Far too often, I meet moms struggling with “supply” and underweight babies because the mom is leaving the baby on each breast for 15 or 30 minutes at a time. The baby may be more alert and active for a minute or two, but then falls asleep. Mom keeps on trying to tickle the baby, change baby’s diaper, or do anything else to keep the baby awake. The baby may be more active for a few sucks after stimulation like this, but then trails off again. The moms often think that any swallows, as infrequent or faint as they are, is a goal. It isn’t.
With ineffective swallowing, not only is the baby not transferring the calories it needs, but it isn’t stimulating mom well because very little milk is being removed by the baby. More time on the breast does NOT = more milk if the baby isn’t effectively removing milk.
It’s fine if you want to cuddle and let baby suckle for comfort, but you need to make sure the baby is doing an appropriate feed first. This means eyes open (not necessarily, but a lot of the time) and active, all business swallowing. Suck-swallow, suck-swallow, suck-swallow. Just like you wouldn’t give a baby a bottle for 30 minutes, the baby shouldn’t be trying to consume calories at the breast over 30 minutes or an hour.
This video is an example of an effective feed, and you see that it takes just 7 minutes for the baby to get what it needs. But it isn’t even about time — it’s about the baby’s behavior and the sounds of active swallows. If you’re concerned you don’t have enough milk, once your baby stops doing active swallows like this, you can hand express to give a bit more flow into baby’s mouth. If baby still stops, then it needs to be moved to the other breast and repeat swallows there. Also notice how this baby comfortably delatches itself at the end — this is because the baby is full. Don’t keep relatching a baby who is delatching itself.
For any moms struggling with supply in this situation, have hope that this mom in the video also came to me at first for “low supply” (related to nipple shields and ineffective feeding right after the baby was born). She completely turned a corner (in a very reasonable way, without killing herself with triple feeding) and now has massive amounts of milk! Three letdowns in these seven minutes and a gulping, happy baby.
