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Q.    My baby is 1 week old.  I'm breastfeeding, but I don't think I have enough milk,  so I give him some formula after each feed.  I'm returning to work after 2 months, but I would like to continue breastfeeding after that, if I can.  How can I increase my milk?

A.    It is good that you are thinking ahead, and planning to give your baby breastmilk even after you return to work.  If you are planning to maintain a good supply after 2 months, it is important to build up a strong supply now.  At 1 week, many mothers won't find a very steady supply yet.  Most of us start off rather low, but as long as you allow the baby to suckle whenever he wants to feed, he will stimulate your breasts to produce according to his needs.  It takes about 6-8 weeks for your supply to match you baby's needs, if you allow him to suckle whenever he asks.

It will be best not to top him up with formula after each breastfeed.  By doing so, formula will make up a substantial portion of his food, making it very difficult for your supply to increase, as demand is curtailed.  Your breasts simply won't receive enough stimulation.  The other problem is that he may come to prefer the bottle and fight the breast, as milk flows so much more easily from a bottle teat.  This will make your breastfeeding more difficult.

As you plan to return to work after 2 months, you can introduce the bottle in the 4th week, if he has settled down nicely to breastfeeding.  He can be given one feed by bottle a day, and this can be of expressed breastmilk (ebm), so that your supply will not be affected.

Just remember that it takes about 2 days to step up or step down your supply.  So even with increased stimulation, it will take 2 to 3 days before you see a noticeable increase.

Q.    I have been breastfeeding for 3 weeks, and seemed to be getting along fine.  Suddenly, these few days, things have gone haywire.  Instead of sleeping for 1-1/2 to 2 hours after feeding, as she has been doing, my baby seems to want to drink very frequently.  Am I losing my milk?

A.    No, you are not losing your milk.  In fact, if you have been fully breastfeeding all this while, you are probably producing more than before.  It sounds like your baby is going through a growth spurt.  Babies go through several of these.  They reach a stage when they seem to grow faster than before, and they need more milk.  As a result, they feed very often for 2 to 3 days.  This is their way of increasing their demand, and telling Mom to produce more!  3 weeks, 6 weeks, 3 months, and 6 months are some of the earlier growth spurts many mothers have observed.  Once your production catches up with the new demand, she'll settle down again.

Q.    My 3 week old baby feeds so often.  I seem to need to feed him every 1 to 2 hours, so unlike my neighbour's formula-fed baby.  Is it because I don't have enough milk?

A.    Your baby's feeding intervals are typical of a very young breastfed baby.  Breastmilk is very easily digested, so baby works through his feed sooner, and looks for another feed.  Such frequent suckling in the early weeks is also very needful to increase your milk supply.  You can do a wet nappy count (using cloth diapers) for 24 hours.  If the baby produces 6 - 8 wet nappies, he IS taking Enough!  It's just that mum's breasts are not transparent, so you can't see him at work!

Q.    My baby is 1 month old.  I breastfed from the beginning, but in hospital I supplemented with water & glucose, and even now, I supplement 2 night feeds.  She feeds every 1 to 2 hours during the day, and may feed for 45-60 minutes.  Is this normal?  As I do not need to go back to work, I would like to fully breastfeed if possible, but I am afraid I don't have enough milk.

A.    You seem to share a common anxiety with many mothers that you are not producin enough milk.  Most newborn babies tend to feed at fairly short intervals, because in the early weeks, the milk supply is not yet well established, and breastmilk is very easily digested.

For the 45 minutes that she is on you, how long is she actively sucking?  If I am not wrong, she is probably sucking strongly for the first 10 to 15 minutes, adn then very intermittently for the rest of the time.  A baby will satisfy his need for food first, but will continue to suck for comfort.  What is important for you to ascertain is that she has latched on properly - that your areola, and not just your nipple, is in her mouth.  This will help ensure that while she is sucking, she is sucking efficiently.

You probably are at present producing a little under your baby's requirements, because of your regular pattern of supplementing.  Our milk production works on a very simple demand-and-supply principle.

The more milk is take out, the more your breasts will produce.  You are probably short by the amout supplemented.

The easiest way to step up supply is to put the baby to feed more frequently in your case, at night.  Bear in mind that supply does not increase immediately.  The breasts take 48hours to respond to the increased stimulation.  For 2 to 4 days you may need to put the baby to the breast whenever she wants, especially at night, to let your supply catch up with her need.

Alternatively, you may like to express any leftover milk after each feed for these 1st few days, and use the milk collected to supplement her night breastfeeds which may, at the moment, be lesser in quantity because she has not been breastfeeding at night for some time.

Try to experiment with lying down to breastfeed, especially in the night, as you may need to go through a period of rather frequent night feeding to bring the supply up again.  Eventually, when the supply has caught up, the feeding interval will space out again.

With some peserverance, you should be able to achieve full breastfeeding before long.



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