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Q.    My baby is 3 months old.  I have now gone back to work and have continued breastfeeding him. I feel however, that I am not producing enough milk.   According to the table in the milk powder tin and also some of the baby books, he should now be drinking 180 ml according to his age and weight which is now at 6.3 kg.  However, when I express my milk, the most I could get is 170 ml after 6-7 hrs interval from the last feed.  I have also noticed that he now gets hungry 2 hrs after breastfeeding, where before, one breastfeeding session used to last him for at least 3 hours.  What must I do to increase my milk supply?

A.    Welcome to the ranks of working and breastfeeding mothers. You'll find that your decision to combine breastfeeding and working outside the home rewarding as you can continue this special bond with your baby.

Usually a mother does not know how much milk her baby is drinking since breasts do not provide volume readings.

Breastmilk contains the perfect constituents required by a baby, and your body's natural supply and demand mechanism ensures that the amount of breastmilk provided is the correct amount for each individual baby.  As long as your baby is wetting enough diapers (6 to 8 cloth diapers or 5 to 6 disposable diapers a day), gaining weight and is active and alert, you can be confident that you are producing enough.

Try to follow your baby's cues to determine how much expressed milk to give and how often.  The amount on the milk powder tin and baby books is just a guideline.  Even the average formula-fed baby may not exactly follow those guidelines.

Remember that a baby who is nursing well will be more effective at removing milk from your breasts than any pump.  So the amount you express may not reflect the amount you are producing.  It is quite natural for the mother's body to respond more readily with milk letting-down for the baby instead of for a pump.  The amount of milk a mother is able to pump varies from mother-to-mother.  It also depends on other factors such as how practiced she is at expressing, how comfortable she is in the setting where she is expressing her milk, and the time of day.  Stress, especially from work, and from thinking "how come I can only express so little?" can certainly affect the amount you can express quite adversely!

If you find that the amount of milk you express does not meet the amount of milk your baby consumes during the time you are away, you may want to consider the type of expression method you are using.  Some women find using double electric pumps more effective, others prefer manual pumps, while others prefer hand expression.  Relaxing, having warm thoughts of your baby, and using breast massage also helps a lot in stimulating milk let-down.

Express regularly while separated to keep giving your body its demand cues.  You might need to add extra expressing sessions while at home, eg. before bedtime or in the mornings.  Milk production is at its greatest in the morning as the prolactin levels are at their highest after you have been asleep.  Expressing from one side while baby feeds from the other side is also effective at producing larger amounts of milk.  This method is convenient & saves time too!

Continuing to directly breastfeed your baby while you are with him is important for working mothers in maintaining milk supply.  This is a good way for you to re-connect with your baby after a long day away.  Some babies even prefer this and may change his feeding cycle to accommodate this - taking less during the day and waiting for you to come home to give him a feast.  This is very normal and termed 'reverse nursing'.  If this is the case, your body may  adapt to the new nursing schedule and produce less milk during the day.  A survival tool for many working mothers in handling night-nursing is to keep baby in bed with them.  Once you have mastered the technique of nursing while lying down, you can quickly perfect the art of sleeping and nursing simultaneously, and still be well-rested the next day for work.

One reason why your baby may be increasing his breastfeeding sessions could be because he is adjusting to you suddenly being away during the day, and trying to catch up on his bonding and suckling time.  Often, changes in routine such as the mother starting work, moving house, or having a visitor stay, may trigger an increased desire to nurse for comfort.

Also, at 3 months, babies commonly undergo a growth spurt, and demand to nurse more.  By taking your baby's lead and putting him to the breast more often and for longer, your body will soon meet your baby's increasing needs. Similarly, by increasing the frequency and time of expression, your supply will soon meet the demand.

Every culture has remedies to increase milk supply, but the only proven method is by making use of our body's natural demand & supply mechanism with more frequent nursing and more frequent expressions.  Remember to also take care of yourself - Eat & Drink to demand as well !



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