Soft breasts: Enough milk?

I have been breastfeeding for eight weeks. I have supplemented with one or two bottles of formula a day. Everything was fine until a couple of days ago. I was engorged because my baby started sleeping seven hours at night. The next day, he refused to nurse all day. He did breastfeed last night and this morning, but my breasts are VERY soft and I do not feel that they are refilling with milk. Is there hope of my milk coming back in?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

I can understand how concerned you must be about your milk supply. Luckily, one or two days with little or no nursing, especially after the first six weeks, should not deal the "death blow" to breastfeeding.

Though I would always recommend expressing your milk (hand-expression or with a breastpump) at regular intervals when your baby is not accepting the breast, once your baby is back at your breast and nursing well, your supply should be returning back to normal within about four days or so.

Though your breasts seem to be soft, that alone does not indicate an insufficient supply. When your baby is at your breast do you hear regular sucking and swallowing? When your milk ejects, or lets-down, a couple of minutes into the feed, it is normal to hear your baby swallowing after each suck or two, with some pauses in between. It sounds like a quiet "ga, ga, ga." You may also notice that your baby has a wiggle at his temples as he sucks and swallows.

To encourage an abundant supply, allow your baby to satisfy both his sucking and his nutritional needs at your breast. I would not recommend using a pacifier at this time. Nurse at least 10 to 12 times a day. Allow your baby to finish the first breast offered, coming off on his own when he is relaxed and satisfied. Some babies are happy nursing at one breast per feed, while others want to nurse at both breasts. Watch your baby, and follow his cues. (If your baby nurses at one breast, you may need to express just enough milk from the "unused" side for comfort. This may be drops, or an ounce or so.)

Does your milk supply at this point seems to be truly compromised, as evidenced by your baby's poor output (typical output for a baby of this age is at least five to six wet diapers a day and regular, substantial bowel movements) or poor weight gain (normally weight gain averages four to eight ounces per week)? If so, you will probably need to supplement with either your expressed milk or formula following a few of his feeds. I would not recommend supplementing after each feed. Allow several feeds each day where he is nursing exclusively.

If you are still having difficulties with a compromised milk supply when you receive this letter, I would highly recommend working along with an IBCLC, as well as your baby's Health Care Provider. It is important to find out the cause of your reduced milk supply and preserve the breastfeeding relationship, while safeguarding the health of your baby. My very best wishes in reestablishing breastfeeding!

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