BREASTFEEDING ( DEMAND & SUPPLY)

 source of article: http://kidshealth.org/parent/growth/feeding/breastfeed_supply.html#cat20573

Whether you're a new mom or a seasoned parenting pro,breastfeeding often comes with its fair share of questions. Here are answers to some common questions that mothers — new and veteran — may have.

How can I increase my milk supply?

Your milk supply is determined by the stimulation that your baby provides while nursing. In other words, the more you breastfeed, the more milk your body produces. So, if you seem to be producing less milk than usual, you should try to feed your baby more often. You also can  pump after nursing to help stimulate more milk production.

Stress, illness, and some medications can temporarily decrease your supply. Drinking water to satisfy your thirst and eating good, nutritious food can help. But also try to take some time for yourself each day, even if it's only for 15-30 minutes.

If your baby is less than 6 months old and you're away from your little one for long stretches during the day (for instance, at work), you should pump or hand express every 3 hours to maintain your supply. Your freshly pumped breast milk can stay at room temperature for 6-10 hours, or in the refrigerator for up to 8 days. When keeping it in the refrigerator, never store it on the shelves in the door.

If the milk is not going to be used within 8 days, you can store it in the freezer for 6-12 months. Put it in the freezer compartment of a refrigerator that has a separate suction-sealed door or in a deep freezer.

If your milk supply still seems low and you're concerned, you may want to talk to your doctor, your pediatrician, or a lactation consultant.

If I wait to nurse, will my milk supply increase?

Actually, no — it's the opposite. Waiting too long to nurse or pump can slowly reduce your milk supply. The more you delay nursing or pumping, the less milk your body will produce because the overfilled breast sends the signal that you must need less milk.

Once babies are back to their birth weight, they can sleep for longer stretches at night and will gradually lengthen the time between nighttime feedings. Letting your baby sleep for longer periods during the night won't hurt your breastfeeding efforts. Your baby is able to take more during feedings and that, in turn, will have him or her sleeping longer between nighttime feedings. Your body will adjust to the longer spacing.

Some moms wake during the night with full breasts and a sleeping baby. If that happens to you, pump for comfort and to help your body adjust to your little one's new schedule at night.

The interval for daytime feedings usually stays between 1 and 3 hours for the first few months and then may lengthen to 4 hours or so. Cutting back on feedings during the day can lead to a decreased milk supply over time.

If you follow your baby's cues and spread out the feedings as he or she wishes, your milk supply should remain at what your baby needs.

I'm producing too much milk. What can I do?

Whereas some women may feel like they don't have enough milk, others may feel like they're making too much. Some mothers' bodies just produce more milk than their babies need. Others overstimulate their breasts by pumping or expressing milk between feedings. If expressing or pumping to relieve discomfort, remove just enough to feel comfortable but don't empty the breast.

Alternate the breast that you start each feeding with. Let the baby stay at the first breast until either the breast is very soft or the baby is full. If the baby is not satisfied with the first breast, then offer the second breast.

A mom may try nursing on one breast only during a feeding to help to lessen her milk supply. Over time, you should notice your milk supply and "let-down" (the milk ejection reflex) become easier to handle.

Sometimes a woman's let-down is really strong and causes the baby to gag and pull off of the breast. If your baby is staying on the breast and handling the flow of milk, you don't need to do anything. If the baby is pulling off and coughing, then you can sit your baby up in a seated burp position. Pat your baby's back to help him or her regain composure. You can use a burp cloth pressed into the breast to help slow the flow, then latch your baby back onto your breast when ready to resume feeding.

Nursing your baby in a more upright position (head above the breast) also may decrease the force of the let-down. A side lying position also might help slow the flow of milk.

My baby favors just one breast. Is this OK?

Some babies might prefer one breast over the other. If this happens, to keep up your milk supply in both breasts (and prevent painful engorgement), alternate breasts and keep your baby on the first breast until it's soft, then move your baby to the second breast. This ensures that your little one gets the hindmilk, which is creamier and contains more calories than the foremilk, which comes at the beginning of a feeding.

Some babies will always take the second breast and some will be satisfied with just the first breast. At the end of the feeding, if both breasts are comfortable, you don't need to pump. But if either breast is still full and uncomfortable, pump or hand express to comfort.

Of course, if your baby won't latch onto one of your breasts, pump or hand express that breast to maintain its milk supply until your little one is latching onto both breasts easily.

Reviewed by: Joseph DiSanto, MD, and Karin Y. DiSanto, IBCLC
Date reviewed: January 2012