Milk Supply: Two weeks to Six Months
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By Denise Altman
So you have made it past the first two weeks! Just when you are starting to feel more like your old self after the birth, all of your helpers go back home or to work and you are now solely responsible for this new little person. That can be a little nerve-wracking when it’s your first, but even experienced moms find that readjustment to family life can be a transitional process. Mothers all over struggle with self doubt, especially when the baby has a change in behavior or routine.
One mistake that women make in the postpartum period is to assume the role of perfection. Many feel that by week three they are should to be business as usual with no more need for rest and healing. They also tend to think that they should be problem-free and totally adjusted at this point. The reality is that it took months and months for this baby to get here, and it’s going to take longer than two weeks for the new family to adapt to each other. In addition, the baby herself is going to take tremendous physical and developmental steps over the next six months, including doubling her birth weight and easing away from total dependence. You will be learning a lot during that time, too, so try to relax and enjoy the ride.
The first month
Have you noticed that your baby has gone from a sleepy little warm bundle to an eating machine? Between the second and fourth weeks, those milk supply doubts come up again. Your baby is eating more frequently and may have gone from one breast to both during the feeding. No, your milk isn’t drying up — it’s the first growth spurt! This frequent eating pattern can last from one day to several.
While your baby is going through an accelerated growth pattern, he is also boosting your milk supply. Now is not the time to supplement. Instead, just sit back and let him take care of this stage. This is an excellent reminder for you to take it easy and continue the recovery process. Research and your baby’s actions are both proving that you should not be running around cleaning the house — isn’t science wonderful? Once the growth spurt is over, feeding patterns should level off again.
At the fourth week, milk supply is well established. Mothers notice that their breast tissue seems softer and they don’t have that “full” feeling unless a feeding is delayed. This is normal; your body has become very efficient at producing the milk your baby needs, right when he needs it. This feels a lot more comfortable, once you get used to it!
Beginning month two
The end of the fourth week, provided that there are no latch problems or feeding difficulties, this can be a good time to introduce a bottle. However, taking a bottle is not a necessary developmental stage, so if you prefer not to give one, that is your choice. Heated debate occurs over whether to offer bottles and what kind to use. If your baby develops a specific brand preference, this is a personality issue and not a breastfeeding issue.
All bottles basically require the same sucking mechanism. One thing to look for is an age-appropriate flow with the nipple opening, usually listed on the packaging. Nipples wear out, so be sure to inspect them before use. If they are cracked or clouded, it’s time to throw them away. The clear (silicone) nipples hold up better to repeated washings.
Many breastfeeding books tell you to let Dad or someone else introduce the bottle for the first time. This is pretty good advice. Your baby is smart and knows you have a bigger, better deal than that bottle. She may refuse it if you try, because she wants the breast; it is a reflection of your wonderful nurturing, not your bottlefeeding skills. However, she may also take a bottle right away. Babies vary on this, even in the same family.
To maintain your supply and continue to feed breast milk, you can pump or hand express your milk in place of a breastfeeding. For example, if you know baby is due to feed at noon, pump at 11:30ish and leave your milk at room temperature in the bottle for the baby. That way, you won’t have a problem with engorgement, and your baby still gets your milk. Be sure to remember that this is a new learning opportunity for both of you. Just as he is adjusting to the bottle, your body may take time to adjust to the pump.
During this time, you will also have your postpartum check-up. If you decide to resume birth control, you will need to evaluate which method is best for your situation rather than restarting the same method before you had this baby. Many birth control pills, including the “mini pills,” can reduce your milk supply. Watch your baby for changes in feeding patterns. If you do take a pill, you may want to consider a progesterone-only brand. There are lots of options out there, including natural methods, so evaluate your options.
Beginning month three
At this point, many babies have the capability to sleep through the night, but this varies as much as babies themselves. Sleeping though the night from a researcher’s definition usually means five hours or more — a lot less than most parents’ definition. Sometimes the change is abrupt: the baby just suddenly starts sleeping longer, rarely if ever waking up to feed again. Other times, it’s a gradual process; the baby sleeps for a long period one or two nights, then wakes up to feed a few nights in a row.
Many times, a baby who is sleeping for six hours or more begins by cluster feeding or nursing every hour several hours in a row. This can be alarming for moms who don’t know what is happening, especially if baby hasn’t started sleeping longer yet. Many moms think that because the baby is nursing more frequently, he is unsatisfied and her milk is drying up. However, as long as her supply is well established, she is continuing to exclusively breastfeeding and she hasn’t started any new medications (or nothing else has changed), her supply is fine. In fact, as the point, her supply is very well established and can accommodate this new developmental stage.
The age at which babies begin to sleep for longer periods varies among babies. Each finds her own “right time” to begin this stage.
Four to six months
Your baby starts developing rapidly now: from sitting with assistance to sitting alone, changes in oral development, more nonverbal and verbal communication and interaction, consciously grasping objects and learning to let go. The list is endless.
Beginning around four months, the world becomes an exciting place, leaving Mommy as, well, a little familiar — still very important but easy to put aside for other things. Babies at this stage often have the unsettling habit of twisting their heads around like little owls at the slightest distraction, all while continuing to suck.
Feedings at this stage can really speed up. Your baby may go from gourmet dining in 45 minutes to fast food in 10. This can lead moms to worry about supply again. The supply is still there; your baby has just gotten very efficient at feeding. This is the point where breastfeeding is so much easier and faster than any other method.
In fact, this is probably the easiest time for you. Milk supply is well established, feedings are short and sweet, sleep patterns are usually longer, most of the time you have a good daily routine. You are going out on errands or just for fun, and you may be meeting other mothers and babies in the same life stage. Enjoy it now. Solid foods are coming and mealtime is about to get really … interesting.
View all articles in the milk supply series
© Denise Altman
