Breastfeeding Misconceptions: Does Baby Weight Loss Mean Mom Doesn’t Have Enough Milk?

How many times have you heard a so-called ‘fact’ from a family member, friend, healthcare professional, or online resource that has your ‘mama-radar’ going off at warp speed?  Maybe something just doesn’t sound right.  Maybe it goes against all of your mama-bear instincts.  Maybe it is completely contradictory to what you heard the previous day.  Well, it’s time to start busting those myths and misconceptions! 

Today, we start our new series called Breastfeeding Misconceptions. 

Every month we will be BUSTING common breastfeeding myths and misconceptions, hopefully making your breastfeeding experience that much easier!

 

Myth #1: If your baby loses weight in the first week, it means your milk supply is low. 

Not true!

 

All babies lose weight after birth:

A newborn baby takes in approximately 5-7ml of colostrum per feeding in the first 24 hours.  Babies are burning more calories than that as they attempt to breastfeed and expel that sticky, gooey meconium.  Nature has provided the perfect amount of colostrum in those first few days to nourish your baby and while the quantity is small, the quality is jam-packed with every calorie, immunological property, protein, vitamin, and laxative that your newborn needs to poop and pee.  Babies are expected to lose weight in those first few days.  That doesn’t mean that mom’s supply is low.

 

Babies typically lose weight until mom’s ‘fuller milk’ comes in:

The amount of colostrum continues to grow as your milk transitions to ‘fuller milk’, which comes in around 2-5 days (depending on baby’s access to breast, effective sucking, birth interventions, etc.)  Typical colostrum amounts are about 5-7 ml per feeding in first 24 hours, 7-15ml per feeding from 24-48 hours, and 22-27ml per feeding from 48-72 hours.  Your baby will most likely lose weight until your ‘fuller milk’ comes in, but that doesn’t necessarily mean that you don’t have enough milk.  What parents want to look for is that their baby is peeing and pooping (at least 1 of each per day of life) and baby’s weight loss plateaus once mom’s fuller milk has come in. 

Here’s a great graphic of a baby’s stomach from Babies First Lactation and Education

babiesfirstlactation.jpg

Delayed milk supply doesn’t equal low milk supply:

There are several situations where a mother is at a higher risk for a delayed milk supply.  As mentioned in this Best for Babes article, there are a number of factors that increase a mother’s risk for delayed milk supply.  Some are beyond our control (or difficult to control): diabetes, obesity, thyroid problems, hypertension, PCOS, preterm birth, and anemia.  There are also factors related to birth that can influence when a mother’s fuller supply comes in: cesarean birth, receiving lots of IV fluids, prolonged pushing stage, stress, cascade of interventions, hemorrhaging, mother-baby separation, just to name a few.  If you are at a higher risk for having a delayed milk supply, it can be very helpful to speak with a lactation consultant within the first 24 hours after your baby is born.  She can teach you ways to hand express and pump to help speed up the process of your fuller milk coming in, thereby DECREASING your risk for a low milk supply.

 

Lots of fluid during labor can cause greater weight loss in babies:

Studies have shown that mothers who have long periods of birth interventions (epidural, Pitocin, eventual emergency cesarean, etc.), tend to have more fluids during labor, thereby inflating baby’s birth weight and causing a large drop in baby’s weight in the first 24 hours.   In those first 24 hours, we are looking for 1 pee and 1 stool (as a minimum.)  For those babies that pee and stool multiple times in the first 24 hours, their weight loss is going to be greater, but that is not an indicator that mom’s supply is low. It just means they had a lot of fluids to expel after birth.  Here are a few articles that explain this phenomenon. Dr. Jen: Newborn Weight and The Boob Group: Birth Interventions and Their Impact on Breastfeeding.  

 

Baby may lose weight (or gain weight really slowly) because they are having a difficult time transferring mom’s milk:

There are many reasons why a baby might lose weight, sometimes continuing past the first week of life, even when mom has a full supply.  Some of these include: engorgement (causing baby to have difficulties latching on), tongue-tie or lip tie, baby is recuperating after a difficult labor, baby is jaundiced, premature baby, etc.  Again, when baby is losing weight due to these situations, it doesn’t always mean that mom’s supply is low. If her baby is having a difficult time transferring milk, then she should definitely meet with a lactation consultant to make sure she is doing everything she can to protect her milk supply until her baby can start to efficiently transfer milk from her breast.

 

Supplementation doesn’t equal formula:

If your milk supply is delayed, if your baby has elevated bilirubin, if your baby has lost more than 10% of his/her birth weight, that doesn’t automatically equal FORMULA supplementation.  Mom may actually have enough of her own milk to supplement her baby with until baby’s weight is back on track.  All she has to do is hand express or pump and see what extra she has.  If mom doesn’t have enough of her own milk to supplement, then the hand expression or pumping (in addition to breastfeeding) will help to bring in her milk supply more fully.  In the meantime, moms have other options.  A mom can use milk bank breast milk or donor milk, if she prefers.  For terrific information about milk banks, check out Human Milk Banking Association of North America and for milk sharing, check out Eats on Feets.  The most important take away of this all…. When supplementation is necessary, it is imperative for a mom to increase her breast stimulation to help bring in her supply more fully.  When her baby is getting a supplementation from another source, it is saying to mom’s body that she doesn’t have to make that amount of milk, which is totally not the case.  The sooner mom’s fuller milk comes in, the sooner supplementation can decrease, so spend the extra time and effort… it will be worth it in the end.

 

Important note: When you might become concerned about your milk supply

While all of the above statements should illustrate why a mother should not be told that she has a low milk supply early on, there are some situations that might indicate that mom has a low milk supply (either temporarily or more long term.)  If you are experiencing any of these situations, please connect with an IBCLC as soon as possible, as sometimes this can be a very temporary situation, as long as measures are taken quickly to protect mom’s milk supply.  Here are some indicators that mom’s supply might be low:

  • Breasts did not grow and/or areola didn’t get darker during pregnancy

  • Breasts don’t feel heavier or fuller by 5-7 days postpartum

  • Fuller milk hasn’t ‘come in’ by 5-7 days postpartum

  • Baby is continuing to need supplementation to gain weight and mom is not making enough to supplement with her own milk

  • Mom has insufficient glandular tissue