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Here’s what a fluctuating milk supply throughout baby’s first year means
Changes in your breast milk supply are completely normal—your milk will have variations even between the start and the end of a single feeding session. Most fluctuations are expected, though sometimes they can indicate an issue you need to address. Either way, there’s a reason for each change you might observe in your breast milk production, and the better you understand what these changes mean, the more control you’ll have over your breastfeeding journey.
In this month’s Ask the IBCLC, our resident IBCLC Katie McGee answers questions about what changes to expect in your milk supply throughout your baby’s first year, and what they might be telling you.
Can a mother’s milk supply vary from day to day, week to week, month to month?
Yes. You may notice that your output appears watery sometimes and creamy other times, or that there are subtle breast milk color changes. The breast fullness of the early postpartum period may also subside over time. These are few examples of the normal changes that you can expect throughout lactation.
Amazingly, breast milk composition changes even during a single breastfeeding session. The milk that comes out at the beginning varies greatly from the milk that is transferred to the baby at the end of a nursing session. These two types of breast milk are called foremilk and hindmilk. Thirst-quenching and often fast-flowing with the letdown reflex, foremilk is released early in breastfeeding and gets milk to the quickly-sucking hungry baby faster. Hindmilk, transferred at the end of a breastfeeding session, is more like a heavy cream. This high-fat and high-calorie milk brings baby to a satisfied and sleepy state (combined with how comfortable they are nestled close to you—the very best place in the world). Variations in composition combine to deliver the perfect balance of nutrition for your baby.
Another variation comes in milk volume. The first milk you produce after delivery is low in volume but high in protective proteins for the baby during the newborn/colostrum phase. Although this is often a cause of concern for mothers, the colostrum phase is normal. It takes time, often several days, for a new mother to make a larger volume of milk. Frequently nursing your newborn—watching for any signs of newborn feeding cues—assists a new mother to transition from the colostrum phase to producing larger amounts of milk. This is the transition commonly known as the milk “coming in.”
If a mother has identifiable risk factors for low milk production, an IBCLC may suggest a proactive plan that includes pumping with a hospital-grade pump to help mom establish a full supply. Scheduling a call or visit with a lactation consultant can help identify any risk factors at play and help you develop an action plan to achieve your breastfeeding goals.
Are there factors that can reduce or increase milk supply?
Yes! Sometimes mothers add pumping in addition to frequent breastfeeding and unintentionally boost supply or establish a supply that is above and beyond what the baby can take in. Oversupply can be challenging to manage. More commonly, low supply is the concern.
There are so many factors that can influence milk volume. Hormonal and anatomical variations with the mother, a mother’s medical, pregnancy and delivery history can impact both how quickly her larger milk volume comes in, as well as her ability to establish a full milk supply. Similarly, issues with the baby’s oral anatomy, and/or ability to breastfeed frequently and effectively influence the establishment and maintenance of milk production. Also, any period of separation, particularly during the critical first two weeks after delivery, is a risk of establishing milk supply.
Some of these factors, such as C-section delivery or a NICU stay, may be unavoidable. Countering the influence with a pumping plan until you and your baby are together and nursing can bridge the gap until you can get on a regular breastfeeding schedule. Later on, in your breastfeeding journey, it may be imperative to set up and stick to a regular pumping schedule at work to meet the needs of your baby.
Are fluctuations in breast milk production normal?
Yes. After weeks of feeling breast fullness, it is not uncommon for a first-time mother to be alarmed when her breasts begin to have periods of softness. Typically, a leveling out of the milk supply happens to meet the needs of the infant at around 4 to 6 weeks.
Sometimes women have a milk supply that is very susceptible to variations in her breastfeeding and/or pumping routine. If a mother goes to an all-day wedding without the baby or a pump, or suddenly the baby is sleeping throughout the night, the next day or two can bring a dip in her previously stable milk supply. Others may experience these schedule changes without any noticeable change in supply. If a mother previously had a full supply before this decrease, it can often be recovered with additional pumping and/or nursing.
At what point should a mom be concerned about variations in her milk production?
Trust your instincts. If something doesn’t seem right, talk to an expert such as a lactation consultant who can answer your questions about common milk supply issues. Watching diaper output, obtaining a weight check at the pediatrician’s office or visiting a lactation consultant for a pre- and post-feeding weight can often provide assurances about newborn intake. Join an online or in-person group for nursing or pumping mothers (such as La Leche League). Mother-to-mother support is invaluable during lactation.
Is there a “normal” trajectory of milk output over the course of baby’s first year, and how big a deal is it if my supply differs?
In the early weeks, infant weight is a big focus. Babies are born with a reserve and are expected to have a decrease in birth weight before regaining to meet birth weight by two weeks old. When lactation is established, a new mother may make drops or milliliters of colostrum on day one. Colostrum is available in the perfect amount for the newborn who needs to adjust to both nursing and life outside the womb much more than they need to take in large amounts of food.
As the days and weeks go on, we look for a mother’s supply to increase to producing close to a liter of milk around the time her baby is two weeks old. When intervention happens early, there is much more opportunity to avoid issues and positively impact breast milk production. So if you feel like something isn’t quite right, get assistance early and often to help the first two weeks go well. This time period sets the tone for your milk-making throughout lactation—even as you reach those big milestones. Sometimes, a mother may face a “pump slump” in her breastfeeding journey that might affect her milk supply. Whether this is a mental block or caused by external issues, there are ways to overcome pumping fallbacks.
If you’re worried about milk supply or have other questions about how lactation works, we have a team of expert lactation consultants like Katie who can help. Schedule an insurance-covered one-on-one appointment with a lactation consultant near you or start your breastfeeding journey by ordering a breast pump through Ashland Breast Pumps today.