1) You can tell by the size of her breasts.
This is a common one and also- totally incorrect.
In reality breast size does not indicate milk making potential, not at all.
Small breasted women make enough milk for their babies alongside large breasted women and some large breasted women battle to make milk alongside their small breasted counterparts. Milk making does not depend on the size of the breast but rather on the existence of the necessary tissue and the efficient removal of milk from the breast. Its a supply and demand relationship that doesn't need a huge storage space to be successful. Many available studies show us repeatedly: Size doesn't matter.
2) She needs to drink MORE water.
To be fair, we probably all need to drink more water, but it's got nothing to do with making MORE breastmilk. The idea that a breastfeeding mother battling with producing an adequate milk supply needs to take in even more water then the optimal amount we're all told to drink is just an unfounded really sticky myth that's refusing to budge. In fact , an over excess water intake in the first few days/weeks post partum can cause more trouble not less.
Breastmilk is always over 80%water- regardless of mom's water intake and even in zones of maternal malnutrition -the water percentages of breastmilk remains the same and production is efficient. Excess water consumption just gets filtered and disposed of by the body and so all you really get is a mom with a very full bladder who needs to pee ALOT.
Rem everybody breastmilk is made in the blood not the stomach and definitely not the bladder so let's stop deciding that lactating moms need to become camels.
3) You need to EAT MORE to make milk.
Confusion around this idea spurted when researchers released the results of a study that showed that: on average, exclusively breastfeeding mothers burn about 400 calories more per day than non breastfeeding mothers. This grew into a nice 'marketing' idea for exclusive breastfeeding as a means for losing weight (another myth by the way,) but also initiated the idea that the low milk supply issues being experienced by some mothers at the time cauld likely be accredited to not enough caloric intake.
And so the habit of looking into mothers eating and nutritional behaviors came into play.
That added with the fact that some women just love to point out others weight and shape (slim women taking the biggest hit) and dietary choices, meant that this offered another great way to 'blame' women for their breastfeeding difficulties.
Unfortunately this thinking is still around and despite the fact that we have much research to directly cotradict this notion- its another sticky one.
In reality breastmilk production has very low caloric requirements and a breastfeeding mother is able to produce enough milk to provide for her infant regardless of her caloric intake.
A recent study of malnourished indigenous lactating women in North Africa found that they were able to exclusively and continuously breastfeed their babies (for no more then a few short minutes per session, on demand and as many as 10 to 14 times in 24hours) and their babies were well nourished and of good size and health. Chubby even, despite the mothers having low caloric and nutritional intake. When additional food was provided for these mothers the differences in results related only to the mothers own energy increase, responsiveness and demeanor, but the breastmilk samples taken before and after her diet was improved were unchanged. In other words- caloric intake improves only for the mothers general wellbeing, health, mental state and physical abilities not her breastmilk.
Her breastmilk is always optimal.
4) She's exercising too much to make milk.
It's the 'doing too much and not resting enough' argument.
But:
Exercise is good for you. Always.
Good when you're pregnant and good when you're not. And- 'rest' is not as influential as we'd like to maybe believe it is. Yes of course we like mom to rest, mainly because no one wants an exhausted mom trying to care for a newborn/infant but; studies show us that busy, active, stressed and tired women produce just as much (and enough) breastmilk as they need to. When is comes to being busy, expending energy and exercising- not only is there no evidence at all that exercising undermines a mother's milk supply, there is in fact multiple studies showing us that exercise was shown to boost all the best happy hormones that assist with producing breastmilk, allowing mother to relax into and enjoy the act of breastfeeding more. Milk supply is not diminished or threatened when we exercise because burning calories is not the means by which milk is produced. Removal of breastmilk drives production, so an effective nursing baby always dictate his mothers milk supply, regardless of what she is or is not doing energy-wise herself.
and that leads us onto:
5) Too much stress stops breastmilk
Confession time: I believed this myself until recently. I too thought that enduring anxiety and stress would take its toll on a woman's breastmilk production but, I am super happy to be proven totally WRONG.
The hormones involved in the parasympathetic stress response actually have no effect on those driving the production of milk. Stress hormones don't effect prolactin (the milk making hormone.)
It's an evolutionary fail safe- which makes complete sense when you think that our original ancestors lived in a state of natural stress for much of their lives- always needing to fend and preserve their lives and safety. Therefore, their breastmilk must've been 'fight or flight' and stress-resistant for the survival of the species. No lovely safe secure houses, cosy blankets, stocked fridges and warm stoves available to our homo Habilis ancestors. Survival was a constant struggle- and so it makes perfect sense that their production of breastmilk must've evolved to happen without being effected by such factors. Homo Habilis breastfed their babies until between 3and5 years of age. That's some excellent milk making happening there.
More recent findings show that lactating women in the most tough and stressful circumstances still produce enough breastmilk to feed their babies- in situations such as civil wars, during nuclear fall outs and in regions of famine. Mothers make milk.
6) You need bigger breaks between feeds to build up Breastmilk
I've often puzzled over the '4 hours between feeds' idea that prevailed over breastfeeding practices for soooooo long, and the closest origins I can posit for it come from the practices undertaken by factory managers and owners during the 2nd world war in the UK. By 1943 90% of single women were working in factories to cover the jobs of the men at war and 80% of married women were too, most of them with 2 or more children to care for and many of them pregnant or breastfeeding. Shifts were long, between 10-12 hours and breastfeeding mothers were not allowed to have their infants with them and so they were given only a few moments every 4 hours to nurse their babies. Babies were forced onto these feeding schedules out of mothers necessity to work. Doctors (knowing no different) deemed this safe and good practice and so 4 hour feeding became the norm of the time.
Seems odd then that we still believe in a practice that originated during such an archaic and unusual time in history but none the less the idea still prevails in many cultures.
Now we understand the mechanisms of making milk and the physiology of the human lactating breast and so our current medical practices promote on demand breastfeeding with much attention paid to ensuring the efficient removal of milk from the breast as the only means of initiating additional breastmilk production.
In truth, the delayed emptying of the breasts and the lengthening of periods between nursing sessions undermines the ability of the breasts to produce milk by literally causing the cellular death of the milk making cells, as they became too engorged. (full) and essentially 'pop.' Once this happens to a lactocyte (milk producing cell within the alveoli of the breast) the lactocyte is destroyed. Thus the longer milk is left in the breast the higher the likelihood of this happening and the lower the ability to produce more milk.
7) Baby needs to feed for a long time for mom to make more milk.
Duration of time baby spends on the breast as an indication of how much milk mom has and how much milk baby is getting is also another sticky myth that refuses to budge.
We know that babies have a range of different ways to feed and a myriad of different nursing habits that they exhibit across the board. The length of time a baby spends on the breast is again completely secondary to his/her effectiveness at removing milk. In Kenya tribal women allow their babies to remain attached to their bodies by tied blankets and babies nurse for around 2mins a session as they desire- these babies are well nourished and fed, growing well. In some western cultures (common in the US and UK) some babies spend anywhere between 10 and 20 minutes at each breast and nurse only every 3,5 hours, also healthy and growing well.
Recently we figured out that a baby suckles for about 140minutes (in total ) each day, regardless of timing of and between feeds. 140 minutes.
Efficient removal of milk is essential and the only measure of future milk production. A baby could suckle at the breast for 40minutes and eventually fall asleep leaving the mother to believe he must be full, when in fact very little milk was actually transferred and baby's sleepiness was a result of mere tiredness. Where as another might stay at the breast for 5 minutes and very efficiently remove a good amount of breastmilk leaving the milk cells ready to produce and refill for the next feed in an hour or 2's time.
Sessions and durations are different but efficiency of removal is the key.
So- How DO we make more milk then?
Im pretty sure after reading the above myths you're well set to answer this question perfectly.
To make more breastmilk, protect our supply and ensure our infants, babies and toddlers are well fed and experience the best possible outcomes of breastfeeding the key is: Effective, frequent and efficient REMOVAL of breastmilk from the breast.
This is done by allowing our infants their free, self driven and frequent access to the breast and ensuring baby is able to remove milk efficiently. This may take some time to assess and ensure (and likely the help of a very good lactation/breastfeeding specialist) as well as some commitment to the essential practices needs (like frequent on demand feeding and creative positioning if need be.) Plus some excellent support and science backed knowledge.
Breastmilk is a natural and evolutionary perogative for us humans - all we need is the correct knowledge of how to maintain and protect our milk making potential.
Hopefully this can be one of those such sources for you.
*Support, Celebration and Love to you Wonderful Breastfeeding mothers!
You're fantastic.
Keep going!
With you always in strength, support and science.
LOY Lactation
* all info provided and research used are related to breastfed infants 0-6months*