Breastfeeding: Demand and Supply

 Babies are born with the innate ability to suck. Newborns suck for more than just satisfying hunger. Sucking is pleasurable, calming and is a pain control mechanisms for babies. 

After a baby is born, their bellies are full of amniotic fluid that is swallowed continuously while in the womb. This is why for the first twenty four hours they do not feel hunger.  The best time to introduce the breast is within the first hour after delivery.  Sucking at breast calms her and reassures her in a world that is not known to her. After she is born an infant enters the active alert stage of wakefulness and this time is important to use as practice for latching and feeding the baby. Over the next twelve hours,  newborns enter the “sleepy phase”. It’s often difficult to wake the baby at this stage as she recovers from delivery. Skin-to-skin during this time assists in maintaining her body temperature and stabilizing her heart rate. It’s also the perfect opportunity to allow her free access to the breast. 
 
After 12-24 hours, the baby begins to  get hungry as the belly empties. Cues that baby is wanting to feed or suck  include:
·    Smacking the lips and tongue thrust movements
·    Bringing hands to mouth
·    Head to the side with wide open mouth

Crying is a late sign of hunger and it is often difficult to latch her when she has reached this point. Being aware of your baby’s hunger cues is important so she does not get frustrated and she can begin to trust that food will be supplied.

Moms often ask why babies suck all the time. Remember that sucking is not just a response to hunger. She may suck to relieve tummy pain, to feel close to mom, to fall asleep. As a response to the frequent sucking, moms often state they “do not have enough milk”. This is common perception occurs because we were not born with volume windows on our breasts! Mom will make milk (supply) as a response to the baby’s sucking (demand). With breastfeeding, demand must occur before supply happens! This is why free access to the breast in the first few weeks is the best way to support your milk supply. The more the baby sucks, the more the breasts are stimulated to make the milk the baby needs, especially after the first few days when the baby will have lost weight. Weight loss is normal in newborns as the body transitions to the extra-uterine world. With good feeding, the baby should regain her birth weight in the first two weeks.

The use of pacifiers when breastfeeding is not recommended until mom and dad can be reassured that baby is not hungry. The basic rule of breastfeeding is: if the baby wants to suck, let her do so on
mom so that milk production is regulated to her needs. Pacifiers in the first few weeks alter the supply of milk in mom because the baby is not “demanding” that mom supply the milk. In some babies, pacifiers can also alter their suck pattern and interfere with a good latch causing mom pain and discomfort. 

In situations where mom and baby are separated, it is important to support mom’s milk supply with the use of a breast pump or hand expression. The demand still needs to occur if baby is not present to stimulate the milk production and support the supply. Double pumping is preferred over single pumping because it increases the hormones in mom’s body that are responsible for milk production. It also saves precious time! If milk cannot be used right away, it can be stored for later use. 

Milk supply normalizes in the first two to three weeks. The breastfeeding rule of thumb is: if baby wants to suck  (demand), allow her to do so at breast to assist and maintain the milk  production (supply). As you and your baby get to know one another, it will get easier to distinguish her needs and you will become confident that your body is making the necessary supply.

 For further information on breastfeeding, visit www.thebreaststart.ca