Doctors’ Notes

Increasing Milk Supply

Since breast milk production is based on supply and demand, the key to increasing supply is to empty the breast more often and more effectively. Some key points to remember are:

The Baby is Better Than The Pump

The best way of emptying the breast is to make sure the baby is well latched on and actively feeding.

Keep the Baby Actively Feeding

Most newborns are very sleepy and once they get to the breast, they often just suck for comfort. Make sure you see the entire jaw moving and hear the baby swallowing. Don’t let him sleep at the breast.

Ways to Keep Baby Active at the Breast

Use breast compressions, gently stroke him, move his arm, use a cool cloth and if he is still not responding, take him off the breast, burp him, change his diaper and re-latch him.

Increase the Frequency of Breastfeeding

Milk supply is increased more by frequent, effective feedings instead of longer, infrequent feedings. If the feeding is lasting beyond 15-20 minutes per side, the baby is probably sleeping during some of that time. Not only is he not taking in milk actively, he’s also not stimulating your milk supply.

Be Sure to Take Care of Yourself

Stress can decrease milk supply, so try to rest as much as possible and make sure to eat and drink well. Sleep when the baby sleeps!

Pumping or Hand Expression

If you are pumping to increase supply in addition to breastfeeding, pump as often as you are able without undue stress. If the baby is active at the breast and you have a choice between a nap and pumping, take the nap. If they baby isn’t emptying the breast then you should pump before napping. But that nap is important! Remember that if the baby is effectively nursing, he is emptying the breast and you are only pumping to increase the stimulation to your breast. Therefore, most mothers only get a small amount of milk when they pump after a feeding.
If the baby is either not at the breast or not effectively nursing, empty the breast by either a pump or hand expression. Make sure to pump every time you are giving a supplemental bottle. If you are pumping instead of breastfeeding, make sure to pump at every feeding. If using a breast pump, a double electric pump is the most effective. Hand expression can also be effective.

Hand Expression

1. Place your fingers approximately 1 inch from your nipple, making a “C” around the areola.

2. Push in towards your chest.

3. Compress the breast by pushing your fingers and thumb together.

4. Release and start again.

5. Alternate repeatedly between breasts.

Herbs to Increase Milk Supply

Fenugreek is the most effective herb for increasing milk supply. It comes in capsule form, usually 580-620mg capsules. You should take 3 capsules 3 times a day for a total of 9 capsules a day. It also comes as a combination with other herbs from a company called Motherlove. You should take wither More Milk Plus, which has the highest dose of fenugreek, or More Milk Special Blend, which adds Goat’s Rue for those mothers whose milk never came in properly. More Milk has no fenugreek and should only be taken by those who are allergic or who cannot take it for other reasons.

Medications

The medications used to increase milk supply are often very helpful, but also carry significant side effects. These side effects are best discussed in person. Please call Kids Plus, or the Breastfeeding Center of Pittsburgh, with any questions.

Dr. Nancy Brent is a former Kids Plus Provider and former Medical Director of our Breastfeeding Center of Pittsburgh.