Increasing Supply

Increasing Your Breastmilk Supply

A low supply of breastmilk can be caused by not getting off to an optimal start with breastfeeding or from many other issues. If you are consistent about following these recommendations you will likely see an improvement within a few days. Although it may take a month or more to bring your supply up to meet your baby’s needs, you will see steady, gradual improvement. You will be glad that you put the time and effort into breastfeeding, and so will your baby!!

Breastfeed more often, at least 8-10 times per 24 hours

	Offer the breast between the usual feeding
	Discontinue the use of a pacifier
	Wake the baby for an extra feeding before mom goes to sleep
	Make sure the baby finishes the first breast in his own time before offering the second one
	Offer both breasts at each feeding
	“Burp & switch breasts”, using each breast twice, in both the cross-cradle hold and the football hold
	“Top up feeds” – give a short feeding again in 20-30 minutes

Assure good positioning and latch-on for maximum breast stimulation

	Hold your baby breast height, rolled facing you, nose to nipple, head tilted back slightly
	Stroke your nipple down from nose to chin to elicit a open mouth
	Wait for your baby to open his mouth WIDE and place your baby’s lower lip on the outer edge of your areola. Fold the rest of the nipple into his mouth, aiming at the roof of his mouth.
	Look for a WIDE latch-on (at least 140^O), the lower lip rolled out and no pain
	Listen for swallowing

Pump using a hospital grade breast pump with a double kit

	Pump between feeding
	Rest 10-15 minutes prior to pumping, eat and drink something
	Apply warmth to your breasts and breast massage before pumping
	Pump for 5 minutes, massage again then pump for another 5 minutes
	Pump at the end of feedings for 10-15 minutes

If your baby requires supplementation until your supply increases

	Use a small feeding cup, a feeding tube at the breast or a bottle as directed by your lactation consultant
	Proper use of a bottle nipple:

Use NUK, Avent, or other nipple with a wide base. Select a nipple with a small hole, or only one hole, usually called “slow flow” or “newborn”. Place it deeply in your baby’s mouth so his gums compress the wide part of the base of the nipple. Hold the baby nearly vertical and keep the bottle nearly horizontal so the flow of milk is slower. (If the bottle is held vertically, gravity helps the milk flow very fast).

Condition your let-down reflex

	Play relaxing music
	Imagine baby, look at picture of baby, smell baby clothing or baby powder
	Always pump in same place
	Do slow, deep, relaxed breathing
	Use quiet, relaxed place for pumping

Mother care

	Reduce stress and activity
	Increase fluid intake
	Eat nutritious meals, continue to take prenatal vitamins
	Back rubs to stimulate nerves that affect the breasts (central part of the spine)
	Increase skin to skin contact with infant, relax together
	Take a warm bath, read, meditate, empty your mind of tasks that need doing

Herbs, foods and medications

	Eat a bowl of cooked oatmeal daily.
	Brewer’s Yeast 3 tablespoons daily, increase by ½ teaspoon daily until results are seen (of equivalent in capsules)
	Fenugreek capsules are helpful for many women. Doses of (580-610 mg) 3-5, three times per day are commonly recommended. Discuss this with your physician. Avoid fenugreek if you are diabetic, hypoglycemic, asthmatic or allergic to peanuts or other legumes Fenugreek is available at most vitamin shops or health food stores. Taken as directed, it may cause a faint maple body odor. That is to be expected and means that the herb is doing it’s job. If you would like to read more about fenugreek, go to http://users.erols.com/cindyrn/fenugreek.htm
	Blessed thistle or other herbs or beverages such as Mother’s Milk Tea taken as directed on package. A good source of herbs and herbal blends is MothersLove Herbals http://www.motherlove.com/prd_tinctures.html
	Metaclopromide (Reglan) 10 mg 3 X / day for 10 days, taper dose over several days, may repeat twice (prescription medication, discuss with your MD)

Keep records. It is important to keep a daily log with the number pumping sessions, amount obtained, amount you are having to supplement your baby and 24 hour totals - this amount is more important than the pumped amount at each session. This will help you see your progress over the days. Keep in touch with your lactation consultant so she can monitor your progress and modify your advice is necessary.

Retained placenta. If you are not seeing progress in increasing your breastmilk supply and you are still having bleeding after 2 weeks, consider discussing the possibility of retained placental fragments with your MD. Small bits of the placenta can secrete enough hormones to prevent a full supply or even prevent the milk from coming in.

Low thyroid. Have your physician check your thyroid levels. Low thyroid can affect milk supply. If you have been taking thyroid, have your levels rechecked after delivery. You may need your thyroid medication adjusted.

Avoid these things that are known to reduce breastmilk supply:

	Smoking
	Caffeine
	Birth control pills
	Decongestants, antihistamines
	Severe weight loss diets
	Sage and jasmine tea, parsley, peppermint candies (Altoids, Starlight mints, etc),

Web sites of interest:

http://www.askdrsears.com/html/2/T022800.asp
http://www.askdrsears.com/html/2/T027100.asp

Please remember that this is general breastfeeding information only and does not replace the advice of your health care practitioner. If you have a problem that you are not able to resolve, seek the help of an experienced lactation consultant.