Hi Katie, Great question. The American Academy of Pediatrics recommends vitamin D supplementation for breastfed infants, as breastmilk is generally low in vitamin D. This is not an issue with breastmilk, but rather the fact that most Americans are low in vitamin D, so a breastfeeding mom who is already low in her own vit D stores is unable to pass along adequate vit D to her baby. However, supplementing the infant is not the only way to boost the baby's stores. Mom can supplement instead (and for some, this can be easier than remembering to give the drops/supplement to the baby!). It looks like your baby is now 6 months old, which means you can start providing foods that are good sources of vitamin D in the next few months as you advance solids. Two great sources are salmon and the yolks of eggs. Sunlight is the best source of vitamin D, however in winter months this is harder to achieve, and there are also the warnings of skin exposure to UV rays. There is some interesting info here: https://kellymom.com/nutrition/vitamins/vitamin-d-and-breastfeeding/ I invite you to speak to your pediatrician before starting (or stopping) any supplementation. It would also be helpful to know your own vitamin D status if you don't already.

Congrats on your new baby! Aside from the fact that your breasts don't feel as full, are there any indications your milk supply is decreasing? Are you exclusively breast feeding? Is your baby having 2-3 dirty diapers/day and 5-6 wet ones? Is she gaining weight appropriately? These are all the main cues that your milk production is just right! As for nursing 10 min on each side (so 20 total for a feed every 2-3 hours) sounds good to me if she's an efficient nurser. Does she have a good wide open latch with lips flanged outward? Do you see her suck/swallow pattern? Is she coming off the first breast naturally (as opposed to you switching her) when she's done that side?

While I wait to hear your response, some helpful tips:

Make sure your diet and hydration are adequate with 3 balanced meals and snacks throughout the day. Aim for at least 13 8oz glasses of water/day.
You can pump after each nursing session while doing gentle breast massage to help increase output and stimulate the breasts to make more milk. You could also hand express, as some moms find it more effective.

Thank you and thanks for the quick response. Yes on the dirty diapers however her poop is more watery now as compare to how sticky it was at first. I wouldn’t know her weight until Thursday. Yes she latches on great. At times I have to switch her to the other breast other times she falls asleep on my breast.

Poop consistency is going to change quite a bit, and a looser stool is totally normal for a 2 week old. Glad to hear she's latching great! Try to keep her awake and sucking at the breast by changing her diaper before feeds, stroking the soles of her feet/cheeks while she nurses, gently tug at the nipple while she's latched to "remind" her to keep sucking. It sounds like you're doing great and your milk supply is prefect for her. Feel free to check in if there are any weight loss concerns after your appointment on Thursday (or of course any time before then!).

Perfect ! Thank you so much this information was really helpful.

Hi Rosemary, it is very normal for many women to have an uneven supply! Some women always make more milk in one breast than the other, no matter how much they try to correct for it...and that's ok! It could be from a variety of reasons, such as asymmetrical anatomy between the two breasts, or having a more forceful letdown in one breast causing your baby to pull off too soon/prefer the other breast, which will increase milk production on the preferred breast side. Your baby could just be more comfortable nursing from one side vs the other, so do make sure to try different positions when nursing.

There are some things you can try:
Pump more (after or in between nursing) on the right side to stimulate that breast to make more milk. Do gentle hand massage while pumping to help increase output. For a short period of time (a few days) you can begin all feedings on the less productive side, as your baby's vigorous sucking at the beginning of a feed can help stimulate that breast to make more milk.

It may take 5-7 days to see any change on the less productive side, so keep at it!

Hi Kendra - how interesting! For many moms, the opposite is true. Are you exclusively pumping? Are you going a longer period between pumps when you're out of the house? Are you using a different pump? Stress can affect supply, so if you're home with your two little ones (it looks like you have a newborn and 20 month old!!) and have all sorts of baby/toddler/home life things you need to focus on while pumping, it could potentially cause your pump output at home to take a dip.

Studies have shown that moderate exercise does not change milk composition, production, or nutrient makeup. But exercise has obvious benefits, including a healthier, happier, more energized mom!

This answer varies depending on how frequently you’re nursing, your own metabolism, and the type of food you are. On average it could be about 4-6 hours, however sometimes as soon as 1 hour and as long as 24 hours!

Hi Shannon, the struggle is real with a newborn and sleep deprivation! Most breastfeeding moms can drink caffeine in moderation. Some babies are especially sensitive to caffeine when they're under 6mo of age. The only way to know if your baby is affected is to watch for any changes of fussiness or even being jittery. However, you should be able to safely consume a few cups. Generally, up to 500mg caffeine shouldn't be a problem for most babies, and that looks like about 3 8oz cups of home-brewed coffee (something stronger like a Starbucks coffee would be less than that). Also, as exhausted as you are, you want to be careful that too much caffeine isn't over stimulating you! You know...so you can sleep when the baby sleeps ;)

Thanks Janel!