NURSING
MOTHERS, INC.
Increasing Your Milk Supply
Factsheet 28
While you may not know exactly how much milk you produce, you can be assured your baby is getting the amount she needs by following her progress over a period of time. As long as you and your doctor are satisfied with your baby’s weight gain, the number of wet diapers she produces in a 24-hour period, and her overall appearance, you needn’t worry about your milk supply. True supply problems are rare; most are temporary and can be corrected by increasing the frequency of nursings. The suggestions below will help you boost your milk supply to meet your baby’s needs.
Understanding Your Milk Supply
Milk production is based on the principle of supply and demand. When your milk “comes in” shortly after the birth of your baby, your body does not know how much milk your baby will need. Nursing when your baby needs to – at least 8 to 12 times in a 24 hour period for newborns – will allow your body to automatically adjust its milk supply to meet your infant’s needs.
The amount of milk you produce is also influenced by how your baby sucks. Effective suckling provides maximum stimulation to the breast. If your baby is sucking effectively, you will be able to see the muscles that lead from the jaw to the ear working vigorously. You also will be able to hear her swallow after every other suck or so. This activity should last for the first 5 to 10 minutes of nursing.
During the course of a single nursing, the composition of your milk changes. Early in the nursing, you produce foremilk (high in carbohydrates), while toward the end of the session, you produce hind milk (high in fats and calories). Your baby needs to nurse long enough to get both the foremilk and the hind milk that are necessary to healthy weight gain. Allowing your baby to nurse each side until she stops suckling usually ensures she gets the hind milk.
Most babies experience “growth spurts,” or periods when their need to nurse increases. It is not unusual during this time for a bay to request very frequent nursings – sometimes every hour or 1½ hours. By feeding your baby as often as he needs, your milk supply adjusts. These periods of increased nursing usually last only 2 to 3 days, after which time your milk supply has increased. You may also notice increased nursing after a particularly busy day, such as grandparents’ first visit. This is a baby’s way of increasing your milk production to meet his growing need.
Increasing Your Milk Supply
If you find your milk supply dwindling, you should determine the cause of the problem. Milk supply can be affected by a number of factors. Fatigue and stress can adversely affect the amount of milk you are able to produce. A baby who tends to be placid or suckles ineffectively may not be providing the stimulation your breast needs to produce milk in sufficient quantity. The use of nipple shields also can lead to under stimulation of the breast, thereby reducing your supply. An illness may make it difficult for either you or your baby to nurse regularly for a period of time. Some products such as oral contraceptives, antihistamines, and diuretics can cause a decreased milk supply, as can caffeine, alcohol, and nicotine. Consult with your doctor and your Nursing Mothers counselor about which of the following suggestions would be ideal for you.
· Take care of yourself. You need to remember that your well being is important to the success of your nursing. Be sure to eat well and drink to thirst. Smaller meals eaten throughout the day may provide you more energy than several large meals. Get sufficient rest by napping when the baby sleeps, especially in the afternoon. Temporarily relax your standards for cleanliness and order. Accept offers of help and don’t be timid about saying exactly what your friends and relatives can do for you. Attending to yourself enables you to attend to your baby.
· Nurse frequently. Try to nurse your baby every 1 ½ to 2 hours throughout the day and at least once or twice through the night for several days (frequency of nursing is measured from the start of one session to the start of the next). You may have to wake a sleepy baby. Keep in mind that more frequent but shorter nursings – at least 20 to 30 minutes – build and maintain a milk supply more effectively than less frequent but longer nursings. While you nurse, lift your breast from underneath to allow complete removal of all the milk. Do not limit feedings to a prescribed number of minutes. If your baby is nursing effectively, hew ill show he d done by falling asleep, coming off the breast, or changing the active suck to a gentler comfort suck. If, however, your baby falls asleep too quickly, you may want to encourage his nursing by trying “switch nursing” (see below).
· Check positioning. Make sure your newborn is positioned correctly at the breast and has latched on properly. This allows her to get the most milk for her effort. Position her to face your breast, so she doesn’t have to turn her head. Her chin should be touching your breast. To reduce body fatigue, avoid leaning into the baby. Encourage your baby to open her mouth as wide as possible, like a yawn, by touching your nipple to her lower lip. When her mouth is wide open, hug her into the breast. She should take the entire nipple and as much of the areola (the colored area) as she can. Her lips will flange outward as she nurses.
· Offer both breasts. While you are increasing your milk supply, encourage your baby to nurse at both breasts for each feeding. Alternate the breast you offer first.
· Express extra milk. Once your baby has finished a nursing session, use a breast pump or manually express for added stimulation. This is particularly important if your baby has not nursed well on both breasts.
· Add massage to your routine. Gentle breast massage before and during nursing can help stimulate the milk-producing cells. Starting at the chest wall, press your fingers against the breast and make a gentle circular motion for several seconds. Lift your fingers and move them to the next location, spiraling around the breast and outward toward the areola. Finish with a feather-light stroking with your fingertips.
· Try switch nursing. Switch nursing may be helpful to encourage some babies. If your baby’s active sucking pattering lasts for only a few minutes, then changes to little sucks with few swallows and longer pauses between sucks, remove him from the first breast, burp him, and switch sides. Repeat this pattern back and forth so your baby nurses each breast at least twice in a session. Switch nursing stimulates more letdowns in a feeding and keeps the milk flowing faster. This may help your baby stay more interested in nursing effectively for longer periods. Keep your interaction calm and watch for signs of stress in your baby if you try switch nursing. Small infants can become overtired or frustrated.
· All baby’s sucking should be at the breast. Avoid using bottles and pacifiers, at least temporarily. Refrain from using a nipple shield. If your baby has a problem with weight gain and you must supplement your nursing, you may use an alternate supplement-feeding method with the advice of a professional.
· For older babies who are getting added nutrition. Solid food, water, juice and formula will decrease your baby’s interest in nursing. When feeding solid foods, nurse your baby first.
It is important and comforting to remember that by taking good care of yourself and nursing your baby more frequently, you can make more milk. Stay in contact with your doctor and with your Nursing Mothers counselor during this time. She will help you choose the steps that will best help you and your baby.
A ton of information on milk supply issues:
http://www.kellymom.com/milkproduction.html
Related Factsheets
Collection and Storage of Breastmilk
Breast Infections and Plugged Ducts
Managing Normal Breast Fullness and Engorgement
Original: Pam Nolan
Revised: 2/95, Lisa Davis; 1/03 Megan Allen
Copyright on the Internet 1999, NMInc.
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