s programmable.
If a mom decides to breastfeed exclusively during the day then give the bottle at night, her body isn’t responding to a demand at night so she doesn’t produce milk. The mom produces a little bit less each feed. So that every time the baby now feeds, kulang na and you have to top up. Every time you top up naman baby gets used to fast flow. There's no effort and so they don’t spend that much time on the breast, until such time they lose interest. They want the bottle all the time. So that’s when you run out.
What are natural remedies to boost milk supply?
Actually milk production begins on the 20th week. So that the reason why milk is not coming out yet is because pregnancy hormones are high (progesterone and estrogen) prolactin, which is the milk producing hormone is suppressed. It means their progesterone went down a bit. So irregardless if a mom gives birth, she’ll have milk for sure.
Some moms improve their diet to boost supply even before they give birth. It’s not really rocket science, fruits and vegetables. Green, leafy veggies specifically. Lessen sweet, high-fat, salty foods. Too much of these contributes to low milk supply. You also want to lessen diuretics, which make you pee a lot, like tea and coffee.
Please us more about the importance of malunggay for breastfeeding moms.
It's potent not only for milk supply but it’s also a rich source of iron, calcium and vitamin C and Vitamin A. My dad, who started taking malunggay 6 years ago, swears it lessened his blood sugar and cholesterol. It’s a good supplement, whether you take it fresh or through capsules.
There are so many Filipino dishes that have malunggay, monggo, pakbet, diningding stuff like that. I have a son who does not eat veggies so what I do is I break the malunggay capsule and sprinkle it everywhere on rice, and even meat dishes.
Water also increases supply. For lactating moms, it’s recommended to drink 2.5-3 liters per day, but they should also be careful not to overhydrate.
That's interesting! How does overhydration work against milk production?
Overhydration will lead to poor milk supply. Why? Because it takes up too much space in the body, no room for nutrients, it also causes you to pee more, like a diuretic, which also lessens milk production.
Dark chocolate also helps! Exercise, as long as done correctly, is good, too.
Is it okay to breastfeed if you're sick?
If you get sick, it also lessens supply, like if you have a fever. It’s okay to breastfeed if you have a fever ha! Actually, it’s recommended because you continue to give antibodies to the child, so she is more protected. Para tuloy-tuloy. You can wear a mask. If you have sore eyes, put mittens on your baby. Breastmilk is absolutely your baby’s first vaccine. For my last two kids, we did minimal vaccinations.
How do you boost the demand?
Since it works on the principle of supply and demand, the best way to boost supply is to boost demand, too. How do you do that? You do that by increasing breastfeeding and latch time. Taking out artificial feeding methods like cup or bottle. Bottle is really the worst. Or if you’re not with baby, you have to regularize your milk expression, either by hand or a pump. Normally, bumababa ang milk supply ng mom because she forgets to express. You want the mom to express as often as the baby feeds when you’re away. Me, as a rule of thumb, baby can feed erratically, I just tell the moms to pump every 2 hours while at work.
You should not let the 4th hour pass without expression otherwise it signals your body to produce less milk. I recommend 2 hours at least, 4 hours max. On the third hour you already start to engorge then magli-leak ka ng konti. I teach moms not to get used to the feeling of engorgement, because it means you’ve already missed a feeding or a pumping. If you don’t mind it, puedeng tumigas yung milk. That’s the beginning of plugged ducts. Like a munggo bean inside, 'pag walang movement.
What is the remedy for unclogging these ducts?
Natural latching. The baby can really draw it out when she latches well. There’s different positions that you can do to take it out. If you do not let baby latch, you can also massage with two or three fingers, in circular motions, never with one, because you’ll plug it eh. Parang you’re trying to soften it in a way. Warm compress or Epsom salt soak also works.
Direct the chin of the baby towards where the lump is.
Changing positions to empty all of the ducts also helps increase milk flow. Where they’re chin is at, that’s where they drain the most.
If not treated, this could result in a infection called mastitis. 'Pag ganun, moms should go to the doctor.
Here in the Philippines we’re so used to going to mga hilot. Pero if it’s mastitis na it’s risky because if mali ang pag-massage, the infection could spread.
If mastitis isn’t addressed, it can develop into abscess, or in tagalog nana and that has to be surgically removed na. So you have to stop breastfeeding temporarily.
What advice would you give a new mom who's so frustrated that she wants to give up on breastfeeding already?
For frustrated moms out there, they have to remember to be happy and content. Because if they feel anything negative, their supply drops. Why? Negative emotions release inhibitors which affect milk supply. Sabi ng matatanda don’t breastfeed angry, kasi mapapasa sa bata, that’s not true. Kaya umiiyak si baby kasi pag-galit, it affects the supply and wala silang makuhang milk.
Their biggest kalaban is postpartum depression, moms can’t do anything about that kasi it’s hormonal. So when that strikes we want a good support system around her, family and friends. If a breastfeeding mom wants to give up, usually social media has a role eh. Kasi they get frustrated kasi everyone is posting these nice stuff.
So if you’re feeling depressed or frustrated, keep the expectations real. Focus on why you’re doing these things, for your baby, think of things that will make you happy first. Only if you take care of yourself, can you take care of your child. Kailangan talaga mommies, they have to feel happy about themselves.
Have a happy list of things that make you happy! Isa-isahin mo yun pag-sad ka. Ako, for example, one item on my happy list is pearl milk tea. Pagka-humingi na ko no'n my husband knows na I’m going through something. It’s your job to take good care of yourself.
Mega malunggay capsules are perfect for breastfeeding mothers. It promotes the growth of the hormone prolactin, which is vital in stimulating lactation. Moringa Oleifera, or Moringa-O, contains more vitamin C than oranges, thrice the amount iron in spinach, and four times the calcium amount in milk. It also contains essential proteins and oils.
To boost your malunggay intake you can also whip up malunggay smoothies using Naturali Virgin Coconut Oil, which is a premium grade virgin coconut oil which contains no trans fats, chemicals or other additives. It is an all-natural, edible oil, made without artificial flavors. It can be used as a cooking oil, moisturizer, or a weight loss supplement that reduces the risk of heart disease.
To know more about Mega-malunggay capsules and Naturali VCO, visit V-Pharma's official website.
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