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Breastfeeding is something both mum and baby have to learn. Sometimes breastfeeding mums have issues with breastmilk supply. These can usually be sorted out, and getting help early can make all the difference.
Mother cuddling her baby
 

Getting help

If you’d like some help with breastfeeding, support services are available. Your maternal and child health nurse, GP or the Australian Breastfeeding Association (ABA) can help and support you with breastfeeding your baby. They can also help you find a lactation consultant if needed.

An Australian Breastfeeding Association (ABA) counsellor can also help – phone the National Breastfeeding Helpline on 1800 686 268.

You’re bound to get lots of different advice – take the advice of the person you trust most, and stick with it.

This article covers issues with supply – not enough milk, oversupply and engorgement. If you’re having other issues with breastfeeding, you could check out our articles on breastfeeding attachment techniques and breast and nipple care.

Not enough milk

Many mums worry they aren’t making enough milk for their baby. You might feel especially anxious in the early days if your baby cries after feeds. But newborns cry for all sorts of reasons. When your baby cries, he could be saying, ‘I’m still hungry’. But he could just as easily be saying ‘I’m tired’ or ‘I’m not hungry now, but I’ve got a tummy ache’.

So you don’t need to give your baby extra feeds with formula to make sure she has enough food.

The best way to know if your baby is getting enough milk is to look at his nappies and weight gains. Your baby is getting enough milk if he:

  • has at least 6-8 wet cloth nappies or five very wet disposables in 24 hours
  • has bowel motions every day (if he’s younger than 6-8 weeks old) 
  • gaining weight at about the right rate (your maternal and child health nurse will let you know).

If your baby’s losing weight, you might be advised to give extra milk (except in the first week of life, where it’s normal for babies to lose a little bit of weight). This could be your expressed breastmilk, or if that isn’t available, infant formula. If you’re concerned about the effect of offering a bottle, use a cup when you give your baby expressed breastmilk.

Even if you have to use some formula, it doesn’t mean you have to wean your baby. You can build up your milk supply to breastfeed fully again.

Building up your supply

Breastfeeding often is the best way to make sure you have enough milk, so you could try fitting in a few extra breastfeeds each day.

For example, if you’re usually breastfeeding every 3–4 hours (from the start of one feed to the start of the next), you could try offering baby a few extra snack breastfeeds in between.

It can also be useful to offer an extra night-time feed or to feed regularly during the evening. Your prolactin levels are higher in the evening, which makes your milk supply naturally higher.

If your baby doesn’t settle after a feed, take a break and give a ‘top-up’ breastfeed again in about 20-30 minutes. There will be more milk there, and this will also help boost your milk supply. You can repeat these ‘top-ups’ several times before resorting to a formula top-up. Each time your baby takes some milk from your breasts, your breasts are getting the message to make more milk.

If your baby’s asleep for a long time or is generally very sleepy and won’t take frequent feeds, just express your milk. You can store it in the freezer for using later on. A baby in the lighter phase of sleep might feed in her sleep, so you could try a feed when you see her dreaming.

You can also try to use the feeds as a time to rest by making sure you’re comfortable. Put your feet up, listen to some soothing music, and disconnect the phone. Looking after your health is important too. You can do this by eating properly, drinking plenty of water and getting some rest.

    If you’re concerned about your baby’s weight gain or if offering extra feeds isn’t helping to build your supply, talk to your child health nurse or GP, or contact a lactation consultant or ABA counsellor.

    Oversupply

    Oversupply of milk might be the problem if your baby has plenty of wet nappies, but you’re noticing other issues with or after feeds.

    For example, your baby might seem to have a tummy ache or wind, or baby might be crying a lot, especially after feeds. You might notice that your milk seems to flow very quickly, and your baby can’t swallow fast enough to keep up.

    It’s great that you have such a plentiful supply! It might also help to know that supply usually adjusts to match your baby’s needs over the first few weeks.

    If oversupply sounds like your situation, you might like to try any of the following:

    • You could feed your baby from only one breast at each feed. Put him back on the same breast if he needs a top-up soon after the feed. Use the other breast for the next feed 2-4 hours later.
    • Expressing a little milk before feeds can make the flow of milk less overwhelming and help your baby attach.
    • Check your position and technique – our illustrated guide to breastfeeding positions and illustrated guide to breastfeeding technique might help.
    • Express a little bit of milk if your breasts feel uncomfortable. But too much expressing will make more milk, so express just enough to relieve pain or discomfort.

    Engorgement (full, sore breasts)

    To get some relief from engorged breasts, you could try the following tips:
    • Take your bra off completely before beginning to breastfeed.
    • Warm your breasts with a warm cloth before breastfeeding to help your let-down.
    • Hand-express a little milk or try reverse pressure softening before starting the feed. This can help your baby attach more easily.
    • Massage your breast gently while breastfeeding.
    • Vary breastfeeding positions – for example, you could try the cradle hold at one feed, and the football hold at the next.
    • Place an ice-pack wrapped in cloth on your breast to relieve pain after breastfeeding. Some mothers find a chilled cabbage leaf placed over the breast can be helpful too.
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    • Last Updated 23-12-2011
    • Last Reviewed 06-10-2011
    • Acknowledgements We acknowledge the assistance of the Australian Breastfeeding Association in reviewing this article in January 2011.
    • Amir, L.H, Forster, D.A., McLachlan, H.L., Moorhead, A.M., Chamberlain, C.R., & McKay, H.J. (2010). Breastfeeding in Victoria: A report. Melbourne: LaTrobe University.

      Australian Breastfeeding Association (2010). Increasing your supply. Retrieved August 4, 2011, from www.breastfeeding.asn.au/bfinfo/supply.html.

      Australian Breastfeeding Association (2009). Too much: Managing an over-abundant milk supply. Retrieved August 4, 2011, from http://www.breastfeeding.asn.au/bfinfo/toomuch.html.

      Cotterman, K.J. (2005). Reverse pressure softening: A technique to aid latching when a mother is engorged. Retrieved December 31, 2010, from http://www.kellymom.com/bf/concerns/mom/rev_pressure_soft_cotterman.html.

      Kramer, M.S., Kakuma, R., & The Cochrane Collaboration (2007). Optimal duration of exclusive breastfeeding (a review). New Jersey: John Wiley & Sons, Ltd.

      World Health Organization (2003). Global strategy for infant and young child feeding. Geneva: World Health Organization.