My friend told me a story about when she was pregnant and her milk suddenly showed up unexpectedly. She was out to lunch with her husband and mother-in-law when she suddenly realized everyone was staring at her chest.  She looked down and was horrified to see that her breasts were leaking milk right through her shirt and everyone at the table was watching, wide-eyed.  Without warning, her mother-in-law burst into tears of happiness, announcing to the whole restaurant that her soon-to-be-born grandchild would indeed have milk to drink.  My friend was a little horrified, but at the same time was glad to know that she wasn’t going to have any problems with her milk.

My milk didn’t show up until after my baby was born, but I did have some warning signs that it was on its way. My breasts getting bigger was the first sign, but I think it was when I was around seven months pregnant that I started feeling soreness in my breasts that I had never felt before. It wasn’t necessarily painful, but it felt like something was going on. Changes were happening, and I was happy at the prospect of the milk getting ready to make its appearance.

When I was closer to my due date I noticed what looked like dried colostrum on my nipples. There wasn’t a lot of it and it wasn’t bothersome, but I was really happy when I noticed it. I think I was afraid that my milk might not ever show up and I wouldn’t be able to nurse my baby, but seeing this let me know that it was on its way.

I never did have a moment when any milk dripped out before I had my baby. Believe me, though, when I say that it didn’t take long after labor until suddenly my breasts were huge and I had more than enough milk available. If I hadn’t been looking for the signs beforehand then I may not have noticed all the changes my breasts were going through. For this reason, I urge you to not panic if you don’t notice any huge changes to your breasts indicative of milk on the way.

After all, if you’re anything like me you’ll have plenty of opportunities after the baby is born to have your milk leak while at a restaurant with in-laws.

Over the last weeks there has been talk about ways to increase milk supply.

Most recently, Mrs. H. has had to tackle this issue, that many breast feeding mamas face. I too, was there when my son was 6 months old and had started solids, but was not ready yet to wean.

There has also been discussion about using Fenugreek, which is a galactogogue?an herb or prescription drug used to increase milk supply. While they do have their place, and work for some women, there are ways to increase milk supply without them. Galactogogues should also not be taken without first consulting your doctor, midwife or other health care practitioner who is completely familiar with your medical history, as should be done with any advice given that affects your or your child’s health.

As a breast-feeding mama, who was concerned that my milk supply was decreasing, I learned that I had to go back to the basics and take a new approach breastfeeding my son when I hit this point in our nursing relationship.

The first thing to remember when it comes to breast feeding is that while hormones do play a pivotal role, it is also controlled by the law of supply and demand.

There are also times when you may think that your milk supply is low, when it may not be. These times include but are not limited to:

• Hormonal changes (such as the return of your cycle)
• Increase in other sources of nourishment such as solids or if you are supplementing, formula.
• You find that you cannot pump as much any more.
• You no longer feel the let-down sensation.
• You are not getting enough rest or are stressed.

Before you get very concerned, ask yourself:

• Is he having a growth spurt?
• Is she still nursing happily and comfortably?
• Is he still wetting/soiling his diapers regularly?
• Has she started solids or been taking a bottle (expressed milk or formula) more often?
• Are you more tired than usual?
• Are you experiencing any unusual stress?from work, from travel, from family-related issues?
• Is your support system strong and encouraging?
• Are you eating/drinking well?keeping yourself well-nourished?
• Could you be pregnant or is your regular post-partum cycle returning?

Some tips for naturally increasing your milk supply

• Increase your healthy, lean protein intake. This can mean lean meats, beans and legumes.
• Increase your fluids?that is water and whole juices. (Skip the caffeine and diet drinks, if possible.)
• Make sure that you are consuming enough calories daily. Remember, that just like when you were pregnant, breast feeding mamas need more calories than women who are not breast feeding.
• Get adequate rest.
• Don’t watch the clock while nursing. Nurse until your baby has finished one side, then offer the other side. (If he is full, offer that side at the next feeding. Pump if you need to relieve pressure, but still offer the un-nursed side at the next feeding.)
• If you can, take a “nursing vacation” even if it means just on the weekend, if you work out of the house. This means do nothing but nurse-on-demand, eat and drink healthy foods and beverages and rest. You may have to bring her to bed with you, or have her in the room with you. Delegate the household responsibilities to others and focus on your and your baby’s nourishment.
• Try pumping and nursing at the same time. (This is called switch nursing.) While nursing him on one side, pump the other side. Before he’s finished on that side, switch him and the pump.
• When you’re nursing (or pumping) make sure that you’re relaxed and calm.
• When you can and if you feel comfortable doing so, lose the bra (especially if it’s an under-wire bra). Ditching the bra will help encourage blood flow and promote good circulation. Your bra, no matter how “unstructured” it is, will constrict your breasts to some degree.
• Try massage. Work in a circular motion with your fingertips from your armpits down and from underneath them up and all around towards the center. Do this on each side. (It is a good idea to do this right before nursing or pumping.)
• Try nipple stimulation. Nipple stimulation releases into the bloodstream oxytocin, which is the hormone responsible for the milk ejection reflex.
• Try warm compresses or a rice-sock that has been warmed in the microwave for about 30 seconds before and during nursing or pumping.
• Get support and help from other breast-feeding mamas and/or a lactation consultant especially if your spouse/partner or family network is not as supportive as you need them to be.

These may or may not work for you, depending upon your unique situation. But, as someone who has tried them and ended up nursing successfully until child-led weaning at 15 months, I can say with a certain degree of reliability that they can work. If they do not work (and it may take a few days to “reclaim” your supply) there may be other issues at play, and you should definitely consult your health care provider.

As always, before embarking on any changes that relate to your health, consult a licensed medical professional who is aware of your and your child’s medical histories.

For additional resources see:

• Breastfeeding 101
• Retaining Milk Supply
• Tips for Breastfeeding Success
• La Leche League
• kellymom.com

Just last Monday, I published a post regarding my diminishing breast milk supply. In my quest to recover from the Over-worrying syndrome, I took my own advice. I advised others to “Call a lactation specialist, talk to other moms you trust, call your pediatrician“.

Here is the advice I got:

Other moms: Take some fenugreek. It worked for me. Also add another pumping session at work.

My lactation specialist’s advice: Keep breastfeeding more. And no, fenugreek will not really increase your supply. Don’t bother with it.

Mina’s pediatrician: You may want to try fenugreek although it may or may not increase your supply. But you must let her eat in demand and your supply should be just fine.

Well, as you can see, I got confusing reports on the effectiveness of the herb that’s been touted by some as a breast milk supply enhancer. That’s the thing with advice, you have to weed through the statements being said to you to find out what exactly will work.

I decided that since there seems to be no consensus on the herb fenugreek, I would nix taking it. However, I heard loud and clear that I need to pump more frequently (as I already nurse on demand), so it was up to me to look at my schedule and see when in my busy day I would fit in the extra pumping. I guess that’s another thing with advice, sometimes advice is hard to implement.

I’m a full-time worker, and I already pump on breaks, and need the lunch as a break from both work and pumping. When I get home, its go go go, in between eating dinner while catching up with my husband, taking care of dishes, nursing, playing a bit with my daughter before I put her to bed and wash her bottles, and get myself ready for the next day. I crash soon after all that is done.

But when your first duty is to be the best mother you can be, you must follow through with your plan of action. So, right before bed, I say hello to my pump again, and let it do its thing while I nod off a little. My husband usually shakes me awake about 15 minutes later, urging me to join him in our bedroom.

So far I haven’t had to supplement. In my mommy world, that is a real feat.

I had a bit of a crisis this past week and weekend. Of course, it was more a case of the Mom Over-Worrying syndrome. The new worry is whether my breast milk is enough to nourish my baby.

I have noticed several things: She’s nursing more often without appearing satisfied even with the introductions of solids. She’s been sucking her 4 0z. breast milk bottle dry at daycare where before she would leave anywhere from 1 to 1.5 oz.

What I did: I upped her her bottle contents to 4.5 oz just to see what she’d do. Again, they were sucked dry. I added, reluctantly, a bottle of formula right before bed and she ate that up, PLUS nursed as well.

My feelings: defeated, not good enough.

Then I took time to evaluate the situation and I realized:

I am enough for her. Now whether that means I have to pump more and nurse more, she is a thriving, growing, beautiful baby girl. She’s perfectly healthy and bright. She’s having enough wet and dirty diapers as well. All indicative of a fine baby.

Supplementing formula while I build my stored supply doesn’t mean I’m a failure. It means I’ve got a plan on how to go back to exclusively breast milk feeding her. It also means I’m flexible enough to adapt when a situation calls for it.

We moms sure know how to over-worry ourselves. But the important thing to remember is to deal with the situation with a clear head, and not get bogged down with feeling of guilt and recrimination. Call a lactation specialist, talk to other moms you trust, call your pediatrician. Get on a course of action to resolution.

I’m not gonna let this new challenge discourage me from breastfeeding. Mina and I will come through this.