Supply issues

All nursing mummies at some point in time have questions about milk supply. I also had some questions then and here I'd like to share what I've learnt in the process of finding the answers.



Supply immediately after delivery

Once after delivery, try to latch baby as soon as possible and frequently to help your milk supply come in quickly. One of the tricks the lactation consultant at Kandang Kerbau Hospital taught me, apart from latching baby frequently, is to pump frequently as well. This two-pronged approach would enable milk supply to come in faster. I understand that there are different takes on using the pump in the first 6 weeks of baby's life but using the pump on top of latching baby helped my milk supply to come in quickly so personally I would advocate the use of the pump together with letting baby latch. By the time I was discharged from hospital, I had more or less sufficient milk to meet Alicia's needs (but being paranoid, I had a tin of formula milk to stand by).

I borrowed the Medela mini electric breastpump from my sister-in-law... it's got the most basic functions but it worked well enough for me:


















Most of my friends got the Medela Swing Breastpump which has the added function of massaging the breast before pumping. For me, I had to manually massage the breasts since the medela mini-electric doesn't come with this function.

















Obviously, the double-pumps are the most effective in stimulating letdowns and for increasing supply. These however come with a rather steep price. But if you are intending to breastfeed for long and you need the pump to be efficient in getting the milk out from your boobies, then I think this is a good choice:



















Oversupply
Some time after the first month, I started to have an oversupply of milk as in the first month I pumped exclusively instead of latching as she, for whatever reason, only managed to latch properly at about 5 weeks old. Expressing milk instead of direct latching meant that my body wasn't producing the exact amount of milk that Alicia needed. I had to put up with terrible engorgement and wait for my body to adjust accordingly as by the 6th week, I was latching her and not expressing milk for her anymore.
A tip for nursing mommies who face issues of oversupply is to express only enough to make you feel more comfortable instead of emptying your breasts when you express (after your baby has finished feeding at your breasts). If it's not that uncomfortable, you can skip expressing altogether. However, if you notice any lumps in your breasts during this period of readjustment, it means that you have blocked ducts and in this case, you will need to clear them.





Soft breasts - drop in supply?
About 2-3 months of nursing and experiencing hard, engorged breasts, suddenly I felt that my breasts became softer, almost like it was before I started nursing. I started to think that my supply had diminished. Fortunately I didn't stop nursing just because I thought my supply had dropped. After reading up on this issue, I realised that having full and hard breasts is not supposed to be the norm throughout the whole breastfeeding journey: this happens only in the first few weeks. What happens after that is that the milk supply will begin to regulate and the breasts will begin to feel less full, soft, or even empty. My breasts also stopped leaking (they were leaking terribly earlier on and I had to keep changing breast pads throughout the day and I always woke up with a wet t-shirt... eww... gross!). I read that this doesn't mean that milk supply has dropped, but that my body has figured out how much milk is being removed from the breast and is no longer making too much. Finally! No more hard, painful and leaky breasts for the whole day!


Forceful letdown (Overactive Letdown Reflex)
I only realised that I had forceful letdown when I confided in an experienced nursing mom about Alicia's feeding pattern. Alicia would gag, choke, gulp down milk frantically, gasp, cough, clamp down on my nipple or pull out altogether when the letdown occurred (and milk would be spraying everywhere, sometimes all over my darling's face). I had read that the letdown was a baby's reward for suckling and yet it didn't seem so for my baby!

How I handled this problem:

• Feed her in cradle hold but in a reclining position so that the milk doesn't flow as fast and she wouldn't choke.
• Feed her in a side-lying position so that the extra milk can dribble out on the bed (place a nappy below)
• Feed her as per normal, but let her unlatch during the strong letdown and place her back to the breast when the 'spraying' was over (cover the nipple with a burp cloth to absorb the milk rather than let the milk soak through the breastpad)

I also tried latching her by placing her on top of me so that the milk had to flow 'uphill' so the flow wouldn't be too strong but she refused to be in that position so I just used other methods.

It was only when she was about 5 months old that she managed to overcome this problem and she started to enjoy the letdown... :)


Lop-sided breasts
This happens when baby has a preference for one side over the other. For some reason, Alicia preferred to feed on one side more so naturally the body responds by producing more milk on one side, and so that meant that the size of the breasts was different.

After consulting the lactation consultant, I was told to keep feeding Alicia on the less-preferred side as the first breast till things evened out. This is because the baby is usually hungrier and so suckles harder on the first breast and due to the hunger, baby will be less picky. I followed the advice and after awhile, she stopped having a preference altogether.


Can't pump out much milk after latching (and not expressing for months)
When Alicia turned 6 months old, I started expressing milk again to mix with her food. That was when I realised that while I had no problems expressing milk out in the past, suddenly I could hardly pump any milk out! What puzzled me was that Alicia was still drinking fine and putting on weight so I called the lactation consultant again.

What I found out was that my nipples are too used to baby's latch (which is much stronger than the pump) so the pump is less effective in getting the milk out. The lactation consultant suggested tandem pumping: feed baby on one side while pumping the other side. Apparently doing this for every feed for about a week would get the nipples used to the pump again. Well, I tried but the curious little one refused to share her milk 'bottle' with a machine that was making lots of noise. So I called the lactation consultant again. This time, she suggested that I cover the motor of the pump so that the noise doesn't affect the baby. I did that but it still didn't work out because Alicia was too busy trying to tug at the nappy covering the pump, the wires, the bottle that was used to collect the milk... oh well... so I will never find out if the advice works. Maybe you can try it and let me know. :)