Midwife & expert Lactation Consultant reveals their 3 tips to support breast milk supply

Please tell us a little about yourself? How did you become an International Board Certified Lactation Consultant (IBCLC)?

Hi, I'm Joelleen Winduss Paye, founder of JWP Holistic Lactation, based in Naarm Melbourne. I've been a midwife supporting childbearing and breastfeeding families for over 13 years, and also a naturopath for six years. I became an Internationally Board Certified Lactation Consultant in 2018 to blend my holistic knowledge and passion for postpartum and breastfeeding. I started practising privately as JWP in 2021, where I offer in-home and virtual consultations for breastfeeding families and breastfeeding education for parents-to-be.

What are 3 tips to support establishing breast milk supply?

I think firstly knowing how to latch your baby to the breast and understanding breastfeeding technique, like the position of your baby's body and mouth to your uniquely shaped breast, is the place to start. It's best to learn about this before your baby arrives because nipple damage is one of the leading causes of early breastfeeding cessation. Having sore nipples early on in your journey can really undermine a good milk supply since having your baby feed frequently in those early days is crucial for stimulating milk production.

Secondly, harnessing the power of skin-to-skin contact to help boost and stimulate oxytocin levels for both mum and baby is a great thing to do. Skin-to-skin increases the bonding between a mum and newborn, stimulates your baby's feeding reflexes, helps with milk flow and supply, and keeps mum and baby together. Skin-to-skin in those early days and weeks is especially important for parents who have experienced birth interventions that can override the body's natural oxytocin flow; it's a great way to boost your levels.

Thirdly, having an understanding of how nutrition affects your postpartum well-being and milk supply is key. A breastfeeding parent should be consuming an extra 300-500 calories per 24 hours, drinking around 3-4 litres of water per 24 hours, and having meals that are balanced with protein, good fats, fibre, and slow carbohydrates. Blood sugar balance has an indirect effect on milk production, as imbalanced blood sugars can wreak havoc on our hormones. It's essential to avoid drinking coffee first thing in the morning on an empty stomach and avoid skipping meals. Doing some work during your pregnancy to plan, prepare, and outsource meals is an excellent way to allow you to focus on being nourished and nourishing your baby.

How to know if you truly have a low supply? What are some causes and ways to support?

There are some cases where a breastfeeding parent will not be able to meet 100% of their baby's needs in terms of milk supply. The leading cause of this is breast hypoplasia or insufficient glandular tissue, meaning that the breast lacks the sufficient amount of milk-producing tissue to make an abundant supply. This is very difficult to diagnose before your baby's arrival, and size doesn't always equate to volume. Other conditions that may delay or cause milk production to be less efficient include PCOS, hypothyroidism, gestational diabetes, and other hormonal conditions. We also know that birthing interventions and events can affect or delay milk production, such as postpartum hemorrhage (large blood loss) and separation of mother and baby for long periods.

If your supply is genuinely low, your baby may be nursing for long periods all the time, have very little downtime between feedings, be unsettled unless they are at the breast, have low output (wet and dirty nappies), their weight gain can drop or plateau, and the breastfeeding parent may not notice the milk 'coming in' or not experience engorgement. It's good to know that genuine low supply isnt that common, and that milk supply can take a few weeks to establish, so get support and give it time.

An experienced IBCLC will review your breastfeeding technique, your baby's suck, your hormonal and health history, as well as your nutritional intake. Sometimes medications, herbs, and nutritional foods can be really supportive here, which is why I love having my extra layer of naturopathic knowledge.

What if you have a really good supply initially but notice that your supply starts to drop around 4-6 months? Any tips on how to support this?

A drop in supply can be common around the 3-4 month mark as this is where we see postpartum depletion really set in, particularly in parents who aren't eating a balanced diet with sufficient calories or aren't taking a good supplement regime. The best advice here is prevention. This ideally starts at preconception, with the parent being well-nourished before the pregnancy begins. Using pregnancy to nourish yourself with nutrient-dense foods and quality supplements really pays off long term. And putting effort and strategy into your postpartum nutrition helps so much here. Not only do you feel more energised and balanced, but your mood can be more stable, and milk supply more abundant when the body isn't in a state of depletion.

Does the return of a regular menstrual cycle impact supply, and will the baby notice this?

This can be mixed. Some periods return very early, and others take several months. Sometimes babies can sense a taste difference around ovulation with the changing hormones, and breast fussing or refusal can occur. I find the luteal phase (leading up to menstruation) is really where the impact can be, as this is where additional calories are required, and hormones tend to be lower. I have seen this manifest with lower milk supply during this time, which babies can be quite sensitive to. A baby noticing that the milk is slower and/or lower may show signs of fussing during feeding and even refuse to drink at the breast, which can be really stressful for the breastfeeding parent. Some mood changes can be present, and increased feelings of tiredness and low energy can also be evident for the breastfeeding parent, and it is usually in hindsight that they piece it all together when their period returns. Good nutrition and cycle syncing are key here. Cycle syncing is where energy exertion is planned according to one's cycle, i.e., higher-impact exercise during ovulation when hormones are surging and energy is abundant, and more low-impact, gentle exercise during the luteal phase when energy is lower, and restful movement is more beneficial.

Find Joelleen on her website at www.jwp.care or Instagram @jwp.ibclc