By Valerie Howes
From the print edition, Spring 2012
Geeta Nadkarni’s newborn, Mika, often spent more than two hours at a time on the breast, but by six days old he’d lost 14 percent of his birth weight. By two weeks, he’d gone nine days without dirtying a diaper. The baby clinic nurse suggested supplementing breast milk with formula. “That really bothered me,” says the Montreal mom. But that evening, as her son cried inconsolably after a marathon feed, she asked her husband to go buy some. “I was crying too. I said, ‘I have nothing to give him.’” It’s not always easy to tell how Baby’s doing at the breast, or to know what to do if there’s cause for concern. Here are some tips for keeping your baby well fed.
• Recognize the Signs of Low Milk
“If a new baby isn’t drinking at the breast at all or goes several hours without a wet diaper, I’d be concerned,” says Jack Newman, MD, of the International Breastfeeding Centre in Toronto. Six heavy diapers in a 24-hour period is average for a baby more than five days old. A small loss, slow gain or temporary plateau in weight shouldn’t cause im-mediate alarm, but in the long run, the scale helps determine if your baby’s getting enough milk.
• Check the Latch
“If the infant isn’t latching on properly, he might not get what he needs, even if the mother’s producing enough,” says Dr. Newman. There should be a pause in chin movement after the baby opens his mouth wide (i.e., while drawing in milk) and before the baby closes it around the nipple and part of the areola. The Canadian Breastfeeding Foundation has informative nursing videos at nbci.ca.
• Feed on Demand
The more that milk is demanded, the more the body will try to keep up with supply. Breasts have vastly different milk capacities within a normal range, says Dr. Newman. Adding a pumping session between nursings can also help stimulate milk production.
• Have a Cuppa
Exhaustion can impact milk production so Toronto-based nutritionist Julie Daniluk recommends drinking oat straw tea, a traditional herbal remedy to help with fatigue and strengthen the nervous system. “It’s very relaxing and very safe,” she says. “Nursing mothers should always check with their physician or naturopath doctor before using any herbal remedy,” says Daniluk.
• Investigate Physical Causes
For Nadkarni, two issues made breastfeeding difficult: her son was tongue-tied (where the tongue is unable to move freely) and she had hypoplastic breasts (insufficient glandular tissue). Your doctor or midwife can help diagnose these issues. Previous breast surgery may also present a challenge. Ask a lactation specialist for advice.
• Consider Meds
Domperidone is intended for gastrointestinal problems such as nausea and acid reflux in babies and adults, but it also stimulates milk flow in nursing mothers. While Health Canada recently released an advisory linking the drug to sudden cardiac arrest in rare cases, Dr. Newman considers that irrelevant to women of childbearing age with no underlying heart condition. He notes: the average age of victims was about 75 and the deaths happened in Europe, where, in some areas, Domperidone is available off-prescription, so is often self-administered. “Domperidone is a safe choice for nursing mothers who’ve exhausted all other options,” he says.
• Supplement Feeds
You may, at some point, need to supplement with formula or donor milk, but to avoid nipple confusion and to continue stimulating production, Dr. Newman recommends using a lactation aid such as an at-breast nursing supplementer—a container attached to a long, thin tube that is positioned by the nipple, so that the baby suckles the breast nipple and the tube containing formula simultaneously.
Staying the Course
Through consultations with a lactation specialist and using some of the above suggestions and the support of her husband, Nadkarni increased her milk flow. At 11 weeks old, her son is now exclusively breastfed and has doubled his birth weight. “What any baby needs most is a mom who’s strong enough and sane enough to be sensitive to his needs,” she says.
Looking for more? Check out these 7 great foods for breastfeeding moms.