Breast-Feeding: How to Increase Your Milk Supply

How do my breasts produce a good supply of milk?

Your breasts should produce plenty of milk if:

• your baby stimulates your breasts by nursing regularly and effectively
• your breasts are regularly and effectively drained by breast-feeding or breast pumping.

The more milk you remove from your breasts, the more milk you will make. If your milk supply is low, there is a good chance you can increase it by stimulating and emptying your breasts more effectively. In general, the longer your milk supply has been low, the longer it will take to produce more milk. In some cases, you may not be able to increase a very low milk supply to normal levels.

What causes a low milk supply?

Most often low milk supply is due to not draining the breasts effectively. Causes of a low milk supply include:

• having a non-demanding, sleepy baby who does not nurse often enough or who does not suck vigorously
• being separated from your baby during the first week after delivery (for example, if your baby was sick and you were not able to nurse or pump)
• having a baby who doesn’t suck well and doesn't empty your breasts well
• regularly using formula supplement, which causes your baby to nurse less often
• having a baby who sleeps though the night (6 or more hours) without nursing
• having health problems after delivery, such as high blood pressure, anemia, or an infection
• being under a lot of stress, going on a weight-loss diet, or going back to work
• having very sore nipples
• having had previous breast surgery, especially around your areola.

A few women can’t make enough milk even though they are nursing a strong, healthy baby and using proper technique. Sometimes no cause can be found for a mother's low milk supply. It is not true that every woman can breast-feed successfully.

How do I increase my milk supply?

• Try to nurse your baby more often.

  If your baby is sleepy, undress your baby to wake her up. Try switching breasts every 5Â minutes.

  During feedings, support your breast with your thumb above and four fingers below. If your baby is sleepy or stops sucking when the flow of milk slows down, use breast compressions to help your baby keep sucking. Squeeze your breast firmly, but gently, to squirt a spray of milk into your baby's mouth. You do not need to hold, just compress, release, then compress, and release again. This can help your baby get more milk from your breasts.

  If your baby is underweight, premature, ill, or has neurologic problems, your healthcare provider may suggest that you limit the length of each breast-feeding so you don't tire the baby. As your baby gets stronger, she can nurse for a longer time. Meanwhile, your baby probably will need extra feedings until your milk supply increases and she gains more weight. You can use pumped breast milk for these extra feedings, and extra formula, if needed.

• Pump your breasts.

  Use an electric breast pump to remove extra milk after feedings about every 2 to 3Â hours. Try to pump right after you nurse your baby. You can go for up to 5Â hours without pumping at night, but aim for 8 pumpings every 24Â hours.

  Record the amount of milk you pump each time. The totals for each day will help you see how much your milk supply is increasing.

  Using an electric breast pump to stimulate and empty your breasts is especially important if your baby needs extra feedings of pumped milk. Babies getting extra feedings may nurse less often, and some who are fed with a bottle will nurse less effectively.

  To find where you can rent a pump, call Ameda at 1-866-992-6332 or Medela at 1-800-435-8316.

• Drink plenty of fluids, eat well, rest, and get support from friends and family.

  Drink plenty of liquids each day and eat healthy meals, plus healthy snacks. Try to get extra rest for at least 2Â weeks. Try not to get discouraged. Keep thinking positively. Get help and support from your close friends and family.

• If you think your let-down reflex is poor, try the tips in the let-down reflex topic.

If you have a medical problem, such as high blood pressure, anemia, or an infection, your milk supply may increase as your health improves.

How do I give my baby extra feedings?

If your baby is very underweight, your healthcare provider may advise you to give your baby extra breast milk or formula as well as the breast milk your baby gets from nursing. Your baby may need extra feedings while you work to increase your milk supply. A very underweight infant is not able to stimulate more milk production by long sessions of nursing. Regular use of a fully automatic electric breast pump after nursings will help increase your milk supply while your baby catches up in his growth. Your baby will probably nurse better once he reaches a healthy weight.

Bottles are usually the fastest way to feed extra milk to an underweight baby. Once a baby has reached a healthy weight, you can try a device called a Supplemental Nursing System (SNS). The SNS can give extra milk to your baby while you are breast-feeding. The baby suckles both your breast and a little tube connected to a bottle of expressed breast milk or formula. The SNS can help a baby nurse more effectively by providing a ready flow of milk at the breast. You can get an SNS from a lactation consultant. Make sure a healthcare provider shows you how to use the SNS correctly. Incorrect use of the SNS can keep your baby from getting the right amount of milk.