There is a common fear that many mothers have if they are nursing or are planning to breastfeed their babies. “Will I be able to make enough milk?” Some women can produce a tremendous amount, and other women have to work a bit to increase their milk production. The good thing is, milk production is a demand & supply process. To speed milk production and to increase your overall milk supply, the key is to remove more milk from the breast and to do this frequently so that less milk is accumulated in the breast between feedings. Here are some tips and different ways to increase your milk production.
How To Start
Immediately following your nursing session (or as soon as you can get settled), get comfortable, relax, and begin to pump. Even if you are not expressing any milk, the stimulation of suckling is stimulating your breasts to make more milk. Don’t give up and think it isn’t working if the milk isn’t flowing.
Make sure you have the suction in a comfortable setting. Some pumps have adjustable suction levels. It is not necessary to turn it up as high as it will go. Instead, if you can express milk, only set it as high as it takes to express milk. If not expressing, put it to a setting that feels comfortable. Pumping may not feel “natural,” but it should not be painful.
How Often to Pump
Ideally, if your supply is low, you should breastfeed every two hours and follow it with a pumping session. If this schedule seems overwhelming, pump the following feedings as often as you can for the longest time you can manage. (I would say no more than 25 minutes per pumping session. These need to be short bursts but frequent.) At the very least, pump after your first feeding in the morning. This is when your supply is likely to be at its highest.
How Long to Use the Breast Pump
If you haven’t expressed any milk after 10 to 15 minutes and haven’t experienced any pain. Shut the pump off and repeat the process after your next feeding. If you can express milk, continue to pump for at least 5 minutes until the last drop of milk falls. You may experience what is called a “second letdown.” This occurs when expressing milk until the flow stops, you continue to pump, and after several minutes milk begins to express again. If you have a second letdown, keep pumping for five minutes after the second flow stops.
Don’t let the breast pump equipment and the thought of frequent pumping intimidate you. Do as much as you can, as often as you can. Remember, every little bit helps.
Read HERE to learn how to clean your breast pump and why it’s important.
Now that you are working on the demand…
Here are some suggestions on how to increase your supply:
- Monitor your baby’s weight often, especially in the early days and weeks, if you’re experiencing low supply. In general, the longer your supply has been low, the longer it will take to build it back up.
- Get help early before weight gain becomes a big concern. Contact a local lactation consultant to come to your home to help. In almost all cases, once a healthy baby starts gaining weight, he/she won’t suddenly begin losing it unless there is an underlying medical problem with mom or baby.
- Take care of yourself. Try to eat well and drink enough fluids. (Here are some great lactation snacks.) Drink to thirst, usually 6-8 glasses a day. Your diet doesn’t have to be perfect, but you do need to eat enough to keep yourself from being tired all the time. It’s easy to get overwhelmed with baby care and forget to eat and drink enough.
- Don’t try to diet while you are nursing, especially in the beginning, while you are establishing your supply. You need 500 extra calories each day while you are lactating, and if you eat high-quality foods and limit fats and sweets, you will usually lose weight more easily than a mother who is formula feeding.
- Nurse frequently for as long as your baby will nurse. Try to get in a minimum of 8 feedings in 24 hours, and more if possible.
- Offer both breasts at each feeding. Try “switch nursing.” Watch your baby as she nurses. She will nurse vigorously for a few minutes, then start slowing down and swallowing less often. She may continue this lazy sucking for a long time and then be too tired to take the other breast when you try to switch sides. Try switching her to the other breast as soon as her sucking slows down. Even if it has only been a couple of minutes. Do the same thing on the other breast until you have offered each breast twice, then let baby nurse as long as she wants to. This switch nursing will ensure that your baby receives more of the higher calorie hindmilk, while also ensuring that both breasts receive adequate stimulation.
- Try massaging the breast gently as you nurse. This can help the rich, higher-calorie hindmilk let down more efficiently. Using breast compression is a simple, easy, and effective way to help your baby get more milk. Newborn babies will often fall asleep at the breast when the flow of milk slows down, even if they haven’t gotten enough to eat. Breast compression helps to continue the flow of milk once the baby starts falling asleep at the breast, so the baby gets more hindmilk.
- Here’s a video that shows Dr. Jack Newman helping a mom use breast compression to help a baby get more milk as she nurses.
- Make sure that you are using proper breastfeeding techniques. Check your positioning to make sure that baby is latching on properly. If the areola is not far enough back in his/her mouth, he/she may not be able to compress the milk sinuses effectively to release the milk. (Read here for 6 rules to get the best latch)
- Avoid bottles and pacifiers if possible. You want your baby’s sucking needs to be met at the breast. If your baby needs to be supplemented, try to use a cup, syringe, or tube feeding system, especially in the very beginning (babies under 2 weeks old). This is less of a concern with older babies who are well established with breastfeeding, as they are much less likely to have trouble switching back and forth between breast and bottle.
- Be sure you have access to a good quality pump. Unfortunately, many of the manual hand pumps or low-cost battery pumps aren’t the best. A hospital-grade rental pump or a good quality double electric, like a Medela Pump in Style or Spectra S2, are great choices. If cost is an issue, check with your health insurance. Many health insurance companies will cover the cost. (Read more here for our favorite breast pumps)
- Tip: often, this is listed under “durable medical equipment” in your insurance policy. You may need to refer to that in your call- and be persistent!) If you do not want to purchase a pump, consider renting a hospital-grade breast pump for a few days. Hospital-grade pumps have stronger, more powerful motors, and are the most efficient pumps you can use. They are bigger and heavier, so they aren’t as portable as other pumps. The hospital, a LLL Leader, or your childbirth educator should be able to provide you the information you need to find a breast pump rental station and also how to contact an IBCLC if you have further questions about increasing your milk production.
- The best way to increase your supply is to double pump for 5-10 minutes after you nurse your baby or a least 8 times in 24 hours. Most pumps work better on the higher suction settings. The minimum is kind of like the baby sucking in his sleep toward the end of the feeding. Maximum is more like the vigorous sucking he does for the first few minutes of the feeding.
- Certain food supplements may increase your milk supply. Before using any of these, it is important to rule out other problems such as illness in the mother or baby. Some herbal supplements have been used for many years to increase milk production, with the most popular being Fenugreek, Blessed Thistle, Red Raspberry, and Brewers Yeast (containing B vitamins). None of these herbal remedies have been proven scientifically to increase milk supply. However, they’ve been used by moms for hundred of years with varying degrees of success. Many moms do see somewhat of an increase, and these herbs are generally considered safe, so it is okay for moms to try them along with other methods if they want to, but to have realistic expectations about the results. (Ask your care provider before purchasing.)
- Fenugreek is rated GRAS (generally regarded as safe), but when taken in large doses, may cause lowered blood sugar, so it should be used with caution by people with diabetes. It is in the same family with peanuts and chickpeas and may cause an allergic reaction in moms who are allergic to them. It has not been known to cause any problems for the babies of the mothers who take it but shouldn’t be used by pregnant women because it may cause uterine contractions. If the Fenugreek is going to help, moms usually notice an increase in one to three days. Fenugreek is used in artificial maple flavorings and may cause a maple-syrup odor in the mother or baby’s sweat. That means that enough of it is in your system to be effective.
- Avoid taking hormonal birth control. Many women experience a loss in their milk production once they get back on their hormonal birth control. Some of them even dry up. Talk to your care provider before you decide on birth control and which option is best for you.
- If all other methods of increasing milk production haven’t worked, there are two prescription medications available that may be used to increase milk supply: Metoclopramide and domperidone. Studies have shown an increase of 66 to 100% in milk production. Depending on the dose given and how much milk the mother was producing before taking these medications.
- Metoclopramide (Reglan, or Maxeran) has been used in infants for years to treat reflux. It’s also given to moms who’ve had a C-section to help prevent nausea. When a lactating woman takes it, it stimulates prolactin production. Also, it will nearly always increase milk output within 2-3 days. A dose of 30-45 mg per day seems to be the most effective.
- If you are taking Reglan, you should also address the cause of the low supply by correcting positioning or pumping frequently, or your supply will drop back to previous levels when you discontinue taking it. Even though Reglan is considered a safe medication for moms and babies, it has frequent side effects for moms like fatigue, irritability, and depression, which have made its use for many nursing mothers unacceptable.
- There is another drug that is more effective than Reglan at increasing milk production. Like Reglan, it is also used to treat gastrointestinal disorders in infants as well as adults. It has the same side effect of increasing prolactin production by the pituitary gland. Domperidone (Motilium) has been used in Canada and other countries for decades and is a safe and effective medication that significantly increases milk production. Domperidone has fewer side effects than Reglan because it does not enter the brain tissue in significant amounts. However, some women have had bad side effects, so be sure to consult with your care provider before being given this prescription.
There you have it! Several ways to increase your milk production. Share tips and tricks that you’ve learned or tried that worked for you in the comments below!
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