Once breastfeeding is established, most parents breathe a big sigh of relief. Got this! Then one day, the baby is suddenly inconsolable and wants to nurse all day and all night, too. A quick check for anything obviously wrong most often finds no fever or symptoms other than a baby who wants to be at the breast constantly.

Before hitting the panic button (is it colic, reflux?), it’s good to remember the supply and demand basics of milk production. Milk supply is based on milk removal. Baby is diligently doing its part to create more milk by putting in extra sucking time. Continuing to nurse on a seemingly empty breast signals the body to make more milk. 

Parents unaware of what a growth spurt might look like might respond by troubleshooting the fussy baby instead of the milk supply. A tired, frustrated parent may reach for a pacifier and some extra soothing techniques instead of one more nursing session. Babies generally respond well to this, but at what price? A pacifier or a handy pinky finger, often used to calm a fussy baby, can short circuit the “make more milk” message the baby is trying to send. If the majority of extra sucking isn’t at the breast, the milk supply will slowly diminish, fussiness increases, and this can be the beginning of the end of breastfeeding for many.

These growth spurts or “frequency days” are common, often beginning in the first week, then occurring every week or two for the first few months, and randomly every few weeks to months after that. A lactation specialist can be vital in resolving sucking or positioning issues that might interfere with milk removal in the early days. Generally, as long as baby can get those extra feeds in, a normal milk supply will catch up with baby’s increased demand within a day or two.

As baby gets older, a series of neglected frequency days can be a cause for an unexpected dip in supply. Older babies can become easily distracted and cut nursing sessions too short. Those learning to roll over or crawl can get so busy practicing, they forget to nurse much during the day at all. When coupled with “sleep training” techniques that limit nighttime nursing, it’s easy to see how an established milk supply can suddenly tank.

Resolving an unexpected dip in an established milk supply includes recognizing frequency days, decreasing pacifier use, increasing nighttime nursing opportunities, and possibly temporary breast pump use to help build the supply. However, a baby who is not gaining well is often simply prescribed supplementation with an ounce or two of formula after each feeding without an accompanying plan to find the root cause and increase the milk supply. With no effort to build up the milk production, supplements will slowly increase as the milk supply decreases.

It can be devastating to not be able to provide baby with a full milk supply. Unfortunately, not everyone’s experiences fit the typical cause-and-effect situations mentioned above, and there are many more complicated reasons for a dip in milk supply that doesn’t recover. After weeks or months of trying everything, it becomes clear in hindsight that the milk supply is not responding. There are many different ways parents ride this out. Some will simply switch gears and move to formula.

Others may continue feeding the baby at the breast using a nursing supplementer to provide formula or pumped/donated milk at the breast. Some babies are happy to feed at the breast and be topped off with a bottle, where other babies will opt to stop at the breast but happily take any amount of pumped milk from a bottle. There are lots of ways to feed a baby; finding the solution that works for each family is the goal.

Understanding the ins and outs of breastfeeding takes time and exposure to others who are nursing. Taking a class before baby arrives is helpful, but continuing to learn, observe, and share about breastfeeding is vital to success. This has been hard to do during the pandemic but opportunities for support are opening up with more virtual and in-person availability.

Local Lactation Support – BirthNet.org
WIC – 831-722-7121
Sutter Lactation – 831-477-2229
Dominican Lactation (831) 462-7862