Many mothers have difficulty at some point in their breastfeeding journey. While each mother and infant dyad will have a different experience, many mothers feel that they are not producing enough breastmilk for their infant. Because each lactation journey is so personalized, getting into the reasons behind a low milk supply is also situational. Maternalwell can help connect you with certified lactation consultants that can explore why you may have a low milk supply and make your personal journey easier with virtual lactation consults. For right now, let’s explore some possible solutions for increasing a milk supply.
When a mother feels that her milk supply is not adequate there are many factors and measurable outcomes that need to be considered, such as volume of milk that she is able to pump, infant weight trends, and diaper counts. These are certainly not the only things to consider, however for the sake of simplicity, it is a good start. A low milk supply may be a real, or a perceived problem, but the resulting stress and anxiety is the same regardless.
If you think her your supply is low because you only pump one ounce at a time, but when your infant exclusively breastfeeds he/she gains weight appropriately and has enough wet and stool diapers, this is most likely a case of not pumping well and is probably not a true milk supply issue. It is more of a perceived low milk supply. This is fairly common and often mothers think “I don’t have enough milk for my baby”.
Breastfeeding, and therefore pumping, is very hormonal. When an infant breastfeeds well, a hormone called oxytocin is released from the brain. This hormone goes to the breast to release the milk from the alveoli (milk making cells) and milk then travels to the nipple via the milk ducts. This is known as the let-down reflex, when the milk starts flowing easily. There are multiple let-downs in a typical breastfeeding session. When you are pumping, your body may not respond as well to a pump as it does to a baby. Shockingly, a pump is not a cute and cuddly baby, it is a machine, and therefore your body may not release oxytocin and trigger those milk let-downs the same way. If you find yourself in this situation, try to trigger the oxytocin hormone release the best you can with things that remind you of your baby while pumping. Looking at your baby’s picture or smelling a blanket that your baby has used may help; while playing on your phone, watching tv or working may hinder that hormonal release. Some breast pumps give you the option to customize your pumping cycle (how fast or slow the suction rhythm goes). If you better match your baby’s sucking pattern, you may find that your body responds with better milk output. Although not pumping well may not start as a true milk supply issue, that doesn’t mean that it can’t become one. If you are depending on a breast pump to empty your breast well while you are away from your baby for long periods of time (such as a typical work day) or consistently (such as a typical work week) and it is unable to do so, your body then thinks your baby did not need as much milk and then will reduce the milk supply in response. If you are using a pump for short periods of time away from your baby, or infrequently need to rely on a breast pump, your body may be able to maintain your milk supply by otherwise breastfeeding your baby on demand.
It is also common for a mother to state she has a low milk supply when she returns to work. Many mothers return to work in the United States when their infant is about 3 months old. Leaving your baby for the first time, or for the first prolonged time is very stressful. While this might not be your first time pumping, it may be the first time you are depending on pumping frequently to not only maintain your supply, but maintain a food source for your child. This is also very stressful! As if this stress isn’t enough, your baby may be feeding more than normal when you are home because they are going through a growth spurt. So, you are stressed, you may not be pumping very much volume when you are away, and the baby is acting like they aren’t getting enough when you are home. All of this may lead you to believe you aren’t keeping up with your milk supply, which then creates more anxiety. If all of that isn’t enough, you may also be dealing with more stressors at work, such as when/where to pump so as not to interfere with your work productivity or co-workers. Stress decreases your milk supply. If you had a good, or at least adequate, milk supply before going back to work, your milk supply will most likely recover as you adjust to your new routine. Try to stay the course and see how your milk production trends over the first week or two.
If you think your milk supply is low because your baby is not gaining weight, not having many wet or stool diapers, and you are unable to pump much milk, this is a true low milk supply issue. To increase milk supply, the first factor to consider is how often you are breastfeeding and/or pumping. Feeding on demand, by following your baby’s feeding cues, not a schedule, is important. If a baby isn’t getting enough milk, they will typically breastfeed more, or cluster feed. This may be because there is a low milk supply or because they are going through a growth spurt and need more milk to grow. Typical growth spurt times are 3 weeks, 6 weeks, 3 months and 6 months. A good start to having an adequate milk supply is creating a demand on your body that milk is needed and the supply will hopefully follow.
A newborn to one-month old baby should naturally be breastfeeding at least 8-12 times per day. After around one-month of age the frequency of feedings will naturally decrease some over time, as the baby becomes more efficient at the breast and then starts eating other foods. If you are putting the baby to the breast you should usually continue to do so. If you are unsure if your baby is breastfeeding often enough, well enough, are struggling with your milk supply, pain with breastfeeding or any other questions or concerns, the lactation consultants at maternalwell.com can help!
You may be tempted to skip right to trying foods, supplements, and/or medications to increase your milk supply, however, adding pumping to your breastfeeding routine should be the first course of action and is necessary to create an additional demand for milk on your body and therefore increasing your supply. To add in pumping, offer the breast first, then pump after. The goal with pumping is not how much milk you can get, but how much you can create. That might seem counterintuitive. Of course, it is great if you can get milk, that is the end goal, but even if you aren’t getting a lot stick with it. Pumping, even if you aren’t getting much, is releasing another hormone from your brain called prolactin. Prolactin is telling your body to make more milk. It may take several days to see an increase in your milk supply, so try to be patient.
When you are pumping, you should pump both breasts for about 15-20 minutes, after breastfeeding. Pumping both breasts at the same time will not only save time, it also increases your prolactin levels, increasing your milk production! Make sure to maximize the features that your pump offers. When a baby breastfeeds, they begin by sucking quickly. This triggers the oxytocin release and starts the first let-down reflex. When the milk lets down the baby is getting much more milk, so the sucking slows and alternates with swallows. It may take a minute or two from when the baby starts breastfeeding to when the milk starts flowing more freely. There are multiple let-downs in a feeding session, so when the milk slows down, the baby will repeat the cycle to get more milk. Depending on the brand of pump you are using, many pumps have a let-down button or feature. The pump may start fast for a few minutes then automatically switch to a slower cycle and/or have a button that switches between the fast and slow. Alternatively, some pumps have a manual control for how fast the cycling is. When you begin pumping, you should be using a fast cycle until your milk lets down. You will see milk spraying or dripping into the bottle when your milk is letting down. At this point you should change to a slower pattern. If you notice that the milk flow has slowed down significantly, then go back to fast and repeat. Trying to mimic what a baby would naturally do if fairly easy and will create better outcomes.
Similarly, to mimicking a baby’s sucking pattern, you can mimic their feeding pattern. As discussed earlier, if a baby isn’t getting enough milk, they will typically cluster feed. Cluster feeding is a lot of feedings in a short amount of time. Most mothers experience cluster feeding for the first time on the second night after their baby is born. The baby comes out of the sleepy phase and there is not yet much milk. The infant cluster feeds and helps to bring the mother’s milk in quickly. This repeats with growth spurts to quickly increase the milk supply. When a baby is cluster feeding, they might breastfeed for 5 minutes, then take a 5-minute break; breastfeed for 10 minutes every hour; or just nurse constantly for hours. This is all normal. To mimic cluster feeding, you can do what is referred to as power pumping. There are different ways to power pump. One way is to pump 10 minutes on, 10 minutes off for an hour. Another is to put your pump in a room that is used often and pump for 10 minutes every time you walk by it for a few hours each day. The result is the same: you are increasing the demand on your body to increase your milk supply.
If you are pumping in lieu of breastfeeding, either by choice or due to separation, you should ideally pump like the baby would feed. Again, mimicking what the baby would naturally do will create better milk production. Typically, a baby will breastfeed about every 2-3 hours. Therefore, when you are away from your baby, or if you are exclusively pumping, you should be pumping at least every 2-3 hours.
Try not to stress over the volume of milk you are pumping during this stage of increasing the demand. You will most likely not see immediate results; it may take 3-4 days or maybe even a week. Your goal should be to make enough milk for your baby. Although it is nice, and surely less stressful to have a surplus of milk in the freezer, focus on making what your baby is taking. If you are supplementing with formula, a good first goal is to replace the formula with breastmilk. Depending on how old your baby is and how poor of a supply you are starting with, you might not be able to achieve a full milk supply by breastfeeding and pumping, but it is an important first step.
The American Pregnancy Association’s article, “Do I Have a Low Milk Supply?”, offers more great information and resources. The article details how to know if your baby is getting enough milk, some rational behind low milk supply and other ways to increase your milk production.
If you are struggling with your milk supply or any other breastfeeding problems, you are not alone! To learn more about our lactation services and schedule a virtual visit with one of our licensed lactation consultants please visit us at Maternalwell.com.