111. Coping With Feeding Challenges

It is important to talk to someone if you’re worried. Generally if your baby is nursing often, has lots of wet and dirty diapers and is gaining weight adequately, you are giving your baby enough milk.

The following factors can decrease your breastmilk production:

• Medical conditions such as thyroid problems or infections
• Previous breast surgery (some breast reduction surgeries)
• Heavy blood loss, during or after the birth
• Stress, pain or feeling very tired
• If a baby is not correctly positioned or latched at the breast
• Infrequent feedings, no night feedings
• Limiting lengths of feedings
• Breastfeeding only on one breast at each feeding
• Use of soothers or bottles, especially in the early weeks, leading to less frequent breast feeds
• Smoking
• Alcohol use
• Some medications including birth control pills, antihistamines and some herbal teas
• Incorrect use of a nipple shield
• Severe engorgement
• Painful nipples or breasts
• Retained placental fragments
• Pregnancy

Talk to your doctor, public health nurse or a lactation consultant if you think any of these may be affecting your milk supply.

• Increase time spent skin-to-skin with your baby
• Get more rest. Ask for help with household tasks
• Eat a well-balanced diet (see Canada’s Food Guide) and drink to satisfy thirst
• Feed your baby often (8 – 12 times a day)
• Increase the number of feeds in 24 hours
• Offer both breasts at every feeding, allowing your baby to finish the first breast first
• Compress your breast (with the thumb on top and fingers underneath) when your baby’s sucking slows down, to increase the amount of milk your baby swallows at each feeding
• You can try switching your baby back and forth between breasts, offering each breast twice more during a feeding
• Express milk after feedings by hand or use an efficient breast pump
• If your baby is not breastfeeding, use an effective breast pump set at a comfortable setting, at least 6 to 8 times a day (including once at night)
• The use of a double pump attachment will reduce time spent pumping and allow more rest time between pumping sessions
• Put warm compresses on your breast or massage your breasts before, and while using the breast pump to increase milk flow
• Ask your doctor about medications that may increase milk supply
• Get help from someone knowledgeable and supportive of your goal to breastfeed your baby!

Sometimes mothers have a large milk supply or the milk comes out very fast from the breast. In many cases, this is temporary, and gets better once your milk supply adjusts to your baby’s needs. You and your baby may benefit from some help if your baby:

• Nurses often, but is gulping at the breast
• Pulls back off the nipple
• Spits up milk often and has a lot of gas discomfort

You might also find that your breasts feel overfull and uncomfortable, and that you leak a lot of milk between and during feeds.  Using different positions, burping your baby often and temporarily breastfeeding your baby on only one breast at a feeding may help. A health care professional who is knowledgeable about breastfeeding can help you with more suggestions.