Breastfeeding – When the Most Natural Feeding Becomes Challenging
Breastfeeding a baby is the most natural way of feeding. As much as we would like to believe that the formula milk is very close to breastmilk and is good enough, the very fact that humans have survived so many thousand years even before formula was found shows how effective breast feeding has been. If you are one of the lucky mothers for whom breastfeeding is going great, then you are blessed. However, there is another population of mothers who struggle to feed their babies. Some say the baby is not latching properly but with some guidance from breastfeeding advisers (in the western world) and grandmothers/experienced mothers (usually in developing world) and over time, one can succeed in making the latching works. There is another category of mothers who want to breast feed but struggle as they do not make enough milk. Every book or website you open will tell you that your body will make enough milk for your baby and that on demand feeding helps your body understand how much is needed. Trust me, it is not everyone’s body that is actually capable of producing enough milk, leave alone excess to pump and store. I am not going to write about the benefits of breastfeeding as there is a lot of literature on it but I thought it will help some if I could share my experience and also present some consolidated information on what you could potentially do to increase milk production.
It is very painful to see your baby cry despite feeding for like an hour. Especially for new mothers, it is not just the physical pain that one has to go through while beginning to breast feed, it is also the agony of not satiating the hungry baby. One would wish all they could do was make enough milk so the baby is full and dozes off. I have been through that pain and can totally empathise. We had to start our little one on formula feed in addition to breast feeding right from day one as he was jaundiced and really needed the food to flush out his system. Once we brought him home, we understood in a couple of days that I was just not making enough and in the months to come I had to cope with the fact that he would be given bottles as well. I was very determined to make breast feeding work for us and had not even thought about ‘what if it was not going well’? We had not bought a pump or even bottle but decided to do so a day after we brought him home. With limited time to explore best options, we went for a manual Philips pump which was okay to start with. I then took advise from breast feeding advisers and soon after that was on an information gathering spree so I could improve milk production. During this phase, I learned that although you may not be aware, women who have some sort of breast surgery, like augmentation or reduction or even fibroids removed (for medical reasons), can potentially have problems with supply. A term that you may want to get familiar with is galactagogue. These are substances that help improve lactation in humans and animals. Based on my experience and information I gathered, I have put together the following information that may help you…
1. The soreness experienced in the first few days of feeding combined with an almost constantly hungry baby can be quite testing. Try not to be put off by it. One could use what are call nipple shields to ease the soreness. These are usually made of silicone and help good latching too. It is also useful for women with small or inverted nipples. Once you and your baby get a hang of breastfeeding, stop using the nipple shield. You need to keep the feeding going in order to increase milk production. Remember it usually is just 24 hours of not feeding that stops milk production
2. Pump as often as possible. As I said earlier, the body learns from the baby how much milk is needed. Try to pump when you get a chance. I say so because, there could be times when you have to complement the feed by giving a bottle to your baby. In such cases, pump to empty your breast so your body does not think baby needs lesser milk. After the first few weeks, the baby’s increases the interval between feeds, pump between feeds as well. I was told that pumping between 2am and 4 am is a good idea as the lactation inducing hormone is at its peak at this time.
3. Try to get a hospital grade pump. Yes it is expensive and I know some do not like it. However, it actually has options of increasing or decreasing suckling just like how a baby does. If you cannot get one, its okay, use a mechanical pump.
4. Try to empty both breasts at each feed.
5. Drink at least two litres of water a day, remember much of the breastmilk is just water and unless you are hydrated you will not make enough
6. Here are some galactagogues that I used and some that I chose not to use as they were very new to me:
a. Fenugreek seeds (called methi in hindi and ‘vendhayam’ in tamil) – I had no idea these would increase milk production and was delighted to learn that. It is quite a common ingredient in Indian cooking so I did not have to worry about taking something new while breast feeding. No point spending money on the capsules available as supplements in shops, instead, I had teaspoon of the seeds three times a day
b. Grains and legumes – oats and barley especially are said to help increase milk production. I would normally have oats porridge (with milk added) in the morning and also boil barley in water until done and drink the water atleast one glass a day. Mung dal gruel is also said to help. Pressure cook mung dal, add milk and jaggery, bring to boil and drink
c. Almonds, cashews and macadamia nuts are said to help milk production
d. Garlic – burn some garlic cloves in the flame or fry crushed garlic cloves in ghee. Add this to warm milk and consume atleast twice a day. They say garlic could thin your blood so do not use with anti-coagulants.
e. Turmeric has anti-inflammatory properties and helps prevent breast infection which could put some off from breast feeding. If you have an Indian diet, chances are you are already getting enough of this wonderful spice, if not about half teaspoon a day is said to be advisable
f. Green papaya is said to be taken as galactagogue across Asia. I did not get a chance to try this myself
g. Spirulina, nutritional yeast and brewer’s yeast, ginger ale are some others recommended by some but I did not get to try these
h. Spices like dill, caraway, fennel seeds are also said to help milk production. I used to chew on some fennel seeds everyday.
i. Green leafy vegetables, carrots, beets and yam are also said to be effective. Also, dudhi (a.k.a sorakai in tamil or lauki in hindi) is said to be effective in increasing milk production. Having plenty of fruits and vegetables will give you the energy and nutrition to make milk.
j. Stinging nettle (also called ‘kuppameni’ in tamil) is another herb I would say that people usually recommend. I bought dried nettle and used to have it as a tea. Just put a heaped spoonful in a cup and add boiling water, cover with lid and allow it to steep for five minutes, drink. It is also rich in iron and a great herb even if not lactating
k. Chaste berry, borage leaf, comfrey leaf, red raspberry leaf, goat’s rue, hops, alfalfa are some herbs that I did not quite use as I had never had them before. The general recommendation is that while pregnant or lactating, try to avoid new ingredients as you may not know how your body will react. However, I believe these herbs are more common in Europe and there are a number of women who seem to report success with these online.
l. Herbal teas – there are a number of readymade preparations that are available in the market. These are usually tea bags containing a number of herbs usually called out on the label. I used a tea by Yogi and it was meant to increase breast milk production. It contained blessed thistle in addition to nettle. In general they say that the concentration of herbs is very small in teas for them to cause any side effects, but it is up to the individual. I preferred to be safe than sorry
m. In ayurveda, shatavari and ashwagandha are two herbs suggested for breast feeding in addition to some other ingredients like almonds etc. I had a capsule called Lactare, available from pharmacies in India, one capsule a day. Doctors in Indian suggest that it is most effective if started soon after birth but I only started taking it later. Shatavari seems to be available as a supplement in health food shops too. I had a chance to have shatavari, available in powder form from ayurvedic shops and even online from the day my second baby was born and I have seen it to be very effective. I think taking the herb in powder form was more effective than the capsule.
n. I also used to take what was called Mother’s Horlicks, specially prepared for mothers to be and lactating mothers. Reason I took it was because it has malted barley in addition to fortified vitamins and malted barley also, I read, helps milk production.
o. Good quality fat such as butter and ghee are also said to be important for lactating mothers. Some recommend coconut oil and coconut milk.
7. Protein rich diet is important to make milk. Increase quantity of eggs, meat if you eat them, legumes, beans and pulses. Have a lot of complex carbohydrate like whole grains rather than simple carbohydrates. The former include brown rice, whole wheat etc. Having a well balanced diet is important anytime, especially while lactating
8. Getting some rest – if you are lucky enough to get some help, try to take it so you can get some rest. One has to come to terms with the fact that some feeds will be bottle feed and you could have your partner or grandparents give the bottle while you get some rest. A well nourished and rested mother produces more milk
I have tried to list as many options as possible. You may have seen that I did not try just one but many of these in parallel. I was also given a prescription for domperidone but chose not to use it due to fear of side effects. On the contrary most other herbal galactagogues mentioned were familiar to me and I chose to use them. It may be a while before ou accept that your baby is not exclusively breast fed but that’s okay. Try your best to feed as much as possible and when you make very little, just think of it as a preventive medicine because even the little milk has anti-bodies that keep your wee one healthy and strong. Try to make the most of growth spurts as that is their way of telling your body to make more milk. It can be quite difficult, but at least pump more during these times. As a typical Indian diet usually includes most condiments, grains, spices and legumes mentioned, I embraced those. If you chose to try other herbs mentioned, try one new herb at a time so you are sure to see if you suffer from any side effects. Give yourself credit for trying so hard to feed your baby and I wish you the best!