When There’s Not Enough Milk

Sometimes, despite doing all the right things, there’s just not enough milk to totally sustain a baby with exclusive, mama-only, straight from the tap, breastfeeding.  Whatever the reason – genetic, environmental, iatrogenic, mother-baby separation, illness, etc., all that can be done has been done and there’s still not enough. What to do?

  1. Realize that breastfeeding is more about the relationship than it is about the volume of milk. Once a baby has made the connection between mom and comfort at the breast, the volume of milk obtained is not as important as the emotional connection that occurs. This is an important concept to grasp. Many babies nurse 3 or even more years. Older babies get a full diet of family-friendly foods, still need and want that connection with mom. But it’s not about the volume of milk, it’s about getting mom’s undivided attention and the feeling of security at the breast.
  2. For a baby to make that connection between breastfeeding and safety in the arms of mama, breastfeeding needs to continue even when full breastfeeding does not provide all the baby’s nutritional needs. Giving up breastfeeding for breast pumping may seem like a solution to address issues of low supply when a baby is an inefficient feeder for some reason, but exclusive pumping does not allow for that connection and interaction to continue. Think hard before you give up direct breastfeeding.
  3. If supplementation is required, and donor milk is available, use that to support baby’s nutritional needs as long as possible. If baby is able to breastfeed well enough, use a lactation aid at breast as much as possible for supplementation. If supplementation must be done away from the breast, use bottles in a manner that supports baby-led feeding.  See http://hopebreastfeedingsupport.com/pacifiers-bottles-and-pumps-oh-my/ for more information on selecting pumps and bottles that may interfere less with continuing the at-breast feeding bond.
  4. Recognize that babies use suckling time at the breast to help with digestion, to comfort and settle. Large volumes of milk are not needed, or even desired for this activity. Breastfeed your baby after supplementing to allow for this benefit. Breastfeed whenever possible instead of giving a pacifier. Some people call this “comfort-feeding.” In the early days, combine comfort-feeding with skin-to-skin care to build the connection between you and baby.
  5. Accept the fact that breastfeeding length and milk volumes do not have to correlate. Adoptive mothers may not have a full supply of milk, but they can still breastfeed. Mothers of toddlers aren’t exclusive breastfeeders, but they can still breastfeed. Mothers with insufficient glandular tissue may not be able to provide 100% of their babies nutritional needs, but they can still breastfeed.

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