Building a bumper milk supply – the early days
One of the biggest hurdles to breastfeeding with a cleft lip and/or palate, apart from finding support and information, is keeping up with supply. Having a baby with a cleft pushes our milk producing capacities to the limit. Breastfeeding a baby with a cleft lip presents many challenges right through the early months up to cleft repair (early weeks or months or not until one year or beyond – depending on the type of cleft and timing of surgery).
Getting breast milk supply off to a good start means there is one less hurdle to face in the months leading up to lip and palate repair. However the baby is breastfed, whether at the breast, or via expressed breast milk, many mothers recount that their supply has dwindled at various times during the early months for various reasons, especially in proximity to their baby’s surgery, during periods of stress and anxiety, and due to the complications of doctor’s visits and travelling while pumping.
One of the best ways to face the pressures on supply in the early months, is to get off to an optimal start.
A few pointers;
- Expressing colostrum in late pregnancy is thought to help later milk production - although this is not scientifically validated (1). Colostrum collected during pregnancy can be helpful for supplementing in the early days (2). Care should be to be taken so that having colostrum available for supplementing does not influence the frequency of breast milk expression post-partum. The priority should still be to express fresh colostrum for the newborn and increase supply rapidly towards full production.
- Baby should nurse within first hour (and continue to nurse on demand), or begin hand expression (and at least every three hours after that). Skin to skin contact has been shown to help increase milk volume (1).
- If baby is not latching well then hand expression is believed to get more milk out than breast pump in the first 48 hours (1) Colostrum can be expressed directly into a plastic spoon which can then be used to feed the baby.
- According to the authors of Making More Milk (1), “one of the difficulties of low milk production is that milk ejection is often less effective when it has less volume to work with, so milk may not be completely drained by the baby or a pump” and suggests that breast massage (and/or breast compressions – described in depth) both before and during feeding and/or pumping to get the most milk out of the breast.
If you have any further tips for building a bumper milk supply in the early days, please leave a message in the comments,
1. The Breastfeeding Mother’s Guide to Making More Milk: Foreword by Martha Sears, RN, authors D. West, L. Marasco
2. Expressing Milk Before Birth: A Tool for Use in Special Circumstances, By Deanna M. Soper, PhD