Do big boobs mean more milk? Why does it seem your friend could feed an army with her breasts while you feel like you’re struggling to satisfy one little baby? We cut through the urban myths, the old wives’ tales and the shock-horror stories to give you the facts on milk supply.
Does milk ever not ‘come in’?
Only very rarely. It can happen in the case of severe post-partum haemorrhaging, where the pituitary gland is affected.
Carey Wood of the Australian Breastfeeding Association (ABA) says it is extremely rare that women will produce no milk. “Some may encounter delays with their milk coming in and this can be due to retained placenta or diabetes, but this problem is usually resolved with help, advice and support,” she says.
Milk usually comes in about three days after giving birth, although it’s not unusual for it take up to five, particularly after a caesarean.
Can breastmilk ‘dry up’?
Breastmilk will never instantaneously dry up. Its supply is governed by demand, so if a baby is feeding less, then the breasts will supply less.
But many mums worry when their once-engorged breasts feel less full.
“In most cases, this is just their breasts adapting to their baby’s feeding routine,” Carey says. “And that’s good because no woman wants constantly engorged and leaking breasts.”
Can supply be increased?
Once the mechanics of actually attaching and feeding a baby are mastered, probably a mum’s major concern is that her supply is enough to feed her baby. Sometimes, if a baby has been feeding poorly, a mum may feel the need to boost her milk supply. To do this, increase the number of feeds.
Make sure your baby is well positioned at the breast and you can hear the sucking and swallowing noises. “A baby who is positioned properly is more able to empty the breast. And if the baby continues sucking even though you feel like there’s no milk left, let the baby continue,” Carey says.
Studies on prescription drugs metoclopramide and domperidone have been shown to increase milk supply. However, there are also side effects. Herbs, such as fenugreek and fennel seeds, have been used for many years to help women with low milk supplies, but the evidence is mainly anecdotal on whether these actually work.
Before taking any substances to increase breastmilk supply, talk to a lactation consultant first. “Solving supply problems could be as simple as having a breastfeeding counsellor watch you feed and realise that there is an attachment issue,” Carey says.
Too much milk?
For most mums, over supply is a temporary issue which either resolves naturally or can be overcome with help. Carey says it takes several weeks for the breasts to adjust to producing the right amount of milk for the baby.
“It’s very normal when feeding begins for breasts to feel engorged and over full. And this can make feeding for you and your baby more difficult,” she says.
The ABA recommends these measures to tackle over supply:
Finish the first breast, letting your baby set the length of the feed. He may not want both breasts at each feed.
Express only as much as necessary for your comfort or to help baby attach.
Carey says another method, ‘block feeding’, can also be successful. This is when a mum feeds off the same side for a block of time, expressing the other breast just enough to prevent engorgement.
Why does supply vary?
Some mums seem to have enough breastmilk to feed a dozen babies while others feel that they need to wring every last drop out of their breasts to satisfy one hungry mouth.
It’s true: some women have a larger storage capacity than others. This has nothing to do with breast size, it’s just
a physiological fact.
Breast milk is produced continually and accumulates in the milk ducts. Studies have found that some women have storage capacities up to three times larger than others, but that in a 24-hour period women will produce roughly the same amount of milk.
Carey says almost every mum who has established breastfeeding can make enough milk to satisfy her baby.
“Yes, some mums have lots of milk and others drain their breasts at each feed,” she says. “But an emptied breast is good as signals are sent to the brain to make more milk.”
Can stress, diet or exercise affect supply?
Carey assures mums that no matter what the external influences, if a woman has established breastfeeding, the supply will not be affected by diet, stress, exercise or other lifestyle practices.
“A poor diet will make a mum feel unhealthy, but her breastfed baby will continue to get the nutrients he requires from his mum,” she explains.
“Stress may have an impact on how often or effectively a mum feeds a baby, or it could inhibit the ‘let down’, but it will not impact on the supply of breastmilk.
“Exercise is a great thing for breastfeeding because it makes mums feel healthy and good about themselves. Babies may not like the taste of sweat or pool chlorine, but the milk supply will not be affected.”
Carey says that even sick mums can feed their babies effectively but they just have to ensure that if they are taking any medications, these are breastfeeding-safe. She says there are some substances, such as antihistamines, which can negatively impact on supply.
So she suggests that before taking any medications, mums should ensure they find out what impact the drugs will have on breastmilk supply and quality.
Does size matter?
No! Small breasts can feed just as well as big ones. It is only the amount of fatty tissue which makes some breasts bigger than others and this has no impact on a breast’s ability to produce milk. The milk-producing apparatus can be the same regardless of size.
It is extremely rare for a woman to be born with insufficient glandular tissue. “Big breasts, small ones, they all have the same ability to feed,” Carey says.