Abstract
Breastmilk provides the ideal nutrition for the infant, and exclusive breastfeeding is recommended for the first 6 months. Adequate milk production by the mother is therefore critical, and early milk production has been shown to significantly affect milk production during established lactation. Previous studies indicate that milk production should reach the lower limit of normal for established lactation (440 mL per day) by day 11 after birth. We have used test-weighing of term infants before and after each breastfeed over 24 h to measure milk production in the first 4 weeks of lactation in mothers with and without perceived breastfeeding problems to provide information on how often milk production is inadequate. Between days 11 and 13, two-thirds of the mothers had a milk production of less than 440 mL per day, and between days 14 and 28, nearly one-third of the mothers had a milk production of less than 440 mL per day. The high frequency of inadequate milk production in early lactation and the consequence of suboptimal milk production in later lactation if left untreated suggest that objective measurement of milk production can identify mothers and infants at risk and support early intervention by a lactation specialist.
Highlights
There is a sound evidence base for the health advantages of breastfeeding for infants and their mothers, and a dose-response relationship has been demonstrated [1]
We recruited mothers under the care of general practitioners or lactation consultants for perceived breastfeeding problems, and volunteers for studies undertaken by the research group (e.g., Prime et al [21]) who were without perceived breastfeeding problems
The most common was a perception of insufficient milk supply (59 participants), but pain (11 participants) and positioning and attachment (10 participants) were mentioned
Summary
There is a sound evidence base for the health advantages of breastfeeding for infants and their mothers, and a dose-response relationship has been demonstrated [1]. Milk production and adequacy at 6 weeks after birth, for mothers of both healthy breastfeeding term infants and non-nursing preterm infants, have been shown to have a significant relationship with milk production 4–6 days after birth [2,3]. Hill et al suggest that interventions that promote an adequate milk supply by the first week postpartum are critical [2]. These include skin-to-skin contact and milk removal (breastfeeding or expressing) within an hour of birth and frequent milk removal during the first 24 h after birth. Breastfeeding or expressing within an hour of birth, has been shown to lead to a higher rate of breastfeeding beyond 6 weeks for term infants [4]
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