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Breastfeeding – When the Most Natural Feeding Becomes Challenging
Breastfeeding a baby is the most natural way to eat. As much as we would like to think that breast milk is very close to mother’s milk and is good enough, the very fact that humans survived for so many thousands of years before formula was found shows how effective breastfeeding 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 doesn’t latch properly, but with some guidance from lactation consultants (in the western world) and grandmothers/experienced mothers (usually in the developing world) and over time, the latch can work. There is another category of mothers who want to breastfeed but struggle as they are not making enough milk. Every book or website you open will tell you that your body will make enough milk for your baby and that feeding on demand helps your body understand how much is needed. Believe me, not everyone’s body is actually able to produce enough milk, let the excess 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 would help some if I could share my experience and also present some consolidated information on what you can potentially do for to increase milk production.
It is very painful to see your baby cry even if he has been eating for an hour. Especially for new moms, it’s not just the physical pain you have to go through while starting to breastfeed, it’s also the pain of not feeding the hungry baby. You wish all they could do was make enough milk so that the child is full and dozes off. I have been through that pain and can totally feel it. We had to start our little one on formula in addition to breastfeeding right from day one as he was jaundiced and really needed the food to flush out his system. When we brought him home we realized within a few days that I just wasn’t making enough and for the next few months I had to deal with the fact that he would be getting bottles too. I was very determined to make breastfeeding work for us and hadn’t even considered ‘what if it didn’t go well’? We hadn’t bought a pump or even a bottle, but decided to do so the day after we brought him home. With limited time to explore the best options, we went with a Philips manual pump, which was okay to start with. Then I got advice from lactation consultants and soon after I was on information gathering so that I could improve milk production. During this phase, I learned that although you may not realize it, women who have some type of breast surgery, such as augmentation or reduction, or even removed fibroids (for medical reasons), can potentially have supply issues. A term that you may want to become familiar with is galactagogue. These are substances that help improve lactation in humans and animals. Based on my experience and information I have gathered, I have put together the following information to 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 let that put you off. You could use what are called nipple shields to relieve the soreness. These are usually made of silicone and also help a good lock. It is also helpful for women with small or inverted nipples. Once you and your baby have mastered breastfeeding, stop using the nipple shield. You need to keep feeding going to increase milk production. Remember that it is usually only 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 it needs. Try pumping when you get a chance. I say this because there may be times when you need to supplement the feed by giving your baby a bottle. In such cases, you need to pump to empty your breast so that your body does not think that baby needs less milk. After the first few weeks, the baby increases the interval between feedings, and also pumps between feedings. I was told that it is a good idea to pump between 02.00 and 04.00 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 people don’t like it. But it actually has the ability to increase or decrease breastfeeding just like how a baby does. If you can’t get one, that’s okay, use a mechanical pump.
4. Try to empty both breasts at each feeding.
5. Drink at least two liters of water a day, remember a lot of breast milk is just water and unless you are hydrated you won’t 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:
one. Fenugreek seeds (called methi in Hindi and ‘vendhayam’ in Tamil) – I had no idea that these would increase milk production and was happy to find out. It’s quite a common ingredient in Indian cooking, so I didn’t have to worry about taking anything new while breastfeeding. No point in spending money on the capsules available as food supplements in stores, instead I got a teaspoon of seeds three times a day
b. Grains and legumes – especially oats and barley are said to help increase milk production. I would usually have oatmeal (with milk added) in the morning and also boil barley in water until done and drink the water at least one glass a day. Mung dal gruel is also said to help. Pressure cook mung dal, add milk and jaggery, bring to a 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 eat at least twice a day. They say garlic can thin your blood so don’t use with anticoagulants.
e. Turmeric has anti-inflammatory properties and helps prevent breast infection, which can deter some from breastfeeding. If you’re on an Indian diet, chances are you’re already getting enough of this wonderful spice, if not about half a teaspoon a day is said to be advisable
f. Green papaya is said to be taken as a galactagogue throughout Asia. I didn’t get a chance to try this myself
g. Spirulina, nutritional yeast and brewer’s yeast, ginger beer are some others recommended by some, but I didn’t get to try these
h. Spices like dill, cumin, fennel seeds are also said to help milk production. I used to chew on some fennel seeds every day.
I. Green leafy vegetables, carrots, beets and yams are also said to be effective. Dudhi (aka sorakai in Tamil or lauki in Hindi) is also said to be effective in increasing milk production. Having plenty of fruits and vegetables will give you the energy and nutrients 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 a lid and let it steep for five minutes, drink. It’s also rich in iron and a great herb even if you’re not breastfeeding
k. Chaste berry, borage leaf, comfrey leaf, red raspberry leaf, rutabaga, hops, alfalfa are some herbs that I didn’t quite use as I had never had them before. The general recommendation is that while you are pregnant or breastfeeding, 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 be reporting success with these online.
l. Herbal tea – there are a number of ready-made preparations available in the market. These are usually tea bags that contain a variety of herbs that are usually called out on the label. I used a tea from Yogi and it was meant to increase the production of breast milk. It contained blessed thistle in addition to nettle. In general, they say that the concentration of herbs in tea is very small for them to cause side effects, but it is up to the individual. I’d rather be safe than sorry
m. In ayurveda, shatavari and ashwagandha are two herbs suggested for breastfeeding 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 India suggest it is most effective if started soon after birth, but I didn’t start taking it until later. Shatavari also seems to be available as a supplement in health food stores. I had a chance to get shatavari, available in powder form from ayurvedic stores and even online from the day my second baby was born and I have seen it to be very effective. I think that 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 nursing mothers. The reason I took it was because it has malted barley in addition to fortified vitamins, and malted barley, I read, also helps milk production.
o. Good quality fats like butter and ghee are also said to be important for nursing mothers. Some recommend coconut oil and coconut milk.
7. Protein-rich diet is important for making milk. Increase the amount of eggs, meat if you eat them, legumes, beans and pulses. Have a lot of complex carbohydrates like whole grains instead of simple carbohydrates. The former include brown rice, whole wheat, etc. Having a well-balanced diet is important at any time, especially when breastfeeding
8. Get some rest – if you are lucky enough to get some help, try to take it so you can get some rest. You have to accept that some feeds will be bottle fed 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 tried not just one, but many of these side by side. I was also prescribed domperidone but chose not to use it due to fear of side effects. On the contrary, most of the other mentioned herbal galactagogues were familiar to me and I chose to use them. It may take a while for you to accept that your baby is not exclusively breastfed, but that’s okay. Try your best to feed as much as possible and when you do very little, just think of it as preventative medicine because even that little milk has antibodies that keep your little one healthy and strong. Try to make the most of the growth as it is their way of telling your body to make more milk. It can be quite difficult, but at least pump more during these times. Since a typical Indian diet usually contains most of the spices, grains, spices and pulses mentioned, I embraced them. If you chose to try other herbs listed, try one new herb at a time to be 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 all the best!
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