EPISODE 14

Low Milk Supply: How to know if you’re making enough milk, and what to do about it.

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Episode Transcript

August 14, 2020

I feel like I may have low milk supply...what can I do about it?!

Today, we’re going to talk about boosting your supply. But Heather, before we do that, I just wanted to ask you, like, what new fun thing did your baby do this week? Oh, she’s starting to talk. She’s in that language leap right now. And she’s, she actually said her first plural yesterday, which was really exciting.

And she also drank pool water out of the neighbor boys’ shoes. So a big developmental milestone. Before we get too excited about her being advanced, she also gurgled pool water out of the neighbor boys’ shoe. Yeah. So she’s, she’s exactly like me in case you were wondering. Perfect. What about you? What’s Griffin been up to? Oh man, my son is a lot.

He’s wonderful though. A little while ago he and my husband came home from the CSA we’re a part of, a community shared agriculture, where we get food from a farm. I wondered what that stood for. But yeah, you’re welcome. There you go. It’s cool. Maybe I’ll have a pod snack about it, how it relates to breastfeeding.

We’ll figure it out. Anyway, so yeah, they came home with like all this fresh produce and I guess my husband had told my son on the car ride that I only like cooked tomatoes, which is like pretty true. And so my son came home and he’s like, mom, I brought you tomatoes, he’s four, just in case you forgot.

And he’s like, and I’m going to cook them for you. And I was like, Griffin, it’s like 9:30 at night. It’s bedtime. And he was like, no, mommy, like, it’s really important. You get tomatoes. They’re so healthy. Can I please cook you something? And I was so, you know, it’s one of those moments as a parent. He’s got ya, in the lesson.

Right. And you’re just like, yes, I could just shut this down and send you to bed. But also like, what the fuck is bedtime? Why do I give a shit when my kid goes to bed, sometimes? It’s not like he’s going to school, whose kid is going to school anymore? And, you know, we homeschool anyway. So whatever. And I was just like, okay, what are you going to cook me?

He’s like tomato soup. I was like, okay. So how are we going to do that? And he was like, well, mommy, you have to boil water for me cause I’m not allowed to use the stove alone and I’m going to cut up vegetables. I was like, okay. So I put on a little pot of water. He was like, which pot, how much, whatever. And then I was like, all right, Bub, what vegetable?

So he gets out two large tomatoes, handful of loose peas, you know a single zucchini and a single carrot. Oh, And no, it was great. He chopped them all up. Really? Really? Yep. He’s very good with a knife. Well, I don’t know if I should be bragging about that. Very good with the knife. With knives actually is flaming Jinsu knives trick.

He’s also really good at lighting matches. And he just does that one, like snap, where he just sends it down the bar, right? Yeah, exactly. But you’re really teaching them well, Yeah, this is our homeschooling priority. But anyway, he listened and he chopped up everything. I mean, not uniformly, but like it was chopped.

And I was like, Hey buddy, it’s probably a good idea to put the red and orange stuff in first. It takes longer to cook and he was like, okay, mom. So he put the tomatoes and carrots in to boil for 20 minutes. And then he put the zucchini and peas in for like three minutes and then he puts some basil in and salt and it was actually fucking delicious.

Really? It was like, it was like despacho. I mean, I had it cold the next day for lunch. Oh, it was great. And I was like, wow! Was the liquid good? Yeah. It was just like, I mean, it wasn’t very much liquid, so it was like a thick stewy thing. Yeah. Okay. And I was like, all right, dude.

Cool. You just, and he’s like, it’s for you, mommy. You should take it to, to work for, for lunch tomorrow. I will. And I did. And it was good. I can totally see him being a little chef someday. Yeah. Anyway, trust your kids sometimes, also don’t let them kill themselves. Yeah. Yeah. I’m not going to be giving my daughter a knife anytime soon, but you know, when she moves forward from the from the shoe debacle. Anyway. You’re such a good mom.

Take chances. Your kid might end up in the ER or they might be in a fucking knife fighter. My son was like, Mimi got me or Pippi got me a switchblade, but I’m not allowed to have it until I’m 12. Daddy keeps it in the safe. And I was like, okay. Yeah, that’s a really odd gift to give, but sure.

Boosting your supply guys. We’re going to answer the question that all of you have had burning in your loins since the minute your baby got on your breast. Do I have enough milk? And how do I make more if I feel like I don’t? Right. So I want to start this one out, just talking about either why so many people actually have low milk supply or why they think they do. Just let me preach for a minute, Heather.

Great. I’m just going to come out and say it. Most birthing environments are not supportive of breastfeeding even at a baby-friendly hospital. Yep. It’s a challenging environment to begin a breastfeeding relationship in. The hospital beds alone are not great at all for breastfeeding in and the constant wakings during your postpartum period and disturbing the baby’s sleep patterns that are natural.

And yeah. Yeah, the binkies, the binkies for the circumcisions and just, there’s so many things that you’re working around other people’s schedules. Yeah. And so you get this rough start and then you come home and basically the whole world and probably yourself, you have unrealistic expectations for new mothers.

You know, a lot of people are just expected to return to normal, to have visitors, to be, you know, seen out in public with their newborn. Like what the fuck. And, you know, a lot of mothers are expected to return to work before six weeks. Yep. And we are just not given the opportunity as lactating parents to establish a healthy, breastfeeding relationship and a functional lactating relationship.

Right. And also, let me just do a shout out to those parents who maybe they have a full six weeks of maternity leave, but they feel like they can’t use it for fear of being left behind in their career or having a male counterpart be chosen over them for a position and just proving to the company that you, that being a mother is not going to hinder your work.

So I feel like a lot of people tend to tend to sell himself short there. And it’s not false. I mean, really, I think we do it for good reason. So, but just shout out to you all who are in those hostile work environments, where you feel like you literally have to sacrifice what you need to do for you and your baby’s health to prove a point. It’s so hard.

So the reality is a lot of people who end up with a low milk supply, this is not your fault and it’s also not a failing of your body. It’s a failing of our society. That it didn’t support you. Yep, exactly. Some people do have some anatomical or physiological issue that prevents them from making enough milk. And those exists, but frankly they’re pretty rare.

And then a lot of people just aren’t given the tools to cultivate confidence about their milk supply. That’s my spiel. So also in the beginning, whenever you are trying to establish your milk supply, if for whatever reason you do need to pump in the first six weeks, we do recommend using a double electric pump.

So if you truly are away from your baby and you have to pump, get a good pump that’s actually going to remove the milk. Don’t be using a hand pump. Don’t use a single, a single breast pump. Use a double. And use a good one. Yeah. Okay. That’s a side note. So what the heck does low supply mean anyway? Low supply means your baby is actually showing effects of it, right?

So that would mean like lethargy, decreased diaper counts. That would be weight loss, right. Not achieving, not doubling their birth weight by six months, you know? Yeah. That failure to thrive. Yeah. Pretty serious. Yeah. Pretty serious stuff going on. Basically your baby’s not growing as we’d expect them to and they’re showing signs of poor health.

And they’re showing other weird signs, like they’re losing weight, but they’re eating all the time. Right? So that can mean like they’re burning more calories than they’re taking in, and that could be like, they have an undiagnosed heart condition that’s causing them to work harder.

That doesn’t necessarily mean you have low supply, but that’s what makes people think they have a low supply. A low milk supply is very over diagnosed by doctors and pediatricians because sometimes, sometimes it is hard to really problem solve and figure out what’s going on with this baby and formula and supplementation can be an easy fix to a lot of problems.

It is an easy fix for that particular problem of weight loss, right? And we also see that these physicians use growth charts to determine whether or not babies are growing normally, but we have some problems with that, actually. Growth charts can come from different sources. The two main ones we see are the WHO growth charts and the CDC growth charts.

And they’re actually based on different infant populations who actually consumed different kinds of food. So the WHO growth charts consider more normal breastfed baby growth lines. And then the CDC ones are actually based on formula fed babies. Formula fed and breastfed together. So then we also see that we have different kinds of growth charts.

There’s weight ones, height ones, you know, baby’s head circumference. And they’re just all these different growth charts. And a lot of physicians aren’t really taught how to use them super well. They’re just like, here’s the chart for babies off it, then they need supplementation. And what we see actually is the most effective chart for determining if a baby has a real growth issue is using the one that is height for weight.

So it has both height and weight on there. And that helps us consider more of the whole child. Right. That makes sense. And sometimes we have babies that are born, say really big. And they have really small parents and they actually go through this kind of period of leveling out on the growth chart and then finding the curve that’s actually more appropriate to the rest of their life.

And that’s much more apparent on the height for weight chart. Right, because if you have an exclusively breastfed baby and you put them up against the CDC chart that takes into account formula and breast milk, it will look like the breastfed babies are falling off the growth chart and they don’t come back until about four months when they start to even out.

And we have another problem with these actually, is that the way that these charts are created is not specific for certain populations? It’s countrywide or nationwide or worldwide, you know, physicians are not taught how to analyze data within their population and then how to place babies within that specific data set. Like that is statistician.

Like, you know, that’s people who do this for a living, just look at data and figure it out. And that shouldn’t be a physician’s job, but it should be explained to them. You know, if you have a specific population where everybody’s under the 50 percentile, that’s going to be, you’re going to look at your babies really differently than if your population has almost all of their babies between the 40 and the 80th percentile, you know, and that kind of stuff happens.

And there are probably, you know, there are lots of reasons for that, but that has to be acknowledged by physicians who work in those areas. And failure to thrive is never a diagnosis that happens by itself. It’s usually a diagnosis that happens with something else. That, so if anyone is just trying to use weight alone, I would question that.

Yeah, that’s it. I would question that. Yeah. And I think that leads right into the next thing I was thinking about where sometimes it’s a failing of our physicians to ask the right questions or to recognize the individual patient in front of them. And, you know, again, that’s a failing of the larger system they work in.

I might go on about that sometime. Sometimes, and ability. And then sometimes it’s a failing to see the mother and baby as a dyad or the parent and baby as a dyad, especially if we’re talking about pediatricians and that’s not their fault. They’re trained to look specifically at the baby. So again, here’s my pitch for family practice.

The lactating parent and the baby can’t be separated at that age. They have to be considered as essentially two inseparable humans. One functioning system. I always like to say that breastfeeding is like a conversation. It’s the only true conversation that your body can have with your baby’s body.

And when you look at the pair as a true breastfeeding dyad, you’re basically monitoring that ongoing conversation. And, you know, if you just think about talking to like Maureen and I talking right now and you guys are monitoring our conversation. You can see that some weeks we’re having good weeks, I bet.

I bet that like, it might be minor, but I bet that you can pick out subtleties where you’re like, Hmm, I wonder what’s going on there. And you know, I think it’s the same exact way when I’m monitoring a breastfeeding dyad. I’ll notice something subtle that’s happening or they’ll mention, oh yeah, they’ve been gassier lately and I’m like, okay, well, what are you eating mom?

And what’s going on with you too? And is it okay? Yes, it’s okay. Yeah, but it’s just a constant fluid process. Yeah. And when we fail to monitor in that way, you know what happens? Isolated poor decisions. Thank you! That have a trickle-down effect. Thank you. Like parents being told to just supplement X amount after every feed without a reason why, or without an expiration date on that.

That’s the thing. A lot of times it’ll just be like, oh, here you just, you know, supplement an extra three ounces a day and then they don’t tell them when they’re allowed to stop. Right. And then we get into a cycle. That top off cycle. Where now your supply decreases because you’ve fed your baby three extra ounces that day.

Right. Right. It’s like, okay, your baby eats from the breast. Maybe they’re a little fussy. Maybe they’re really hungry. Top them off with an ounce, then they wait a little longer to feed and then they feed a little less at the breast. And then they’re fussy again, you give them a little more milk. Formula or something, and you just get into the cycle where they slowly transition away from drinking breast milk.

Huh. And it sucks and it can happen pretty quickly. So I think it’s very irresponsible of any healthcare provider to recommend supplementation without staying in contact with that parent. Especially if they want to breastfeed. Right. I can’t tell you how many calls I get from parents that are currently supplementing, which is not, I’m not against supplementing.

Some people have to do it, but what is the goal? You know, these people have a goal of exclusively breastfeeding. And if you don’t monitor that and constantly shift, because what works for one dyad might not work for another dyad. You have to constantly reevaluate what’s going on so you can make sure you can get them to that goal and get rid of the supplement.

Dude, this is like the number one piece of counseling advice that I have. I teach doulas with the earth doula program. The thing that I say over and over when we’re talking about breastfeeding is you have to understand what the parent’s goal is first, because maybe their goal is that they just want to do any amount of breastfeeding at all.

And it doesn’t matter to them how much they supplement. Maybe their goal is not that they want to get away from that nipple shield. It’s just that they actually don’t like using bottles or like, you know it who the fuck knows what it is, but you certainly can’t know without asking. Right. Definitely ask for sure.

Right? Because you don’t need to lead somebody to an exclusive breastfeeding relationship if that’s not what they want. Don’t overcomplicate their already complicated life. There’s that physician part of it. I think there’s like kind of two more parts of this low supply equation that I think of that really have to do with this head game.

Right. Somehow I don’t know where or why maybe, you know, Heather, somehow, everybody got this expectation that they should be able to fully feed their baby and pump more. Yeah, I am not actually sure. I think that that is maybe twofold. So I think one part of it is our deep seated biological fear that our babies are going to starve.

And that comes when your baby pops out of you and your body realizes I have to keep this thing alive with my body, you know? So like you could be all fine from the neck up, but somewhere deep inside of you, you have this biological fear that if you let up for even one second, your baby could die and that’s obviously exactly what your biology is built to avoid.

So there’s that low lying energy of like, don’t fuck up. Don’t fuck up. Don’t fuck up. And then on top of that, we are bombarded with freezer, stash pictures of milk all over Facebook and you know, blogs about how you can get a hundred ounces in the freezer by the time you go back to work at six weeks and. Yeah. And so that’s part of the reason why we really, for a long time in our Facebook group, didn’t allow pictures of pumped milk, because it’s just so hard to police that and make sure we’re sending the right message to people about how much they actually need.

Right. And let’s be clear. It is normal to not be able to pump anything else after feeding your baby. Making exactly enough for your baby and no more is exactly right. Right. And although let’s also say, this is the perfect time to say this, your breasts are never truly empty. No. You’re always in milk making mode, but what your pump is able to remove is not necessarily what the baby can remove. Your pump is a machine. It’s not a dynamic organism, right? It’s gears, it’s plastic, it’s metal. It’s not going to be able to remove exactly what you have available, but your baby, that’s why your baby might nurse for two hours, just for comfort.

They just nurse that breast that’s just making a few drops at a time and that’s fine. Dude. Wouldn’t like, if you laid on the couch, and somebody dropped a single drop of real maple syrup into your mouth every five minutes, you would just fucking lay there all day wouldn’t you? Yeah. And you better believe that that syrup maker wouldn’t be like a hope this is enough. I’d be like, girl, you’re fine. I ‘ll take what I can get, like happy to be here. Some babies just do that. That’s fine. So, this all leads into my big leading question. Before we even go into, how do we address low supply? Is the problem low supply or is it low confidence?

So pause the episode here, y’all.

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Before you’re like, yes, I need to know how to fix my low supply. Stop and meditate on that question for a minute. And you know, just enough is enough for your babies. Enough is enough. The average person only has 10 extra ounces of milk in the freezer at any given time. You only need to pump enough to replace what your baby is missing when you’re gone.

And you’re pumping during that time. So it’s not your, you should not run out. There’s like this fear, and this is what bothers me about the freezer stash pictures. It’s like anybody that’s using this biological fear that we have, it’s called fear-mongering. To make a profit, to get more blog posts, likes, to get more shares on Instagram.

And that is just playing on people’s biological fear. And I hate that so much. Okay. You’ve had your meditation time. You’ve considered whether or not you really have low supply or low confidence. And if, if you came to the conclusion that it’s low confidence, let me tell you you’re amazing. Your baby is healthy.

Every single person who has had a baby that they have fed with their own body has wondered at some point in time, if it’s enough. We love you. We do love you. And we’re proud of you and your baby loves you. I mean, we also, those all apply if you actually have low supply too, but anyway, okay. So if you’ve listened to all that and you’ve come to the conclusion that yes, you really do not make enough milk for your baby, let’s talk about how to change that.

Yeah. Well, let’s talk about where they’re at. So say they’re in the first six weeks. So the first six weeks after birth is when your milk is being regulated. That’s when that conversation of breastfeeding is just beginning, right? Through conversation, just like when you make a new friend, you get to know each other, you get to see boundaries, you get to see what’s needed, what’s not needed. And that’s exactly what’s happening in that first six weeks.

I’m just going to put it out there. If you feel like you never entered that conversation fully, your milk hasn’t come in well, before we even started about increasing supply, you need to look at your own body. Because in those first six weeks, you know, maybe you’re bleeding a little bit more than you thought you would, and you’re just not making a lot of milk.

Basically barely any, you should talk to your doctor. You can have a fucking piece of placenta in that uterus. Also if you’re exhausted, but more so than the new parent exhausted, where like you’re trying to balance your checkbook and you forget how to do addition, like that kind of mental fog brain fog, brain fog of that level.

That could be a thyroid problem. And a lot of people’s thyroids do take a hit after they have a baby. So that’s something to get checked out as well. And it’s a very easy test, so do it. And, and if you just feel really tired again, and it’s maybe more than normal. And you’re not making enough milk and maybe you had a hemorrhage during birth, anemia is going to affect milk production too.

Right. So I, I think that everyone needs to be taking their prenatal for at least the first six weeks postpartum, but you might have to add some iron into it. Yeah. And I like food-based iron supplements. Ones that are literally just iron are going to constipate the fuck out of you and you don’t actually absorb that much.

Right. Also, if you have iron in your multivitamin and it also has calcium, you’re not getting that iron. Yeah. Cause the calcium blocks it. Yeah. It’s anyway, another rant for another day, Heather, but if you can’t find an iron that’s like a food product iron and you only have the pills, make sure you’re taking it with vitamin C to increase absorption and take some fucking Colace with it.

So you don’t rip your butt hole open with your constipated shits. Yeah, but usually you can find products like Hemaplex or Floradix at Walmart or Walgreens. FloridaX, I think that’s what it’s called. Right? I don’t know. I think it’s flora decks. Flora dicks. No, that’s a bag of dicks. Okay. It’s one of those, you’ll figure it out.

Okay. So we’ve ruled those out and you, you still aren’t making enough milk. We have, you know, this basic tenant that babies demand influences your supply. So it’s not actually supply and demand, it’s demand and supply. It goes in that order. Yeah. Why have we ever switched that around? Well, we weren’t always talking about breastfeeding with that, but I hate when lactation folks switch that around anyway.

So we have just like these very basic concepts that influence all of our suggestions. In the first six weeks, the big concept that we work with is that the more frequently you feed, the more prolactin your body makes and therefore the more milk you’re getting. And also your body knows that your baby is young and your body is trying desperately to figure out how much milk that thing needs. It also doesn’t know, like how many fucking babies you have.

True. And it also, and your baby’s stomach is really small and your body is trying to figure out how it can get the most amount of calories and nutrients in your baby without hurting your baby. So that’s why the smaller tummies need more frequent feeds. So if you’re trying to boost your supply in that first six weeks, increasing the frequency of feeding and allowing that conversation to happen more frequently or pumping more frequently, or even hand expressing or hand express, nipple stimulation. Just at all. Anything? Yeah. Good. I’ve told people who are just like, I’m so exhausted. I can’t remember to do this. I don’t want to set alarms. I’m like, okay, every time you pee, I want you to hand express.

Even if you get a single drop out and it dribbles down your front, whatever. Just that stimulation is going to remind your body about prolactin. Yeah, that’s cool. Or something else like that, you know, I’ve also had this really works with your first baby, but not if you have like, more than that. Think of your favorite small treat like chocolate chips or M & Ms or something.

And you want to increase the frequency of how much you offer your breast to the baby. Put a little bowl of those out and count out 12 of them. You get one every time you feed your baby and when you run out, put 12 more in, right. And your goal maybe is to eat 15 M&Ms today. Yeah, that’s really cool.

That’s a good idea. I like that. Yeah. It’s fun. You get chocolate. Some of the apps exist that like show you how much. I think that those kind of create a little bit too much anxiety. I cannot handle them, but if you like them, they’re available. Yeah. There’s lots of apps and you can time exactly how many minutes on which boob, but I feel like there are some people that learn and process information better when they have more information.

But I think there are actually a whole lot more people who have trouble processing information when there’s too much of it, especially in the postpartum. Yeah. So maybe you just need an M & M or raisins if you want to be healthy or whatever. Peanuts, right. Peanuts, whatever you want. That might be an offering the breast every half an hour all day.

And that’s okay. I don’t want you to think that that’s too much. You’re not going to spoil your baby. That actually can be normal and it’s going to help you increase your milk supply and that’s different from feeding on demand. So we’re specifically talking about people that have low supply, truly low supply and want to increase their supply in the first six weeks.

So offering the breast every 30 minutes is not unreasonable. And that might be because your baby is sleepy or unable to finish feeds like late preterm, sleepy because they’re jaundice. I mean, who the hell knows what’s going on? There’s a million different things, a million different variables that can happen in that first six weeks.

So in addition to all the things we already talked about, skin to skin basically does a lot of the similar things that hand expressing does where it’s stimulating your skin, it’s stimulating your nipples and you know, every time something strokes your breast, a little spurt of oxytocin is released in your brain.

Yeah. And, and that literally, that is my first piece of advice. And also the first one to get dismissed by clients, literally at any point in their breastfeeding relationship, if they’re like I have low supply. It’s like, Hey man, 24 to 48 hours go to bed naked with your baby. Put on a good TV show. Yeah. Why do they always push back on that?

Because it works. It does. It works really well. I think it’s just, sometimes it’s so hard to conceptualize taking that much time for something that feels extravagant, maybe luxurious, just lying in bed for 24 hours. Maybe they also can’t stand the thought of being inactive and it not working. Yeah. Maybe it just doesn’t feel as actionable.

I don’t know. I’ll often tell people to go take a bath with their babies. Like the babies that get angry at the breast, you know, the late pretermers are classic for that, the popping on and off and all that bullshit. I’m like do some skin to skin in the tub. It’s nice. It’s very tactile. It kind of resets everybody. Different environment.

Like you’re not in that stressful nursing chair that you’re always nursing in and it’s just more relaxing. And when you’re relaxed, your oxytocin’s able to help your let down. And it’s just a nicer situation. Yeah. And I also want to say like, if you’re experiencing low supply and you’re not feeding on demand, that might be the easiest intervention you can make.

If you started out feeding on a schedule, because some doctor told you to do it, or your mother told you to do it, or a nurse told you to do it, that is old, outdated advice. So unless your baby has a specific medical problem where they actually don’t show any feeding cues like ever, you should feed on demand and use early feeding cues.

Yep. Early feeding cues, like rooting where they kind of bob their head up and down and trying, trying to like find something to latch on to on your shoulder or bringing their hand to their mouth, or even just smacking their lips or turning to try to bite the blanket next to them. That’s also a good one.

Like really anything before crying guys. Yeah. And those are just. Those are really good pieces of advice for any time you feel like your supply has taken a hit for any reason. Yeah, but especially in that first six weeks. Yeah. So then after the first 6 weeks, after the first 6 weeks, well, increasing the frequency of a feed might help.

What usually helps more is removing milk entirely from the breast. And you have to think about why this works physiologically because at this point, your milk is technically quote unquote regulated. So your body knows how much this baby, your body thinks it knows how much this baby needs, but as your baby grows, what is cluster feeding?

Cluster feeding is when your baby nurses and nurses and nurses and nurses, and is constantly sucking on your empty breast to let your breasts know that, Hey, we’re growing and we need more milk. So that breast is getting completely emptied over and over. So, you know, pumping after a feed consistently is going to tell your body up, nope, we need to make a little bit more, right.

This baby’s just eaten more. Right. And that’s where power pumping kind of comes into play. So I don’t really do power pumping in the first six weeks, unless it’s like a crazy situation, but that, that would require a whole consult for me. But if you are after the first six weeks and you feel like you have low supply and you’re pumping after feeds and you’re still not seeing a difference, then I recommend in the mornings, when your milk is the most voluminous, after you feed your baby.

Haha did you just say voluminous? I don’t think that word means what you think. When your, when your milk is luscious and puffy and full of sexuality, what am I trying to say? When you have the most milk? Yeah. When you have the most volume. Yeah. When you’re full. I just feel like voluminous, the connotation of that word is different. This was an odd context.

I’m sorry. So when, when you have the most milk in your breast in the morning, and that’s like 4:00 AM to 7:00 AM. Feed your baby. Yup. I know. Feed your baby. And then you’re going to pump for 10 minutes. Then you’re going to take a 10 minute break. Then you’re going to pump for 10 minutes and you’re going to take a 10 minute break.

Then you’re going to pump for 10 minutes again, and then you’re going to take a break and that if that doesn’t tell your body something’s going on, I don’t know what will. But the thing is, when you do an intervention like that, you have to do it consistently every day, the same time every day, for at least three days.

I think I have that written in all caps in our notes. CONSISTENCY OF INTERVENTION. Yes. Yes, because we are not robots. Our milk supply is not a light switch that you can flip on and off. It’s something that has to be consistently communicated because it’s a big deal for your body to do that. So your body has to make sure that that’s something that it definitely needs to do, because it knows that if it just Willy nilly, can you imagine if your supply just like, went up like crazy for no reason? And you were like, whoa, and then your baby starts having all these symptoms? Or the opposite where your supply just goes way down for no reason at all?

So your body is trying to prevent your baby from having a reaction. So it’s slow and steady wins the race bugs. So sometimes. When you nurse a baby, who’s a preemie, or maybe isn’t a strong nurser or they just don’t have a good suck and you pump after that feeding, but you know that baby didn’t necessarily finish that feeding, you can go ahead and give them that pumped milk.

We’re not saying to do this so you can build up your freezer stash. No, we’re doing this so you can maintain an adequate supply for your baby that is enough, right? Absolutely. So hopefully you’ve gotten a couple of basic concepts and tools from that.

I did want to mention some other factors that might be influencing your lower supply especially if you’re having trouble, like none of these interventions work, right? So we mentioned hypothyroidism and anemia already, but something that could be influencing this, if you have had a previous breast surgery, you simply might not make as much milk, there just might not be as much room or you might’ve had glandular tissue removed. Well that’s, yeah, so mostly that’s for like breast reductions. Right. But a lot of times people, the jury is out on whether or not breast augmentation can cause low supply or if it was because they had insufficient glandular tissue to begin with, which is why they got a breast augmentation that caused it.

So there’s a lot of confounding variables there. I actually have breast implants and I love them. I’m not ashamed of it. And I breastfed my baby just fine. Yeah. And that also brings me to mentioned insufficient glandular tissue. We’ve mentioned it a couple times already. But it is a condition where you just don’t have the normal amount of mammary glands, and I’m not going to go into it today. We’ll probably do a pod snack on it sometime. But that could be a reason you have a low supply. Any recent trauma or illness that your body’s experiencing might cause your supply to dip. Yeah, transient, it can be transient, but you’ll have to send your body, you have to heal. And you have to send your body that clear message that we still need to make milk.

Yeah. The return of your menstruation postpartum, that is such a common culprit for a sudden dramatic supply drop. And again, it’s usually temporary, but it is just long enough to freak you the fuck out. Yeah. And try not to be mad at your body for this, because you got to think about your body is now trying to manage two different things at the same time. It’s trying to manage keeping a human alive while thinking about making another human. Right. And then what we see here is the interesting relationship between progesterone and prolactin. The way that they function essentially is to cancel each other out. So on our milk making cells, we have receptors that literally fit both progesterone and prolactin.

And before you have a baby, progesterone goes in that little keyhole and that fills that up, but it also kind of preps it to get prolactin. And then when you’re not making as much progesterone anymore, here comes prolactin to fill the keyhole. So they have trouble existing in the same space and that’s because your body doesn’t particularly want to lactate and have a baby at the same time. Yeah. And that’s, that’s put into place for protective purposes for your body. And that’s okay. And it’s okay to disagree with your body and it’s okay to be mad at your body for how that works. But it’s normal, but your body will respond.

If, if this happens to you and you have your temporary dip, you’re going to do skin to skin. You’re going to either increase the frequency of pumping if you’re in the first six weeks, which you probably don’t have your period at that time, but I hope not, but it happens. It sucks. And then you’re going to pump after feeding and do a power pumping session for three days in a row.

And hopefully you’ll be back on track and your body will be like alright already. I’ll make the milk! The last one I want to mention, especially if you’ve been experiencing lactational amenorrhea where you have not had a period yet, you might be pregnant. Yeah. You might be pregnant and you might not realize it because you don’t have periods to track, but progesterone might be really high.

Right. Your progesterone is skyrocketing. Your prolactin is dropping. That’s normal. What I did postpartum because even when my periods came back, they were so irregular. It was terrifying to me. So I really didn’t want to be pregnant. I literally went on Amazon. I found a bulk pregnancy test kit that was like just the strips, not like the stupid housing.

And I bought a pack of 50 of them. And I just fucking took one whenever I thought I might be pregnant for no reason. Yeah. It was great. And then I’d pee on it and be like, yes, not pregnant. But then also if you do get pregnant, but you’re not done lactating, it’s fine. Just your progesterone skyrockets in the beginning.

And then it levels off after the placenta takes over. So don’t worry about it. Just keep nursing if you want to. If you want to, and sometimes your baby will self-wean. That’s a whole other pod snack, but we are going to have an episode on breastfeeding during pregnancy, meaning blah, blah, blah. There is a bug in the alcove and it’s bothering me. Heather cannot handle bugs. No, I’m an, it’s like a single fruit fly that’s like hovering around. Like possibly the most harmless creature out there. It’s going to die in like 24 hours. No, I’m afraid I’m going to take a deep inhale and it’s going to get lodged in when you just swallow. Swallow a windpipe situation, just swallowing the bug.

Just rushes down. Bye guys. Bye.

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