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Breastfeeding

Notes on breastfeeding and milk supply

General Info

  • Breast milk has about a million benefits to babies. So use it! 

  • WHO recommends breastfeeding exclusively for 6 months, and then combine with solid food for 2 years. But it might suppress ovulation, so can act as a birth control. The longer you can breastfeed, the better for the baby, but is hard on mom - aim for at least a year.

  • More caloric breast milk (from higher weight moms or non-first-time moms, e.g.) will likely create more adventurous, secure babies. Babies also get stressed out and nervous from cortisol in stressed moms’ milk. In other words, hormones and nutrition in breast milk affects babies’ moods and temperaments! 

  • Babies generally feed 6-12 times per day (breast-fed babies usually want food more frequently), but schedule is erratic (often clustered), and more frequent during growth spurts. They typically spend about half an hour nursing each time. ​
  • Mom should eat at least every three hours (e.g. every time baby eats, eat right afterwards) to keep up milk supply. Also, postpartum moms are more sensitive to insulin, putting them at risk for severe blood sugar drops. Food delivery (e.g. Picnic app) is a great option to help. Eat plenty of carbs - restricting these can negatively affect milk supply!

Tips

  • Don’t drink or take certain medications while breastfeeding - passes to baby

  • Might need vitamin D supplements while breastfeeding so baby gets enough (recommended baby gets 400 IU a day) - don’t worry too much if you miss it a day or two, though. Baby can also get vitamin D through breast milk itself if mom is supplementing enough. Probably need to continue supplementing vitamin D even after solids are introduced. Buy vitamin D (oil-based) and vitamin K drops from pharmacy or drugstore and introduce once baby is one week old. 

  • Infants might not get enough iron, either, but iron supplementation is not typically recommended unless infant is showing signs of anemia. Rice cereal is fortified with iron, so once baby starts eating, it’s not a worry. Delayed cord cutting can also reduce anemia risk. 

  • Good tips on breastfeeding diet here - main thing to avoid is high-mercury fish. Alcohol is probably fine, actually, but if you’re really concerned, wait two hours after drinking to nurse or pump (Cribsheet p.104). Caffeine can make some babies fussy and irritable, though. 

  • Bifidobacterium infantis - bacteria that used to grow in baby’s guts due to sugars in breast milk, but is getting less common in industrialized nations. However, it has a bunch of benefits to babies so might be worth feeding baby a probiotic with this bacteria in it! Note, however, that baby has to consume the probiotic, not mom.

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Pumping

One recommendation is that it works well to choose just one feeding (e.g. in the morning, because that’s when milk is most plentiful) and just pump after that feeding. If you start early, you should work up to getting a bottle’s worth of milk over a week or two, and then while the kid has that bottle, you can pump another bottle during that feeding. Anecdotal stories that relaxing and looking at your baby (or a picture of him) can increase milk supply when pumping. 

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Prolactin

Prolactin is the hormone responsible for making breast milk. There are foods with phytoestrogens which help boost and support your natural prolactin levels.

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There are several main classes of phytoestrogens. Lignans are part of plant cell walls and found in fiber-rich foods like berries, seeds (flaxseeds), grains, nuts, and fruits. Two other phytoestrogen classes are isoflavones and coumestans. Isoflavones are present in berries, grains, and nuts, but are most abundant in soybeans and other legumes. Coumestans are found in legumes like split peas, lima and pinto beans. Eating these will naturally increase prolactin which in turn helps support making milk

Foods that Increase Prolactin:

  • Oats are rich in plant estrogens and beta-glucan. But other grains like brown rice, barley, and quinoa work as well!

  • Garlic! It will definitely flavor your milk, but research shows babies love the flavor and often suck more in response.

  • Fennel: Raw or cooked, fennel seeds can be added to a recipe, or drunk as a tea. There are also many lactation specific supplements that include fennel in pill form for a more concentrated dose

  • Dark Leafy greens like spinach, kale, collard greens, and broccoli. And yes, you can eat broccoli while breastfeeding.

  • Seeds: Sesame seeds, flax seeds, and chia seeds are all super boosters of making milk and can be added to baked goods and smoothies very easily

  • Berries: Get a phytoestrogen boost with fruits like strawberries, cranberries, and raspberries.

  • Nuts: Almonds are high in linoleic acid and known to be the most lactogenic nut. Packed with healthy fats and antioxidants, Vitamin E and omega-3, walnuts, cashews, and pistachios are all good choices. Snack on raw or roasted nuts, add them to cookies, smoothies, and salads.

To Increase Milk Supply

  • Most women have their milk come in around 3 days after birth. Try to breastfeed in first hour after birth - this can reduce the risk of delayed milk onset. 

  • Can also help to pump frequently (e.g. right after every or at least some feedings) so your body thinks there’s more demand and produces more supply. 

  • Try not to stress (obviously this one’s a nasty cycle because stress -> less milk -> more stress etc. etc.)

  • Power-pump (20 minutes pump, 10 off, 10 minutes on, 10 off, 10 minutes on)

  • Eat more (need 300-500 extra calories a day), and try to include the following foods:

    • Protein (esp chicken, egg tofu, fish)

    • Pumpkin

    • Oats

    • Flax

    • Brewer’s yeast

    • Fluid, calorie, and carb intake

    • Fennel 

    • Fenugreek 

    • Sesame seeds

      • Note: the things in bold have scientific studies backing them; the others are anecdotal galactologues​

  • Reduce caffeine intake 

  • Here is a useful Reddit thread on things that might hurt milk supply

  • And here is a nice one on things that could increase it

  • Do a feeding or pumping session during the night to keep up demand

  • Try to rest and sleep as much as possible

    • Side note: p. 102 of Cribsheet suggests some options for helping treat oversupply (do NOT pump more because it contributes to feedback loop!)​

Indications that Baby Is Not Getting Enough Milk:

  • Still drinks from the bottle after

  • Head butts and re-latches

  • Kneads breast

  • Had pinkish urine a couple of times (dehydration)

  • Extra long feedings (over an hour) = sign baby isn’t getting enough

  • Sleeps too long

Lactation Consultant Plan: 

Schedule:​

  • 8:00 feeding - as normal

  • 11:00 feeding - offer 40ml breast milk/formula from the bottle after nursing if he wants it

  • 2:00 feeding - 170ml from the bottle while Yani power pumps (10 minutes on, 5 off, repeat for an hour)

  • 5:00 feeding - offer 40ml from the bottle after nursing

  • 7:30 feeding - offer 40ml from the bottle after nursing (more if he keeps fussing)

  • 9:30 - Yani pumps 10-15 minutes


 

Can reduce supplemental bottle feeds to 20ml after a week or so

 

  • Yani takes 2 fenugreek capsules 3x a day

  • Yani eats lots of protein, and tries to incorporate foods like salmon, spinach, eggs, oatmeal, Greek yogurt, cottage cheese, nuts, and chicken

  • Yani tries to put on some weight

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