Supplementing And Supply

Supplementing, while sometimes necessary, can be an incredibly slippery slope. Especially when an IBCLC is not involved. For every oz you supplement, you are telling your body it doesn't need to make that oz of milk. In which case, your body begins to decrease it's supply with each bottle. An IBCLC can help to try and keep this from happening through additional pumping and other methods of increasing supply. 

There are many reasons moms believe that they need to supplement. Most of this comes from misinformation, lack of support, and predatory marketing on the part of the formula industry. Let me be clear we in no way are bashing or looking down on moms who formula feed or supplement. As said above, it can be a necessity, and most of the admins on this page have had to supplement with formula at one point or another. But it is important to know when it may be necessary to supplement, and when being a nervous mom is making us feel as if we are not making enough for our babies. 

http://kellymom.com/bf/got-milk/supply-worries/low-supply/

So the first thing to remember is that our bodies were made to feed our babies. Milk production is an amazing, and seemingly complicated process that happens just by putting our babies to the breast and letting them nurse (http://kellymom.com/pregnancy/bf-prep/milkproduction/). To quote this link directly, "For the most part, milk production is a “use it or lose it” process. The more often and effectively your baby nurses, the more milk you will make." This means that if a true supply issue exists (as opposed to a milk transfer issue such as latch problems or TT/LT), bringing baby to the breast is the best way to remedy this. Galactagogues such as fenugreek, mothers milk tea, blessed thistle, oatmeal, etc. do nothing for milk supply if you aren't bringing baby to the breast as much as possible. Increasing baby's time at the breast alone will typically boost supply on it's own. 

Here are some common reasons moms believe they are not producing enough milk for baby, and thus feel they need to supplement:

*Baby is fussy after feedings and does not seem satisfied or is nursing constantly - This is common, especially during growth spurts and developmental milestones such as rolling over and sitting un-supported. Growth spurts make babies feel generally yucky because of bone growth and brain development. It's a confusing, and sometimes painful time for babies and they will fuss. That's just the nature of it. It's most common to see this in the evenings, accompanied by cluster feedings (another reason mom's believe they aren't producing enough milk to satisfy baby). This is a great link that discusses cluster feedings and fussy baby and how it does not have to be a link to low supply http://kellymom.com/parenting/parenting-faq/fussy-evening/
http://www.ivillage.com/growth-spurt-or-low-milk-supply/6-a-127423

*After nursing, baby quickly takes another ___ oz from the bottle - This is a common misconstrued sign that baby is still hungry after nursing. The first thing to consider is how long it takes for the receptors in the brain to tell the tummy it is full. That is why paced bottle feeding is so important when exclusively pumping or when baby is with a caregiver. After nursing, it may take 10-20 minutes for baby's brain to actually signal to his/her tummy that it is full and satisfied. Especially if there has been a long stretch of sleep. In these instances, it can be helpful to nurse baby on one side for 10-15 minutes, then take a short break. Maybe 10-15 minutes to change their clothes and diaper and interact with them, then offer the first breast again. This gives their tummy some time to know it is full. Another reason babies seem to drain a bottle after nursing is due to sucking and swallowing reflexes. An older baby will probably refuse the bottle if they aren't really hungry (although not all). But a younger infant will suck on anything you put in their mouth. When a bottle is placed in a baby's mouth, they will instinctively suck. Then, their mouth will fill up with milk and they will instinctively swallow. This will go on until the bottle is empty. (http://www.mother-2-mother.com/cc-baby-B.htm#Fussiness)

*Baby is fussy at the breast and seems angry like no milk is coming out, but will gulp down a bottle without a problem - Like most humans, babies are impatient. They want what they want, and they want it now. Unlike adults, however, babies do not have the cognitive ability to understand that they will get what they need if they put in a little effort. When baby gets a bottle, even the slowest flow nipple is easier for them than the breast. This is often how nipple preference happens. Baby figures out that they will get their milk quicker and with less effort from the bottle, so they prefer to eat that way. While this kind of fussing at the breast is quite common during growth spurts, it doesn't have to be an issue all the time. A good way to help with this is to feed baby before they are really hungry. When baby starts to show the very first signs of hunger (like, waking up), put them to the breast and start the feeding. When babies get so hungry that they start to cry, it is usually necessary to calm them down in order to nurse them happily at the breast. A very hungry baby has a hard time latching on because they are feeling distressed and cannot calm down. If this seems to be a regular occurrence,make sure you are putting baby to breast as soon as you see early hunger cues. http://kellymom.com/bf/normal/hunger-cues/

*My breasts feel soft, they never actually fill up (anymore) - This is common, especially after your milk has regulated around 6 weeks. The shapes, size, and feel of your breasts do not indicate a supply issue. It is actually better that your breasts do not feel like rocks all the time. That is called engorgement and can lead to clogged ducts and mastitis if it happens often. Some moms may never feel their breasts get hard and full, even from the beginning. Again, this is not an accurate sign of low milk supply.

*When I pump, I only get a couple oz out, so baby must not be getting much - It is NORMAL for a mother who is nursing on demand to pump between .5-2 oz TOTAL for an entire pumping session (between 2 boobs). Your baby is WAY more efficient at removing milk from your breasts. More efficient than a pump will ever be. So pumping output CANNOT be used as a gauge to how much milk you are making.

So how do you know your baby is getting enough milk?http://kellymom.com/bf/got-milk/supply-worries/enough-milk/
If baby is gaining weight (and following their own growth curve), if baby is producing enough wet/dirty diapers a day (5-6 sopping wet diapers a day and a few poops), baby is alert when awake, and baby is relatively happy, you are very likely producing plenty of milk for your baby.

If you are not seeing these signs, contact an IBCLC ASAP to have your baby's latch checked for milk transfer issues. If low supply is suspected by your IBCLC, he or she can advise you of methods that can help you increase your milk supply. It is important to remember that anything you ingest to increase milk supply has risks and benefits to you and your baby and should be done so after evaluating said risks with an IBCLC.