User:Clayoquot/Low milk supply
Definition
[edit]Most mothers can produce enough milk to provide all the nutrition their baby needs for the first six months, as recommended by the World Health Organization.
Parking Lot
[edit]Definition
[edit]Copious milk production usually begins 48 - 72 hours after delivery, and adjusts to match the demand of the baby, or multiple babies in the case of multiple births.
What is normal milk volume in mL/day?
First days are colostrum. Delayed onset of lactation:
Fatigue is a risk factor for low milk production.[1]
Mothers who express breast milk, but do not directly nurse their baby, usually see milk supply decline after several weeks.[2]
Risk factors for delayed onset of lactation include Caesarean delivery.
- Build supply in the early weeks by activating prolactin receptors
Adequate rest for the mother is essential for successful lactation.[3]
- Infants should be fed on cue. Restricting the length or frequency of feeds to conform to a schedule is associated with low supply.
- Pumped milk volume is not an indicator
- Weighing before and after each feed for 24 hours, in the mother's home, is an accurate way to measure milk intake.[4]
- Delayed onset of lactation
Domperidone is effective in women whose concentration of prolactin is low.[4]
Domperidone has few, if any, side effects.[4]
Fenugreek has been shown to be effective.[4]
Domperidone is preferred over metoclopramide because it does not cross the blood-brain barrier, has less risk of side effects, and less of it passes into breast milk.[5]
- Incidence of actual vs perceived
- Incidence of delayed onset
- More common in first-time mothers
- Use a lactation aid to increase milk transfer and teach the baby how to nurse.
- If medical issues are the cause, address the underlying issues...
- Keep the baby fed with supplementation if necesssary. "Feed the baby" as the first rule of lactation consultants.
Supplementation
[edit]- Tricky because supplementation can make the problem worse
- Appropriate when cause is medical
- Donor milk vs friend vs formula
- How to administer: bottle/syringe/lactation aid. When supplementation is done through a lactation aid at the breast, the baby almost always receives some breast milk from the mother .
- ^ Lawrence, 2016 & p. 352.
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