Regardless of which feeding philosophy you follow, you cannot add to what nature has left out. The anxiety created by the fear of failure (and in some cases, the fear of judgment from others) is a contributor in its own right to milk deficiency.

In most cultures, up to 5% of women during peacetime and 10% during wartime are not able to produce adequate milk for their infants. Some mothers experience sufficiency that wanes to insufficiency by the third month. This can take place in spite of having all the “correct” pieces of the puzzle in place: appropriate rest and nutrition, good latch, nursing frequently enough, and sufficient support from family.

If you question your milk supply at any time, observe the following:

• Is your baby routinely fussy after every feeding?

• Is he having difficulty going the appropriate duration between feedings?

• How is the stress-level in your life (this can affect the taste and production of milk) and in your home (which can affect your infant directly)?

If you’ve eliminated what you can and you’re still unsure, consider the following:

• If you question your supply in the first 2 months, consider feeding on a strict 2.5 hour routine for 5-7 days. If your milk production increases (demonstrated by your baby being more content and sleeping better), work your way back to a 3-hour minimum. If no improvement occurs, supplement with a formula to give you peace of mind and your baby more calories

• If you question your milk supply in the 4^th month, try adding a few extra feedings to your daytime routine. Also, consider your caloric intake as mommy—if you are dieting, you should stop. This can adversely affect your milk supply. Additionally, you could step back to a strict 3-hour routine and then gradually work your way back to where you were (probably a 4-hour routine by this point) and see how things go. If you have no improvement after several days, supplement with formula.

The four-day test involves adding one to two ounces of formula after each nursing period. Then express your milk with an electric breast pump, doing 10 minutes per side. Keep track of how much extra you are producing. If your milk production is plentiful, the problem lies with your baby. He is either not latching on properly or is a lazy nurser.

If additional stimulation doesn’t occur from pumping and you’ve reviewed everything else, then you may be among the 5-10% of women who can’t provide a sufficient milk supply. Learn and discern what is best for your family (nursing or bottle-feeding) and make no excuses for your decision. It is your family!