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If you are breatfeeding your baby on demand, you are most likely producing enough milk.

However, should you have any concerns that you do not have enough milk look for the signs that indicate that your baby is getting enough  – such as weight gain, alertness, sleep and general mood. (as well as urination and bowl movements in the early days)

These 6 tips might help you can increase your breastmilk supply :

1.  Avoid all kinds of artifical nipples (bottles or soothers).  All sucking should be at the breast.

2. Additional use of a breastpump may help to stimulate supply.

3. Herbs, such as Fenugreek, Goats Rue, Blessed Thistle and Fennel Seed have been known for centuries to help increase breastmilk supply.

4. Skin to skin contact with your baby will help stimulate your prolactin; invest in a soft sling which will allow skin contact between you both.

5. Co-rooming (and night time feeding) has also been shown to help with supply.

6. Diet – make sure you are getting enough rest, drinking enough and following a lactogenic diet.

If  you are concerned for you baby consult your healthcare professional.

3. Urination.

With six soaking wet (not just wet) diapers in a 24 hours hour period, after about 4-5 days of life, you can be reasonably sure that the baby is getting a lot of milk (if he is breastfeeding only). Unfortunately, the new super dry “disposable” diapers often do indeed feel dry even when full of urine, but when soaked with urine they are heavy. It should be obvious that this indication of milk intake does not apply if you are giving the baby extra water (which, in any case, is unnecessary for breastfed babies, and if given by bottle, may interfere with breastfeeding). The baby’s urine should be almost colourless after the first few days, though occasional darker urine is not of concern.
During the first 2-3 days of life, some babies pass pink or red urine. This is not a reason to panic and does not mean the baby is dehydrated. No one knows what it means, or even if it is abnormal. It is undoubtedly associated with the lesser intake of the breastfed baby compared with the bottle fed baby during this time, but the bottle feeding baby is not the standard on which to judge breastfeeding. However, the appearance of this colour urine should result in attention to getting the baby well latched on and making sure the baby is drinking at the breast. During the first few days of life, only if the baby is well latched on can he get his mother’s milk. Giving water by bottle or cup or finger feeding at this point does not fix the problem. It only gets the baby out of hospital with urine that is not red. Fixing the latch, using compression will usually fix the problem (See Protocol to Increase Breastmilk Intake by the Baby). If relatching and breast compression do not result in better intake, there are ways of giving extra fluid without giving a bottle directly (handout #5 Using a Lactation Aid). Limiting the duration or frequency of feedings can also contribute to decreased intake of milk.

2. Baby’s bowel movements.

For the first few days after delivery, the baby passes meconium, a dark green, almost black, substance. Meconium accumulates in the baby’s gut during pregnancy. Meconium is passed during the first few days, and by the 3rd day, the bowel movements start becoming lighter, as more breastmilk is taken. Usually by the fifth day, the bowel movements have taken on the appearance of the normal breastmilk stool. The normal breastmilk stool is pasty to watery, mustard coloured, and usually has little odour. However, bowel movements may vary considerably from this description. They may be green or orange, may contain curds or mucus, or may resemble shaving cream in consistency (from air bubbles). The variations in colour do not mean something is wrong. A baby who is breastfeeding only, and is starting to have bowel movements that are becoming lighter by day 3 of life, is doing well.
Without your becoming obsessive about it, monitoring the frequency and quantity of bowel motions is one of the best ways, next to observing the babies drinking, (see above, and videos at www.thebirthden.com/Newman.html) of knowing if the baby is getting enough milk. After the first 3-4 days, the baby should have increasing bowel movements so that by the end of the first week he should be passing at least 2-3 substantial yellow stools each day. In addition, many infants have a stained diaper with almost each feeding. A baby who is still passing meconium on the fourth or fifth day of life, should be seen at the clinic the same day. A baby who is passing only brown bowel movements is probably not getting enough, but this is not very reliable.

Some breastfed babies, after the first 3-4 weeks of life, may suddenly change their stool pattern from many each day, to one every 3 days or even less. Some babies have gone as long as 15 days or more without a bowel movement. As long as the baby is otherwise well, and the stool is the usual pasty or soft, yellow movement, this is not constipation and is of no concern. No treatment is necessary or desirable, because no treatment is necessary or desirable for something that is normal.
Any baby between 5 and 21 days of age who does not pass at least one substantial bowel movement within a 24 hour period should be seen at the breastfeeding clinic the same day. Generally, small, infrequent bowel movements during this time period mean insufficient intake. There are definitely some exceptions and everything may be fine, but it is better to check.

1. Baby’s nursing is characteristic

A baby who is obtaining good amounts of milk at the breast sucks in a very characteristic way. When a baby is getting milk (he is not getting milk just because he has the breast in his mouth and is making sucking movements), you will see a pause at the point of his chin after he opens to the maximum and before he closes his mouth, so that one suck is (open mouth wide–>pause–>close mouth). If you wish to demonstrate this to yourself, put your index or other finger in your mouth and suck as if you were sucking on a straw. As you draw in, your chin drops and stays down as long as you are drawing in. When you stop drawing in, your chin comes back up. This same pause that is visible at the baby’s chin represents a mouthful of milk when the baby does it at the breast. The longer the pause, the more the baby got. Once you know about the pause you can cut through so much of the nonsense breastfeeding mothers are being told—like feed the baby twenty minutes on each side. A baby who does this type of sucking (with the pauses) for twenty minutes straight might not even take the second side. A baby who nibbles (doesn’t drink) for 20 hours will come off the breast hungry.

Using a breastpump can seem like a bit of a minefield, especially when you are considering going back to work and have several other things on your mind as well. Expressing breastmilk for your baby during the day is a sizeable commitment and will require lots of forward planning and a fair bit of kit. Once organized however, expressing can easily slot into your day and need not be too much of a mission. The tips below are the 6 most important issues to consider:

1. Invest in as good a breastpump as you can afford.
The best and quickest pumps are double pumps with variations of speed and suction (sometimes called 2-phase expression). Also make sure that the pump is fairly quiet if you will be using it in the workplace.

2. Make sure that you have a suitable place to store your milk at work.
Often there will be a fridge at work (make sure that the milk is stored at the back and not in the door), but if not, invest in an ice pack which will keep your milk cool for up to 8 hours.

3. Invest in a hands-free expressing bra.
This will free you up for tasks such as talking on the phone, writing emails, eating your lunch, etc. They also seem to have a positive effect on your milk yield.

4. You will need a suitable carry-bag with a mini-ice pack inside for transporting your milk safely and hygienically.
Make sure you are very organized and chill the ice packs overnight before work so they are ready to go in the morning.

5. Remember that breast pumps are different to your baby and your breasts may take a while to get used to them.
It is better to begin expressing one or two weeks before you go back to work so that you are already familiar with the drill by the time you get to the office.

6. Take regular breaks to express at set times
Remember to eat a healthy and balanced diet and drink plenty of water.

Breastfeeding mothers frequently ask how to know their babies are getting enough breastmilk. The breast is not the bottle, and it is not possible to hold the breast up to the light to see how many ounces or millilitres of milk the baby drank. Our number obsessed society makes it difficult for some mothers to accept not seeing exactly how much milk the baby receives. However, there are ways of knowing that the baby is getting enough. In the long run, weight gain is the best indication whether the baby is getting enough, but rules about weight gain appropriate for bottle fed babies may not be appropriate for breastfed babies.

Ways of Knowing  my baby is getting enough breastmilk?

1. Baby’s nursing is characteristic – See blog post “Is my baby getting enough milk  – Part One”

2. Baby’s bowel movements – See blog post “Is my baby getting enough milk  – Part Two”

3. Urination – See blog post  “Is my baby getting enough milk –  Part Three”

Express As Much Milk As Possible

If you are using a breastpump to remove (express) milk for your baby, it is very important that you have correctly-fitted breastshields. The breastshield is the part of the pump collection kit that fits directly over your nipple and forms a seal around the areola (the darkened part of your breast).  The breastpump works by creating a vacuum, which gently draws your nipple into the tunnel of the breastshield–just like your baby would draw it into the mouth with sucking.  A correctly-fitted breastshield will help make your pumping comfortable, and allow the pump to remove as much of your milk as possible with each milk expression.

Medela Breastshields – 5 Different Sizes

Medela PersonalFit™ breastshields are available in four sizes:  Medium (24 mm), which is the size in Medela’s breastpump kits; Small (21 mm), Large (27 mm), Extra Large (30 mm), and XX Large (36mm).  Medela’s breastpump kits make it easy to use a larger or smaller breastshield, because all sizes are designed to fit into the same connector on the collection kit.  Many women appear to benefit from a size other than the standard 24 mm breastshield.  In one study, many mums were fitted with either a Large or Extra Large breastshield within the first days after birth, and even more mums eventually used these larger sizes in order to pump comfortably and effectively. It is almost impossible to tell which size breastshield is the best fit without watching the nipple movement during pumping.  The following tips will help you determine whether a different size breastshield would be right for you.  Then, you can discuss your observations with your nurse or lactation specialist.

Choosing the Correct Size Breastshield – Signs to Look For

To determine whether you think you might need a Large or Extra Large breastshield, look at your nipple as it is drawn into the tunnel of the shield during pumping.  It should move freely and easily, and should not rub against the sides of the tunnel.  If the breastshield fits tightly, your nipple will rub against the sides of the tunnel with each vacuum movement of the pump.  After several pumpings, you may notice that the outside of the nipple (rather than the nipple tip) is tender or sore.  You may also see a little ring of skin flecks in the tunnel of the breastshield after you pump.  While a little circle of milk in the tunnel is normal, a ring of skin flecks probably indicates that the tunnel is too small, and that you would be more comfortable with a larger breastshield.  When your nipple moves freely in the tunnel of the breastshield, you will also note a gentle pulling movement in the areola each time the pump cycles.  If you do not see any movement in the areola with the pump vacuum, the breastshield is probably too small.

What Happens When You Use the Wrong Size Breastshield?

A tight breastshield can affect breast emptying and lead to problems with milk supply.  During pumping, your milk flows out of the breast due to a combination of the pump’s vacuum and your milk ejection (or let-down) reflex. However, a tightly-fitting breastshield does not allow good breast emptying–even with the best breast pump and a strong milk ejection reflex–because it squeezes the small ducts inside the nipple that carry your milk out of the breast.  Ordinarily, these ducts increase in size when you feel milk ejection so that the milk can flow out of the breasts quickly and easily.  However, if the ducts are squeezed by a tightly-fitting breastshield, some milk stays behind in the breast.  Eventually, this incomplete milk removal can lead to plugged ducts, mastitis, and problems with low milk volume.  You may note breast engorgement that seems to last a long time–or little “knots” or hardened areas in the breast that do not seem to empty with milk expression.

Choose A Medela Personalfit Breastshield

If you have either or both of these symptoms–nipple tenderness around the outside surface of the nipple or problems with breast emptying– your pumping will probably be improved with a larger size breastshield.  You will want to correct this problem as soon as possible after your baby’s birth before the nipple tenderness and back up of milk in the breasts affect your milk supply.  For more information or to purchase Medela’s PersonalFit breastshields, contact your lactation specialist.

By Paula P. Meier, RN, DNSc, FAAN

  • National Breastfeeding Helpline:0844 20 909 20
  • La Leche League: 24 hours, 0845 120 2918
  • National Childbirth Trust: 8am-10pm, 0300 330 0771
  • Breastfeeding Network: 9.30am-9.30pm, 0844 412 4664

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Express Yourself Mums is delighted to launch our new website offering you an easier and clear shopping experience. Breastfeeding and expressing is still very much our speciality, however new product ranges include developmental baby toys, nursing and breastfeeding bras, slings and weaning products. If you need advice on any of our products do contact us and we will be happy to help. Enjoy your visit. We are currently offering Ameda Elite and Medela Lactina and Medela Symphony hospital grade breast pumps for hire and rental.