How to calculate milk supply.
Calculating a mother’s breast milk supply.
Mothers can have a breast milk supply that is:
Excessive (more than her baby needs)
Adequate (supports normal weight gain)
Borderline (supports slow weight gain)
Inadequate (does not support normal weight gain).
Determining the mother’s breast milk supply using AC/PC Weights
(AC is an abbreviation of a Latin term meaning “before meals”. PC is an abbreviation
of a Latin term meaning “after meals”.)
Using a digital scale, weigh the baby before and after feedings.
Subtract the before feeding weight from the after feeding weight to determine the amount
of the feeding.
He should be in the same clothes and diaper for both weighins.
A one time feeding with a AC/PC weight can give you an indication of the mother's milk supply.
However a one time test may be subject to sluggish let-down due or distraction or sleepiness
of the infant.
If test weights can be done at several feedings, you can get an average of the mother’s
output. This will give you a clearer picture.
A good rule of thumb for determining an infant’s intake per day is to multiply the
infant’s weight by 2.5.
Divide the intake per day by the number of feedings per day to determine the feeding size.
Infant's weight X 2.5 = Total intake per day
Total intake per day / number of feeds per day = Ounces per feeding
Baby One weighs 8#
So, Timmy needs 20 ounces per day to maintain normal growth.
He feeds an average of 8 times each 24 hours. So his intake per feeding should be about
2.5 ounces.
If the weight gain in his AC/PC test breastfeeding is about 2.5 ounces, then his mother’s
breast milk supply is adequate.
But if he actually got about 1.5 ounces in his test weighing. He will need a supplement
of one ounce per feeding until his mother’s milk supply is increased to meet his needs.
Baby Two weighs 6 ½#.
Her AC/PC test weight showed she gained 3 ounces during the feeding and the mother states
she does not feel her breasts are “emptied”. She is able to pump 1.5 ounces
after the feeding.
Baby Two needs 16 ¾ oz per day.
She feeds an average of 10 times each 24 hours.
So, she needs 1.6 oz per feeding.
Her mother is over-producing 2.9 oz each feeding.
She would undoubtedly also have some other symptoms of over-supply such as uncomfortably
full breasts, perhaps plugged ducts
The baby may experience colicky symptoms, loose, frequent, greenish stools and gas from
an imbalance of foremilk and hindmilk.
This method of calculating an infants intake may not be accurate for premature infants
or those who are severely under weight and need extra calories for catch-up growth. Consult
with the infant's physician for guidance.
How to increase breast milk supply
Get the best latch-on possible. Teach the mother how to check for a good latch-on and make sure that the baby achieves and maintains that through each feeding.
Completely empty the breasts at each feeding. The baby can do this by feeding on both breasts, then returning to each one for another short feeding to completely empty them, if necessary. The mother can use a breast pump at the end of most feedings to make sure they are completely empty. Milk contains a protein, the FIL factor (Feedback Inhibitor of Lactation) that tells the milk producing cells to cut down milk production. So any milk remaining in the breasts at the end of the feeding should be removed.
Eat and drink adequately. A good well-rounded diet gives the mother the nutrients she needs to meet her daily activities as well as produce breast milk. Mothers should drink to thirst and they are usually thirstier. A good rule of thumb is to drink enough fluids to make the urine a pale yellow color. If it is yellow or brownish she needs to drink more.
Feed the baby through the night. Prolactin levels are highest at night and breastfeeding or pumping can be most effective in increasing supply at this time.
Beer has been recommended for decades as a galactagogue (agent to increase breast milk supply). It is thought that the B vitamins in beer are good for supply, others think that the alcohol content helps mothers relax and achieve more let-down reflexes. Studies have shown that babies consume less milk at a feeding where alcohol is present. Mother’s should use their discretion on this topic.
A variety of herbs including Fenugreek and Blessed Thistle are known to increase breast milk supply. They are available as tinctures (the strongest preparation), tablets (next strongest preparation) and teas (mildest preparation). Mother's Milk tea, a blend of several herbs is widely available at grocery and health food stores.
Be careful of these herbs, only use them with the guidance of a herbal specialist.
Discontinue the use of a nipple shield. Using a nipple shield decreases the amount of stimulation to the breast and the amount of milk transferred. Both can adversely affect supply. If a nipple shield is required, choose a silicone one that will allow for more stimulation and use
Oats are widely recognized to increase milk supply. Mothers can eat a big bowl of oatmeal daily until their supply seems to increase.
Massage and breast compression. Instruct mothers how to massage their breasts throughout feedings from the outer area towards the nipple. This can significantly increase the amount of milk that is transferred to the baby. Periodically the mother should compress the whole breast.
Stop taking any medications that are known to decrease supply. All of the following have been associated with lowering milk supply: birth control pills, antihistamines and some decongestants, some weight loss medications or appetite suppressants, very high doses of vitamin B-6, diuretics, etc.
Check for thyroid function and anemia (refer to mothers MD). If increasing supply does not respond to the usual methods, low thyroid or anemia may be suspected. Other symptoms of low thyroid include excessive hair loss, dry skin, increased sensitivity to cold, loss of appetite, extreme fatigue, depression, and a swelling in the neck area. Symptoms of anemia are paleness of the inside of the lower eyelid, fatigue, lethargy, and dizziness.
Stop smoking. Mothers who smoke more than 20 cigarettes a day often experience a lower milk supply. Their babies also tend to gain weight more slowly than the babies of mothers who smoke fewer cigarettes each day or those who do not smoke at all.
Retained placenta can reduce supply or delay the milk coming-in. Excessive or prolonged post-partum bleeding is the most common symptom. Instruct the mother to check with her health care provider to see if treatment is needed.
Insufficient glandular development. Very rarely, the milk ducts and alveoli have not developed well enough to produce normal volumes of breast milk. Mothers with this condition typically report that their breasts did not change in size or shape during pregnancy and there may be a marked difference in the size or shape of the breasts. Commonly there is an unusually large space between the breasts. The milk does not come-in as expected and the breasts never feel full or engorged. These mothers should still be encouraged to breastfeed if there is some milk present. While their babies will need to be supplemented in order to receive enough calories, the amount of mother's milk received will still be invaluable.
Discontinue the use of a pacifier. Along with compromising milk supply, pacifiers have also been linked to greater incidence of ear infections, thrush and premature weaning. If one is used, use it only after a feeding and watch for signs that the baby is becoming attached to it.
Avoid early introduction of solids. Solids displace the breast milk in the baby's diet. He in turn nurses less frequently; thus reducing the amount of stimulation his mother receives. Delay introducing any solids (cereal included) before the 6th month and breastfeed BEFORE offering the solids until closer to the end of your baby's first year.
