Children & Adolescents Clinic

 Home Parent's Guide

Clinical Reference Systems: Pediatric Advisor 10.0

How to Increase Your Milk Supply

How do my breasts produce a generous supply of milk?

Your breasts should produce a generous supply of milk if:

  • your baby regularly and effectively sucks from your breasts
  • your breasts are regularly and effectively emptied during feedings (or by breast pumping).

Typically, 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, it may not be possible to increase a very low milk supply to normal levels no matter what you do.

What causes a low milk supply?

Low milk supply is one of the most common breast-feeding problems for nursing mothers. Frequent causes of a low milk supply include:

  • having a nondemanding, sleepy baby who does not awaken often enough to nurse 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 sucks improperly and doesn't empty your breasts well
  • regularly using formula supplement, causing your baby to nurse less frequently
  • having a baby who sleeps though the night (7 or more hours) without nursing
  • being ill yourself with complications after the 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 that make it hard for you to breast-feed
  • having had previous breast surgery, especially if it damaged your milk ducts.

A few women are unable to make sufficient milk even though they are nursing a vigorous, healthy baby and using proper technique. Sometimes no apparent cause can be found for a mother's low milk supply. The popular myth that every woman can breast-feed successfully is simply not true.

How do I increase my milk supply?

  1. Try to nurse your baby more often.

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

    If your baby is underweight, premature, ill, or has neurologic problems, your doctor may recommend 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 require supplemental milk feedings until your milk supply increases and she gains more weight.

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

    Drink plenty of liquids each day and eat regular nutritious meals, plus healthy snacks. Try to get additional rest by doing only the bare necessities for at least 2 weeks. Try not to get discouraged. Keep thinking positively. Get help and support from your close friends and family.

  3. Pump your breasts.

    Use a rented, hospital-grade, electric breast pump-- preferably with a double collection system--to pump your breasts after feedings about every 2 to 3 hours. Try to pump right after you nurse your baby. You can go 5 hours without pumping one time at night, but aim for seven pumpings every 24 hours.

    Record the amounts of milk you pump each time. The totals for each day will help you know 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 to drink supplemental formula. Babies getting supplements 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/Egnell at 1-800-323-4060; Medela, Inc., at 1-800-Tell-You (1-800-835-5968); or White River at 1-800-342-3906.

  4. If you think your let-down reflex is inhibited, try the suggestions for conditioning your milk ejection reflex listed on the let-down reflex topic.

    See The Let-Down Reflex

If you have physical problems, such as severely sore nipples or a breast infection, your milk supply may increase as your nipples heal or your infection is treated.

When and how should I use supplements?

Remember, above all else, your baby's welfare is the most important concern. If your baby is very underweight, the doctor may decide that your infant needs to gain weight fast. In this case the doctor may recommend giving your baby infant formula in addition to breast milk feedings while you work on increasing your milk supply. A seriously underweight infant is not in any condition to stimulate more milk production by long sessions of nursing. Regular use of a hospital-grade electric breast pump after nursings will be more helpful in increasing your milk supply while your baby catches up in his growth. Prompt improvement in your baby's weight will reassure you and your doctor about your baby's health. Your baby will probably nurse better once he reaches a healthy weight.

When supplements are necessary, formula or your expressed breast milk can be fed to your baby by bottle, cup, syringe, or a device called a Supplemental Nursing System (SNS). The SNS can provide supplement to your baby while you are breast-feeding. The baby suckles both your breast and a little tube connected to a bottle of formula or expressed breast milk. 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 Medela, Inc. (1-800-835-5968) or from a lactation consultant. Make sure a health care 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.

Bottles are usually the fastest way to give a supplement to an underweight baby. Once a baby has reached a healthy weight, one of the other, slower methods can be used. You should not try to use one of these other feeding methods unless a lactation consultant or a health care provider shows you how.

Written by Marianne Neifert, M.D., and the clinical staff of The HealthONE Lactation Program, Rose Medical Center, Denver, CO. (303) 320-7081.
Copyright 1999 Clinical Reference Systems