I gave birth to my daughter Olive at home in October 2012. It was an exhausting experience — I went into labor on a Monday (right at the 42 week mark) and gave birth to her in the early hours of the morning that Friday. She was nearly 9 1/2 pounds! I was in (unmedicated) labor nearly four days! Imagine little to no eating and sleeping during that time. My mind and body were beyond spent and I literally felt like I had nothing more to give. But of course, I had to “give” more because I was handed over a baby to care for, love, and be her sole source of food.
A few days after my daughter was born and my milk came in, my supply dropped dramatically. Miraculously, Olive had actually only ever lost 2 ounces and then went on to gain weight her first week of life (which is rare for breastfed babies — they typically lose several ounces of weight the first week or so before they start putting weight back on). But one day, she was wanting to nurse and root all day and night long, couldn’t be separated from my breast, and was crying out of sheer frustration. It was the most horrible feeling for both of us.
The labor had been so intense that my body shut down and went into what felt like a healing phase, and instead of having enough milk for my daughter, my supply became very low. We were referred to a Certified Lactation Consultant who weighed my daughter before and after feedings to determine just how much milk she was transferring (not much at the time). To make up for what I was unable to provide her, we were able to supplement with donor milk from other women we knew who also had young babies.
Though our midwife had tested my thyroid levels through out the pregnancy (at my request) to ensure there were never any problems (there weren’t), we also tested my thyroid levels postpartum to make sure that my Hashimoto’s Disease was still in remission and that the stressful labor had not induced any thyroid problems. My thyroid disease was still in remission, which was good to hear, but didn’t give us any clues as to what specifically could be causing the lactation problems.
This trying experience allowed me to learn quite a bit about lactation, galactagogues (those substances that increase milk supply), and general tips and tricks for successful breastfeeding. Because so many of my clients are women who are wanting to get pregnant and prepare for a successful pregnancy, this is a pertinent topic!
Thyroid disease (and other hormonal problems) and autoimmunity can certainly take a toll on conception, pregnancy, and breastfeeding, which is why having an arsenal of options and knowledge is so important. The following tips aren’t 100% fool proof, but they do help so many women to successfully breastfeed. Ultimately, you’ll need to address the underlying causes of the thyroid or autoimmune disease to achieve optimal health and lactation. But thankfully, with time they also helped me to successfully nurse my daughter — at 6 weeks old, we were able to stop using donor milk and I was able to exclusively breastfeed her, have her gain healthy weight, enjoy our new life together, and even begin donating milk to other moms in need. I ended up nursing her for 2.5 years.
- Galactagogues are your friend. Galactagogues are substances that increase milk supply. Well-known galactagogues include: fennel, fenugreek, blessed thistle, alfalfa, nettle, Goat’s rue, marshmallow root, and red raspberry leaf. Many women are advised to take just one from this list (usually in tea or supplement form). However, I did not want to put all of my eggs in one basket, so to speak, so I took many at once. You will need to check with your lactation consultant about which will be best for you. I also found that tea was not the best source of galactagogues for my situation. If you think about it, herbal teas can be great because they are encouraging you to drink water (which you need to produce milk), but they don’t seem very concentrated. I took tinctures with great results (Mother Love carries several, as well as Maxi Milk). I also bought fenugreek and fennel seeds and ground them in my spice grinder, and then took a few teaspoons of that powder daily. I also cooked with fennel seeds on a weekly basis. I tried to get the most potent sources of galactagogues in my system. I took these every few hours through out the day. After about 3 months, I was able to stop using these altogether. Though if you need them, you can continue to take them. (Note that fenugreek is related to the peanut, and is therefore considered goitrogenic).
- Avoid anti-lactogenic herbs. These are substances that are known to decrease milk supply (which is great for when you’re trying to wean a child, but not so great when you need to increase supply). Avoid parsley, mint, and sage. Cabbage is also sometimes considered anti-lactogenic. I noticed decreases in milk supply any time I over-indulged in mint chutney at our favorite Indian restaurant! Others include: rosemary, thyme, and lemonbalm. Be sure to check all sources of exposure — toothpaste, shampoo, lotions, aromatherapy, etc — not just the foods you’re eating.
- Add electrolytes. Our lactation consultant mentioned that some women have anecdotally observed that electrolyte water helps to increase their supply. After drinking myself up to my neck in electrolyte water I got from Whole Foods, I had a thought: just what is in this water that I could be taking more potent doses of? The answer of course was potassium, calcium, and magnesium. I began using a magnesium oil spray with great results — this seemed to increase my supply way beyond what herbs alone could. Magnesium is also a supplement I typically recommend to my clients and I knew that stressful situations can induce magnesium deficiency (hello labor and delivery!).
- Enjoy lactation cookies. You don’t need a better excuse to eat cookies than breastfeeding. Lactation cookies actually seem to work very well for many women. They include a mixture of galactagogues (in food form) that usually do the trick. The magical food combination usually includes oats, flax seeds, and brewer’s yeast. While these three ingredients aren’t generally the best for thyroid and autoimmune disease, they do help with lactation, which gives them the green light in my book. I’ve made these gluten-free by buying gluten-free oats and brewer’s yeast. However, one thing I teach my clients is that proper preparation of grains is essential to thyroid and immune health. So, simply pouring oats out of a bag and baking them in cookies is not a good idea. But in the case of lactation cookies, I find that soaking oats ahead of time reduces the galactagogue properties. Therefore, if you are in a dire situation and really need these cookies, just bake them without soaking the oats. Also, many recipes call for peanut butter (which is yeasty and goitrogenic), so feel free to use another nut butter in its place.
- Invest in a breast pump. I had no idea I would need an electric high-powered breast pump. I just though having a manual pump would be a good idea in the event that I needed to leave my daughter for a few hours and needed to have someone feed her milk from a bottle. However, renting, and then buying a breast pump was a life-saver! The more stimulation you receive, the more milk your body is told to make. The idea that your breasts need time to “fill” with milk before you can feed the baby is false. Your body manufactures milk according to “request”. Therefore, to increase your supply, nurse your baby and pump several times throughout the day. The more demand, the more supply. A lactation consultant can prescribe how much pumping per day is right for your situation and also give other guidance (like flange size, pump brand, etc.). Also do not mistake the amount of milk you pump for how much milk your baby is transferring while nursing. No pump can ever replicate the sucking action of a baby and therefore, many women do not get the same amount of milk as their nursing baby receives. Some women barely respond to a pump at all.
- Nurse as often as baby wants to. Scheduling feedings for your baby is counterproductive to a high breast milk supply. This goes back to demand and supply. If your baby is hungry every hour-and-a-half but you won’t allow him to feed until every 2 or 3 hours, you will be decreasing the demand for your milk and therefore decreasing your supply. Also, not all babies are hungry every 2-3 hours. Some babies (many babies when allowed, I suspect) will nurse as often as every 45 minutes or so in the first weeks even if the mother’s milk supply is adequate. There were some days after my milk supply became stable that I was literally nursing my daughter every hour. I felt okay about this because we had worked with a lactation consultant who measured how much milk she was transferring and while I knew she was getting enough, I also knew that if she was hungry, I was going to feed her and not limit her intake at all. This nursing on demand increased my supply and kept her happy and healthy.
- Don’t try to get baby to sleep through the night. Sleep training is right for some families, but in the early months, it can sabotage breastfeeding. This goes right back to demand and supply. If you don’t let baby nurse for hours on end, your body will think it doesn’t need to manufacture so much milk. Now that my daughter is a little over 6 months old, I can say with certainty that I have been her on-call everything for the last 6 months, but it gets better! This is a short phase in your child’s life and while your needs and health are important, realizing that being on-call for your child, especially for feedings, is biologically normal, helps us cope. At first, I got very little sleep but as my daughter has gotten older, she has naturally fell into better and longer sleep cycles and requires less frequent nursing. But waking up every hour or two or three to feed baby those first few months of life helps establish a milk supply. I would also suggest co-sleeping to make those nighttime feedings easier on both of you.
- See a Certified Lactation Consultant. This person will be able to determine just how much milk your baby is receiving at the breast (via a very sensitive scale). But they will also be able to identify any other potential problems that are common (and that I haven’t mentioned here): tongue tie, lip tie, forceful letdown, delayed letdown, shallow latch, etc and etc. This person should never push formula on you, but should instead offer solutions for your situation. Beware of LCs who are slow to offer support and ideas and are quick to just suggest formula as a “solution” to the problem.
- Get real information, don’t believe misconceptions. Resources like KellyMom.com are great places to commiserate with other nursing moms and get solid information on biological norms for breastfeeding. Don’t allow friends or family to pressure you into giving up with comments like, “he’s nursing again?”, “that’s all you pumped?”, “if you gave him formula, he would sleep through the night”, “you don’t have to breastfeed to be a good mom”, “breastfeeding is gross”, etc.
- Relax. I feel like my biggest challenge in successful breastfeeding was being able to relax. My labor was very tiring and feeling like I couldn’t properly feed my baby was traumatic. I had a very difficult time relaxing and enjoying those first few weeks. I had to get a change of scenery (leave the house!), spend time with other people (other moms who had babies around the same time, friends, family who came to help), and do things that I enjoyed (listening to music, watching something funny on TV, talking about something other than breastfeeding, etc.). Stress hormones will wreak havoc on your nursing relationship. De-stressing is essential!
- Don’t forget that breastfeeding isn’t all-or-nothing! If you and your care provider/LC come to the conclusion that your baby needs supplementation due to low supply, do not panic. Do not feel like a failure. Breastfeeding does not have to be all-or-nothing. If your baby gets several bottles of donor milk or formula everyday but still gets even a tiny amount of breast milk from you, it is worth it. The immunological properties and emotional connection your baby receives will make all of the effort worth it. You can still nurse even if you cannot provide your baby with 100% of its nourishment. Any amount you can provide is a blessing.
- Look into donor milk if you cannot exclusively breastfeed. We used donor milk for the first few weeks of my daughter’s life while my body healed from my intense labor. Do not be afraid to rely on donor milk if you cannot meet your baby’s food needs at the moment. Donor milk is a wonderful and healthy alternative to formula. If you don’t know anyone personally who is able to donate, see resources like Eats on Feets and Human Milk 4 Human Babies (check their Facebook pages for local chapters and locals offering donor milk in your area!). It may seem risky or strange at first — to accept milk from a person you may not know — but there is alot of trust and integrity in the milk donation community. Women who donate are generally very proud of the fact that they do so and are willing to explain their health history (any possible health concerns), medication use, and food intake, with great transparency. Offering milk bags to your donor mom is always a nice touch too.
- Remember that breastfeeding is natural but it doesn’t always come naturally. This will save you lots of frustration and tears as bumps in the road may appear. Think of them as things to work through and that usually there is always a solution. This way, your nursing relationship won’t come to an end at the slightest problem.