Most women who stop breastfeeding do so because they are convinced that their milk supply is insufficient. The idea of not being able to provide in the needs of this little baby they love so much is daunting. Most of the time a mother actually had enough milk, but simply didn’t understand normal breastfeeding patterns and didn’t receive the right information and support. There are various false alarms that wrongly indicate a low milk supply. In this article, we will discuss how to boost your milk supply.
Dr Christina Smillie, a paediatrician and International Board Certified Lactation Consultant (IBCLC) makes a strong case for believing in our bodies’ ability to make enough milk for our babies. Mothers should try to not look at their production as a ‘milk supply’, as this implicates a stash that can run out. We don’t worry about running out of other bodily fluids, like tears or sweat. We know that we will make it as we need it! You should rather focus on your breasts’ milk production capacity. While there are some things that can increase this capacity and other factors that can hamper it a bit, the capacity is there.
The only true way to judge if you have enough milk is to look at your baby’s nappies and weight gain. if your baby is having 5-6 wet and/or dirty nappies in 24 hours and has a sufficient weight gain, you don’t have a low supply. If this is not the case you may have a reason for concern.
READ MORE: Five basic tips for breastfeeding
What would truly cause milk supply problems?
It’s true that there are some women who really do struggle. There are various medical factors that can potentially affect supply, including hypothyroidism and previous surgery to the breasts.
Milk supply is also a special challenge for mothers expressing milk for their babies, as the stimulation from a breastpump is never as good as that of a baby sucking on the breast. For those with babies in NICU, mothers exclusively pumping and bottle feeding, and those breastfeeding while back at work this is, unfortunately, their reality.
Lastly, there are many other breastfeeding practices that can accidentally lead to a low supply, many of them advised by healthcare professionals who should know better.
Below, a few tips to help you boost and maintain your milk supply
You should firstly consider seeing a lactation consultant to help you determine the extent of the problem as well as the possible causes.
Back to breastfeeding basics
The main factors involved in milk supply are nipple stimulation and proper breast emptying.
Anything that interferes with these will affect your milk supply.
- Make sure your baby is latching correctly and emptying the breast well. The latch shouldn’t be painful, you should hear baby swallowing, and your breasts should be soft after feeds.
- A lactation consultant or a healthcare professional experienced with tongue ties should exclude the presence of a tongue tie, as this is a common reason for low supply, even in a baby who was initially feeding well.
- Feed baby on demand – as much as she wants, when she wants. Scheduling baby’s feeds can cause a lot of harm.
- Allow your baby to empty the breast and come off on his own, before moving him to the other breast. Some babies drink from one breast a feed, while others may ask for both.
- Do skin-to-skin contact with your baby, the more the better. Use a wrap or a sling to help you with this during your daytime activities.
- Do not use a pacifier to attempt to lengthen the time between your baby’s feeds. Comfort sucking is an important aspect of stimulating milk production
Despite lots of negative press, nipple shields can be a wonderful tool for babies not latching. But you should know that the stimulation on the nipple via a silicone shield is not as good as without it, and supply may be affected.
In fact, if you are struggling so much with breastfeeding that you need a shield, you should definitely also see a lactation consultant.
Because of the shield, a mother may not experience nipple pain, even though her baby is not latching correctly. This may lead to her missing a latching issue. The baby should not suck only on the tip of the shield, but should still pull the whole nipple and areola into her mouth. You should hear swallowing and should see milk in the tipe of the shield.
To ensure that you establish your supply properly it would be worthwhile adding extra expressing sessions to your schedule in the first weeks if you are feeding with a shield. You may also need to give baby some extra expressed breastmilk to ensure proper weight gain until feeding is established.
Avoid top-up feeds
Remember that you make milk on demand. If part of baby’s demand comes from a formula bottle, your supply is going to be lower than it should be. Many mothers start with a small top-up that gradually becomes bigger and bigger until she eventually is giving mainly formula.
You should try to treat the problem at its root rather than going straight to a formula top-up. For this you may once again need professional help.
If you do need a top-up, try to rather use expressed breastmilk. If you have to give formula you should continue expressing milk to stimulate your breasts in the place of any feedings missed.
Expressing breast milk for stimulation
Expressing extra sessions with a breastpump will help to stimulate your own supply. There are a few ways to go about this.
Ideally, you should express a few minutes extra after every feeding that baby had on the breast. Most mothers struggle to find time to do this. If you are unable to manage you can choose to add in 2-3 expressing sessions to your daily feeding routine. You should express in the place of any feedings that you miss (for example when you are back at work).
If your reason for expressing is to boost your supply, the amount of milk you manage to express is less important. There will be some sessions where you get out no or only a small amount of milk. But keep going as the stimulation is what you’re after, and you will reap the rewards later.
There are many tips for better expressing. You should try to relax and not focus on the outcome too much. Read a book or listen to some music. Cover your breast and the pump so that you’re not tempted to sit and measure the millilitres, which can cause anxiety and indirectly lower the volume you express. Massaging your breasts before and during expressing, and applying heat to the breasts can yield a better milk volume.
Choosing the correct breastpump plays a major role in the success of the whole process. You need a pump that can maintain a higher amount of cycles in a minute, something that many of the on-the-shelf breastpumps are unable to do. A double pump will offer better stimulation and higher milk volumes than a single pump, and will save you a lot of time. The flange size should be correct for your nipples, as a flange too big or too small can substantially influence supply. Considering the cost of formula feeding the money spent on a good-quality breastpump is well worthwhile.
ALSO READ: How to choose a breast pump
Power pumping is a method of expressing milk that can give you that extra boost for your milk supply that you need. It’s more effective for some mothers than for others, and although there are no guarantees that it will work it is definitely worth a try.
Power pumping simulates cluster feeding in baby, where a baby has some periods in the day where he has a few feeds on top of each other.
A power pumping session should not replace any of your regular feeding/expressing sessions, but should be added on top of your normal regime. One session of power pumping a day is usually enough. It can take up to 7 days to see a difference in your supply.
Power pumping needs takes an hour and work as follows:
- Pump for 20 minutes
- Rest for 10 minutes
- Pump for 10 minutes
- Rest for 10 minutes
- Pump for 10 minutes
Galactogogues – natural remedies to help boost milk supply
Society loves quick fixes, and most mothers who experience milk supply issues envision the solution to lie in a tablet/herb/food/lactation cookie. The sad truth is that these may offer supportive treatment but will rarely on its own have a massive effect.
Galactogogues are herbs and ingredients that increase milk production. There are many natural products marketed for this purpose, but they are difficult to comment on. What work for one mother may not work for another. Ingredients are often not backed by research. Herbal products are poorly regulated, so dosages and the quality of different brands can differ vastly, making research even more challenging.
Even though herbal products are natural, they can still have side-effects on mom and baby, and interactions with other medications that the mother is taking.
Fenugreek is a herbal supplement that can increase supply for some women. However, it can influence blood sugar levels and should be used with caution in women with blood sugar problems. It can also cause side-effects like a dry mouth and a change in body- and urine odour.
Alfalfa, blessed thistle and caraway are herbs typically recommended for milk supply.
Medication to help boost your milk supply
Your doctor can prescribe medication to boost your supply, though this should not be the first course of action.
Esperide is an antipsychotic drug with the side-effect of causing milk supply. Esperide can have many side-effects and should be used with caution.
Newer medication protocols make use of the drug Domperidone, which is considered to me more effective and safer. However, it’s very expensive and should be used with caution in clients with cardiac arrhythmias. It is also not available in all countries.
A word of hope
With the correct help and support, most women will be able to successfully produce the breast milk their babies need. But circumstances differ, and a mom is by no means failing if she is struggling to do so.
Remember that there is not only one correct way to breastfeed. Some mothers will simply end up feeding both breast and formula.
Any breastmilk that your baby is getting is worth gold. Find joy in this gift that you are giving your baby, and be proud of yourself for persevering. Because that is what a big part of motherhood is all about.