How can I increase my milk supply?

During the first trimester a pregnant individual's metabolism increases, which uses up a lot of energy.  Increasing progesterone levels also make you feel more sleepy. The best way to increase milk supply is to increase breast stimulation.

• Feed baby on demand, at least 8 times/24 hours.
• Offer both breasts at each feed
• Try switch nursing technique-Offer each breast 2-3 times during a feed. Once baby becomes sleepy at breast, or is no longer effectively sucking/swallowing, offer the second breast. Continue with this pattern until baby has fed from each breast 2-3 times. This helps encourage more active swallowing and promotes multiples letdowns throughout a feeding.
• Use breast compressions during feed to increase sucking and swallowing.
• Feed baby in skin to skin contact.
• Express/pump both breasts after feed to increase stimulation to breast.

Lactogenic foods (foods that my help increase milk production)

There is limited data to support the effectiveness of lactogenic foods, but some parents have found the following foods to be helpful in increasing milk production. 

• Oats, fennel, garlic, peas, yam, almonds, sweet potato, coconut water, brown rice, ginger.

*There is limited data in the form of controlled trials regarding the use of medications and herbs to increase breastmilk production. It is best to speak with your primary care provider prior to use.

Why is my baby feeding so frequently?

Most breastfed babies will feed approximately every 2-3 hours, on average for the first few months of life. It is common, however for babies to increase the frequency of feeds at different times for different reasons:

Growth spurts

• Growth spurts commonly occur around 10 days-2 weeks, 6-8 weeks, 3 months and later. Babies feed more frequently during growth spurts due to increased caloric needs. Frequent feeds increase breast stimulation and in turn increase milk production.  Most babies will return to their regular feeding patterns within 24-72 hours.

Cluster feeding

• Cluster feeds are periods when baby breastfeeds frequently (ex/every 30-90 minutes for a few hours), followed by a period where baby sleeps longer between feeds.  Cluster feeding is very common in newborns and often occurs in the evening.

* During growth spurts/cluster feeds, it is common for parents to think they are not making enough milk (breasts feel softer (due to frequent feeds) and babies often appear more fussy and unsettled during these times. If baby continues to meet output norms and has been gaining weight well there is no need for concern. If cluster feeding behaviour is lasting most of the day, and for longer than 72 hours, contact PCIL/breastfeeding appointment for further breastfeeding assessment/support.

How can I tell my baby is getting enough breastmilk?

You may notice that your breasts feel full and firm before a feed and softer/less full after a feed. After feeding, baby comes off the breast relaxed, sleepy and content.

How long should each breastfeeding session be?

• A newborn feed can last approximately 20 minutes to 45 minutes depending on how hungry and/or sleepy your baby is. Let them feed on the first breast until you no longer see active sucking/swallowing. Most parents notice their breast is noticeably softer/less full feeling post feed. You can use breast compressions to help increase milk transfer at breast.
• Once baby is done on the first breast, you can burp them/change their diaper (if needed) and offer the second breast. Allow baby to feed on second breast until active sucking/swallowing is no longer seen and baby is sleepy, relaxed and content.
• If your baby still appears hungry after coming of the second breast, offer the first side again.
• The length of feeds varies between all babies. As babies grow they often become more efficient at removing milk and length of feeds may shorten.

How often should I pump?

If your baby has been latching well to breast since birth there is no need to pump in the first 6 weeks. Your baby feeding frequently and on demand will establish your milk supply. Pumping too frequently in the first 6 weeks can result in an increased milk supply which may cause your breasts to feel full and uncomfortable and baby may have difficulty coping with the milk flow/volume. After six weeks, breast milk supply is usually well established. At this time, parents can begin to pump more regularly (if wanted). Many parents like to have extra breastmilk stored in the fridge/freezer, although this is not needed. It is best to start introducing pumping slowly, maybe one pumping session every 1-2 days and gradually increase the frequency if your breasts remain comfortable and baby continues to cope well with the flow of milk.

How do I store my breastmilk?

If baby is not latching well to breast, it is important to express breasts frequently with hand expression/pumping to maintain your milk supply. If this is the case, contact PCIC/PCIL for additional assessment/support.

What flange size should I be using when I pump?

• Flange size varies between all brands. It is important to refer to the manufacturers instructions to determine suitable flange size.
• Needed flange size may vary between breasts and change over time.
• Using an improper flange size can result in decreased milk removal from breast.
• Measure nipple from edge to edge, no extra mms needed-need to reword this

Signs a parent may need a larger flange size:

• Nipple rubs along the tunnel of the flange, even when completely centered.
• Nipple blanches or turns white.
• Nipple does not move freely in the tunnel of the flange.
• Discomfort around nipple and areola even on low suction setting.

Signs a parent may need a smaller flange size:

• Areola is going into the flange and getting hurt, pinched or bruised.
• Nipple bounces in and out of the nipple tunnel of the flange.
• Air seal is difficult to maintain

Does my breastfed baby need a vitamin D supplement?

Yes. Health Canada recommends that exclusively and partially breastfed infants and young children from birth to 24 months receive a daily Vitamin D supplement (400 IU).

What is causing my mood swings?

Your mood swings are directly related to your changing hormone levels. Mood swings are most common during the first trimester (6th‐10th week) and then again in the third trimester.

Is feeling anxious and depressed common during pregnancy?

As many as one in five pregnant people will feel anxious or depressed during pregnancy. Pregnancy is a time when some pregnant people are at greater risk of becoming depressed and/or anxious. Roughly 10 – 19% of pregnant people will have these feelings.

I have a history of anxiety and depression, how will that affect me during pregnancy?

You are at higher risk for experiencing anxiety or depression in pregnancy if you have had  a previous history, previous loss or trauma, family history, pregnancy complications, lack of support, stress, and abuse. If you feel you may be at risk, talk to a healthcare provider for further assessment and/or symptom management.