Ask the Lactation Consultant
Q. I keep meeting people who say they didn't make enough milk for their baby - but I thought milk supply is based on demand - what causes things to go wrong and what can I do to ensure an adequate milk supply for my soon to be born baby?
A. That is an excellent question, and the answers are both simple and complex. Although milk supply is one of the most common breastfeeding concerns, in reality, for the majority of women, as long as baby is adequately latched soon after birth and on cue thereafter, milk production will be ample.
Occasionally, however, other factors will come into play that impact milk supply. These influences on milk supply can be either baby originated or mother originated, and sometimes both. One of the best things you can do for milk supply prenatally is to evaluate your own health history for any yellow flags regarding possible milk production problems. If you do have any indications of a possible problem, a private prenatal consultation with a skilled lactation consultant familiar with milk supply dynamics can be instrumental in both maximising your body's ability to make milk prenatally and in evaluating how things are going once baby is born.
Although yellow flags for low milk supply are just that - yellow (rather than red) - and many women go on to make plenty of milk, even in the presence of such yellow flags, it is definitely beneficial to address any issues prenatally, as it is during pregnancy that the final stage is set within the breasts for milk production.
Some conditions that can influence milk supply detrimentally, and can benefit from prenatal consultation, include:
- History of low milk supply with a previous baby
- Polycystic Ovarian Syndrome
- Infertility/trouble conceiving, history of miscarriages/progesterone support
- Hormonal imbalances of any kind
- Symptoms of hyperandrogenism, including hirsuitism, acne, male pattern baldness, etc.
- A history of irregular menstrual cycles/amenorrhea
- Minimal or no breast changes during pregnancy (look for 1 or more cup sizes increase, veining and tenderness)
- Gestational Diabetes
- Pregnancy Induced Hypertension
- Maternal illness (chronic or acute)
- History of breast surgery or injury (including breast reduction and breast implants)
- Breasts that are unusually shaped or extremely asymmetric in size (many unusually shaped breasts produce plenty of milk, but it may be worth consulting about)
For more information about prenatal consultation, see Beyond Birth.
