Mother’s Own Milk:
Establishing and Maintaining a Good Milk Supply for Your Term Baby
Stimulating the breast often during the first days and weeks after giving birth is a great way to get a good milk supply. Begin nursing or expressing milk as soon after delivery as possible. To get your body to make more milk you must remove the milk your body has already made, so it is important to nurse or express milk every two to three hours (8 to 12 times every 24 hours).
If you are feeding your baby at the breast:
Use your baby’s signals to guide breastfeeding. If your baby is waking up and moving, making sucking motions/sticking out the tongue, or nuzzling you (also called rooting) it is time to breastfeed. Your baby may want to eat every hour or so, and most babies feed 8 to 12 times each day. In the early days and weeks after birth, a term baby should not go more than 4 hours without eating. Late preterm infants (those delivered at 34- 36 weeks) should eat more frequently (at least every 3 hours).
Some issues with milk supply are related to improper equipment, poor fit, or inefficient latch and suck. Our lactation consultants are here to help you with these issues, both in the hospital and with follow-up appointments if needed.
If you are expressing your breast milk using your hands (hand expression) or a pump:
- Empty your breasts as often as your baby might eat (every 2-3 hours).
- Try to pump both sides at the same time using a hospital-grade electric pump.
- Have a calm, soothing routine when you pump:
- Use a warm cloth to warm your breasts.
- Sit in a comfortable chair with a table close at hand.
- Have a drink nearby such as water or milk (pumping makes you thirsty).
- Have your pump supplies within reach (extra bottles, washcloth for drips, and lids for bottles).
- Play calm, soothing music in the background.
- If possible, pump while you can see and hear your baby. If you are away from your baby, have his/her picture or a blanket or piece of clothing that he/she has worn recently. Seeing, hearing, and smelling your baby are very powerful ways to get your milk to “let-down.”
- Pump after you hold or feed your baby.
- Massage all areas of your breast before and during pumping to help the milk to move from the deeper breast tissue to the nipple where it exits the breast (also called “hands on pumping”).
- Have your partner massage your upper back and between your shoulder blades to help relax you and help the let-down reflex.
Herbs, Nutritional Supplements and Medications:
- A balanced diet is very important—your body needs fuel and building blocks to make milk.
- Continue to take prenatal vitamins or multivitamins while you are producing breast milk.
- A bowl of oatmeal each day may help maintain or increase your milk supply. Oatmeal is a healthy addition to your diet and will cause no harm to mom or baby.
- Before you begin taking a new medication or supplement, discuss the risks and benefits with your healthcare providers and a trained lactation specialist.
- Fenugreek may help increase your milk supply when taken as a part of a balanced diet that includes plenty of liquids. There is limited information about the safety of fenugreek, especially for moms of preterm babies, but there are very few warnings of it causing harm. Other things should be done before starting a supplement such as fenugreek.
- Herbal preparations such as “lactation tea” sometimes contain fenugreek, milk thistle and many other herbs. These products may contain herbs that decrease milk supply or can cause harm to babies.
- There are no prescription medications available in the United States that will increase milk supply.
Things that do not help your milk supply or may cause harm:
- Reglan may cause permanent side effects in you or your baby and is not recommended for increasing milk supply.
- Beer, hops, and brewer’s yeast do not improve milk supply. Multiple studies show decreased milk production in the hours after ingestion as well as poor feeding and increased drowsiness in babies.
- Over hydration: while dehydration will affect your milk supply, drinking too much water may be dangerous as well. “Drink to your thirst” means you should drink water or low-fat milk when you feel thirsty (on average 8-10 eight ounce glasses a day). So basically, drink a glass every time you feed or pump.
- Mint: peppermint and spearmint may decrease your milk supply.
- Too much caffeine will decrease your milk supply.
- Cold medications containing decongestants or anti-histamines usually cause temporary decrease in milk supply.
- Some birth control medications may affect your milk supply. Have a careful discussion with your healthcare provider about birth control options that will have little or no effect on your milk production. Breastfeeding alone is not considered effective birth control.
Other considerations, if the above techniques have not helped:
- Anemia can cause difficulty developing a good milk supply.
- Some women in the post-delivery period have low levels of thyroid hormone. Discuss this with your healthcare provider (OB or primary care physician)—often correcting the imbalance improves milk production.
- Retained parts of the placenta may cause a failure to produce enough hormones to produce milk, and can cause also illness, pain, bleeding and infection in the mother. Removing those parts of the placenta will often correct this problem.
- A small number of women lack the hormones that are important for breast milk production. Your healthcare provider can help you decide if checking for these rare conditions is needed.