Milk Supply and Intake: The First Six Months

By: Denise Altman Milk Supply

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 should 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 to parenthood at this point. The reality is that it took months and months for this baby to get here, it’s going to take longer than a few 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. The baby is eating more frequently and may have gone from one breast to both during a 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 the baby is going through an accelerated growth pattern, he is also boosting up 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, frequent feedings 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, the body has become very efficient at producing the milk the baby needs, right when he needs it. This feels a lot more comfortable, once you get used to it!

Beginning Month Two

By the end of the fourth week, provided that there are no latch problems or feeding difficulties, if you want to introduce a bottle this can be a good time. 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 when to offer bottles and what kind to use. However, if your baby develops a specific brand preference, it is a personality type, 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 will hold up better with 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 bottle feeding 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 breastmilk, you can pump or handexpress 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 the baby still gets your milk. Be sure to remember that this is a new learning opportunity for both of you, just like 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 your pregnancy. Many birth control pills, including the “mini pills” can potentially 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 take the time to decide what is best for you.

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 through the night from researcher’s definition usually means five hours or more; which can be a lot less than the parent 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.

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, that he is unsatisfied because her milk is drying up. However, as long as her supply is well established, she is continuing to exclusively breastfeed, and she hasn’t started any new medications (or nothing else has changed), her supply is fine. In fact, at this point, her supply is very well established and can accommodate this new developmental stage. However, when they sleep longer varies among babies. Each finds their own “right time” to begin this stage.

Four to Six Months

Your baby starts developing rapidly now; 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. This leaves mommy, well, a little familiar-still very important, but easy to put aside for other things. They often have the unsettling habit of twisting their head around like a little owl at the slightest distraction, while continuing to suck. At this stage, feedings can really speed up. Your baby may go from gourmet dining in 45 minutes to fast food in ten. This can lead moms to worry about supply again. The supply is still there, the baby is just now very efficient at nursing. This is the point where breastfeeding is 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, and 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.

Denise Altman is a private practice lactation consultant in Columbia, South Carolina. She has also written two books for lactation professionals, available through Hale Publishing and enjoys presenting at conferences and workshops. She can be found at and on Twitter: @feedyourbaby




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