The longer you nurse, the more robust your supply ...but why?

[vlc]

Does anyone know, please? I mean, what is the physiological dfference between a breast which has been lactating for a few weeks, and one which has been lactating for several months? Because I was idly wondering why low frequency feeds were unsustainable early on in breastfeeding, but as few as one or two feeds a day were easily enough to maintain a supply a year later.

What happens here? It's not like boobs have memory. Something must change physiologically.

As the baby sucks more, your tits send messages to your brain saying that you need to increase supply. Brain then sends messages to tits saying increase supply so they do.

Thanks for replying, scrooged, however that's not exactly what I was asking.

I want to know why it's possible to maintain a supply indefinitely on very low frequency feeds after a year or so (when this would be impossible earlier on)

Your body gets used to the reduced amount, as long as there's some feeding going on your brain produces more. Does this make sense? It's your brain that sends the signals to your boobs, if there's one feed going on then the signals are still being sent.

I think it's to do with frequent feeding upregulating prolactin receptors. See the explanation and graph here of how milk supply works.

The prolactin receptor theory suggests that frequent milk removal in the early weeks will increase the number of prolactin receptors in the breast, and so the breast is more sensitive to increases in this hormone, increasing the ability of the breast to produce more milk. So frequent feeding in the early days sets the mum up to be able to make a good milk supply.

In the early weeks a mum may have copious milk because of the relatively high prolactin levels. The switch over from prolactin-driven milk production to established lactation where removal of milk from the breast is the main regulator of supply may also have some noticable effects. For example, because of the naturally high levels of prolactin initially, even if the baby's not removing milk effectively or very frequently, the supply may remain high, and if mum has a powerful let-down then baby may still be able to receive a lot of milk even with inefficient feeding. Then, as the hormone drops off, this 'unmasks' the previously hidden problem that milk removal isn't happening efficiently/frequently enough, and supply may drop. At that point, the baby will need to feed v frequently to increase mum's supply. Although this may work if mum feeds on demand, the change in behaviour can be misinterpreted as indicating that a mum's milk isn't good or plentiful enough and she may feel that supplementing is needed, where perhaps if she went with the flow, her supply might catch back up.

Sorry, should say went with the flow and if necessary improved baby's efficiency at the breast through skilled help with positioning and attachment (latch).

i think early on the babyies need for milk is increasing rapidly and so your body has to work hard to keep up with it, therefore low demand feeding wouldn't work because there's not enough stimulation to increase your supply in lne with the growing baby - the milk wouldn't go away, but the baby would very quickly need more than you could produce.
later on the growth spurts are less and the baby is no longer entirely reliant upon milk so the amount required becomes more constant.
does that make sense?

grendles explanations sounds much more impressive

Thanks Grendle, but I thought that autocrine control was well sorted out by 3 months or so. So that doesn't explain what further changes happen after that point.

For example, I believe one or two feeds a day wouldn't be enough to maintain a supply at, say, 6 months, but they would be enough at 16 months. At both stages lactation would be 'established' and under autocrine control, so there must be something else to differentiate the two scenarios. I take scrooged's pont about the body 'gets used to' things, but I wonder what that actually means from a physiology pov.

Hope this doesn't seem pedantic. I just want to know and haven't seen an explanation yet.

I can't think of any reason why someone couldn't just do 2 feeds a day from 6 months onwards if they chose to and maintain it for as long as they continued to do those 2 feeds. I'm sure I know of people who have successfully done this. Perhaps someone else will know differently?

Is there a reason you're concerned about it?

Not concerned, just nosy, really...my 18 month old still feeds 8-12 times a day, so very academic interest! I suppose after a worrying start (slow weight gain) part of me doubts my ability to maintain a supply on a couple of feeds a day (should she ever reduce to this) and knowing the biology of it all fascinates me.

I think I recall a thread where someone lost their supply at 8 months by cutting down to one or two feeds a day and tiktok commented that it was probably too soon to be able to maintain a supply at these levels. I may be wrong, though!

I can certainly see that a baby might not maintain their feeding as long as a mother might wish at the level of only a few feeds a day in the second half of the first year. Babies who have been cut back in their breastfeeds at 6 months ish to only a few feeds a day anecdotally do seems to sometimes stop before 12 months, apparently spontaneously. I'm not sure I've seen any evidence that this is to do with milk supply, however, and could possibly just be behavioural? Nursing strikes are common at this sort of age, and also cutting down to only a couple of feeds a day under the age of 12 months would mean supplementing the other feeds with formula, so flow preference could come into it perhaps?

This suggests that partial weaning is possible beyond the early weeks, and seems consistent with the info in the LLL's Breastfeeding Answer Book.

Found a couple of threads where tiktok refers to this...here and here

OK, well maybe she knows more than me about this ? I'm always learning new things and always interested to learn more. It'd be great to see the research references and understand the suggested mechanism.

I think Grendle's explanation is a good one, and the threads you link to, vlc, where I talk about maintenance of bf on a few feeds a day only are in line with what she says...except my observation is that 2 feeds a day at six months will not be enough to maintain any sort of milk supply in most mothers, whereas it might be 'safe' to reduce it to this level a few months later. I think I would say the same about a mum of a baby of 8 mths who wanted to feed once only a day - I'd be surprised if bf lasted long after this.

It's a spectrum, anyway. I agree there may well be a behavioural element to the whole thing - mothers' behaviour and baby's behaviour - when breastfeeding ceases entirely after a baby is down to 1-2 feeds at, say, 6-8 mths.

The prolactin receptor theory is actually more than a theory - it's pretty much accepted that this is how bf works, and is shown in the way early, frequent feeding is definitely associated with (if not actually the reason for) longer maintenance of bf. But the precise details - how much freq feeding you need to 'survive' a major drop in demand after how many mths - must vary between individuals.

It is clearly possible to increase a supply that seems to be dwindling at any time - mothers who have been bf toddlers aged, say 20 mths, once or twice a day, can turn up the production (because the baby is ill and refuses all solid food, for example) pretty easily, and this increase happens within a day or so.

Lots to think about

Thanks ladies for your responses, very interesting indeed.

Lots to think about, as you say, tiktok!

Wow Starlight! You just COMPLETELY articulated a truth for me;

"not being believed was the biggest risk to my bfing and I still have a desire to be understood......"

Abso-bloomin-lutely. I wanted to compress hundreds of hours of learning about bf and convey it to every HCP within 5 minutes - without sounding like a desperate loon. I failed, obviously.

I hope there is better knowledge in the future for the next generation's sake.

i bf for 8 mths on just one boob in am and one boob before bed for 8 mths with my daughter once she hit 11 mths, i am also feeding my son just am and before bed and have been doing so since 11ish mths and no probs with supply with either of them. Also dropped to one boob at either feed with my son at a year but got masitus a few mths latr so started doing a double feed and with in a day or two my boobs started producing milk in both boobs for the two feeds i was doing instad of one boob which i was pretty amazd that it only took a few days for them to cotton on

Been doing 2 bfs per day from 5.5-6.5mths no problem and for nearly 2 mths now (dd 8.5mths), she has only one bf per day, first thing in the morning.

Maybe I am just lucky. Never had a problem with supply and supply seems totally fine now.

tiktok i agree
I do not enjoy bf but always do it

i am currently still fully bfing my 6.5 month old dc6

dp asks me why i dont 'cut down' the feeds it is becasue i know once i lesson the feeds to less than four it is the beginning of the end