Where Oh Where Did My Breastmilk Go?



Millions of breastfeeding mothers ask this question to themselves (and others) at least once if not 100 times during the time they are breastfeeding. The answer depends on where you are on the journey. This blog will review the answers.
First Week:
Every woman, just by the act of being pregnant and giving birth (even if sadly they don’t give birth to a live baby or they give birth to a premature baby) produces milk for a short period of time. This is called “lactogenesis two”. It is related to hormones released after the placenta is expelled from the mother. If you birth the placenta, you should get milk about 40-72 hours later. But if you DO NOT breastfeed that milk production is quickly shut down. Otherwise, every pregnant woman would walk around making milk forever.

What happens if you want to breastfeed but for what ever reason you haven’t been removing milk in the first couple of days, especially after lactogenesis 2 begins? Your body thinks you will not be breastfeeding and it down regulates milk production. Within a very short period of time, you stop making milk.

SOLUTION: Remove milk frequently (8-10 times in 24 hrs) in anyway you can, preferably by having baby suckle, but hand expression (a great video on how to hand express) and/or pumping can stand in too. The key is to REMOVE the milk!! If you do, the milk will increase and  continue to flow.

First 6 weeks:

Sometimes it seems that you were making milk just fine and then  it “disappears”. Commonly I will hear concerns about the baby being so hungry all the time that they are never satisfied at the breast. The very next comment is usually, “and so I gave him formula”.

Remember this: YOU HAVE TO REMOVE MILK TO MAKE MILK

Every time you supplement with a liquid that you have not made, you tell your body to make less. It is just survival. Imagine how uncomfortable you would be if you kept walking around with all that extra milk! Babies go through growth spurts around 2, 6 and 12 weeks of age. This is a time when they pick up the pace of nursing to make your body make more milk. It can be a little annoying for those days as your already established routine gets disrupted, but if you relax and let baby eat when demands, you will be ok.

However, if you find that baby is ALWAYS in a growth spurt, you have an issue. This is a time to seek out a lactation consultant to review the situation.

After 6 weeks:

Common causes of a decrease in milk production after it is well established are:

1. Resumption of menstrual cycle and ovulation
This is usually temporary and if you plow through nursing frequently will resume normally. If your baby is so used to a certain amount of flow and starts rejected the breast, make sure you PUMP to maintain stimulation through the temporary dip.

2. Starting Hormonal Birth Control
Many OB’s will suggested hormonal birth control at the 6 week postpartum visit. These include birth control pills, IUDs, patches, vaginal rings etc. JUST SAY NO THANK YOU!  Although the hormones are “safe” for breastfeeding babies, many women see a drop in supply at a time when many are not quite up to full supply. Use a nonhormonal birth control if you are one of the few participating in sex...

3.Going Back to Work
Obviously, being separated from your baby isn’t great for your milk supply. I’m sure you can imagine a myriad of reasons why you might see a drop in supply. But again, remember the cardinal rule: you have to remove milk to make milk. Working is a huge roadblock to the efficient removal of milk. Whether it is not pumping enough throughout the day, freezing up at the sight of the pump, a broken pump or the number one killer of supply, supplementing from a store of milk pumped earlier, usually the drop in supply is really a drop in removal and the reflexive drop in supply. See blog entry: 7 Ways to Survive Going Back to Work for solutions to this problem.

4. Supplementing with Formula
The more you give baby a liquid you do not produce, the less milk you will make. For some women, this can happen very quickly (see above). Remember, you are part of a two part equation, you can not worry just about feeding the baby, you must remove milk to make milk. EVERY time you supplement you need to remove milk by some means. If you do not, your milk supply will drop off.

5. Postpartum Depression and Anxiety
It is very important to recognize these disorders as they not only affect your supply but your entire life and happiness. (See: postpartumprogress.org for list of symptoms) 1 in 5-6 mothers suffer, many without recognizing they are. Get help. There is no shame, you are not a bad mother. You are not alone. Click here.

Remember that these are just simple explanations for a complex process, and often professional guidance is the way to go. Please visit your local IBCLC, lactation consultant for more individualized help. Or visit: www.Breastfeeding-MD.com

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