How To Increase Your Milk Supply

WHAT YOU SHOULD KNOW:

• Breast milk provides the best nutrition for your baby. Breast milk has substances in it that are healthy for your baby. Breastfeeding helps protect your baby from infection. It also may decrease your baby's risk for allergies and other medical conditions, such as asthma and diabetes. Breastfeeding can decrease your risk for diseases, such as breast and ovarian cancer and diabetes.
  
  
• Your breasts have tissue in them that are filled with cells that make milk. You will lactate (create milk) for as long as milk is removed from your breast by breastfeeding or pumping. After giving birth, you will breastfeed your baby colostrum until your milk supply comes in. Colostrum is a thick type of milk that has many nutrients in it. It normally takes about 2 to 4 days before milk starts replacing the colostrum.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

• Galactogogues: These are medicines that may help your body start making breast milk or increase how much milk you make.
  
  

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Reasons your breast milk supply may decrease or be absent:

Even if you are breastfeeding your baby correctly, you may have a low or absent milk supply. Certain factors may delay how soon your milk comes in or cause your body not to make milk. Ask your caregiver for more information about the following:

• Abnormal hormone levels: Certain hormones (body chemicals) help your body make milk needed for breastfeeding. When the levels of these hormones are increased or decreased, your milk supply may decrease.
  
  
• Giving birth: Having your baby preterm (too early) or by Cesarean section (C-section) may lead to a low or absent milk supply. A C-section is when your baby is delivered through a cut in your abdomen. You may have a low or absent milk supply if you had a large amount of bleeding after giving birth. You also may have trouble making milk if part of the placenta stays in your uterus (womb) after giving birth. The placenta forms during pregnancy and brings oxygen and nutrients from the mother to the fetus (unborn baby).
  
  
• Abnormal or altered (changed) breast tissue: If your breasts do not develop (grow) normally, you may have a low or absent milk supply. This may occur if your breasts are far apart and tube-shaped. You also may have a decreased milk supply if you had surgery on your breasts. This includes having breast implants or having surgery to decrease your breast size.
  
  
• Medicines: Certain allergy, birth control, and pain medicines can lead to a low or absent milk supply.
  
  
• Medical conditions: If you have medical conditions, such as diabetes and high blood pressure, they may cause problems with your milk supply. Problems with your ovaries, such as having cysts (lumps), can cause a low or absent milk supply. You also may have trouble making milk if you are obese (weighing more than caregivers suggest).
  
  
• Breast problems: If your breasts become engorged or infected, your milk supply may be decreased. Engorgement can occur when your breast milk comes in, causing your breasts to become swollen and painful. Sore nipples may make you breastfeed less, causing delayed milk creation.
  
  
• Stress: As a new mother, you may have increased stress, be very tired, and worry more. This may cause you to have a decreased supply of breast milk.

Signs that your breast milk supply may be low or absent:

• Your baby looks as if he is losing weight.
  
  
• Your baby is four or more days old and has less than six wet diapers a day.
  
  
• Your baby is four or more days old and has less than three soiled diapers a day.
  
  
• You do not hear your baby swallowing while you are breastfeeding. Your baby also may seem tense (not relaxed) while trying to breastfeed.
  
  
• Your baby shows signs of hunger more often than usual or acts as if he did not get enough milk after a feeding. He also may not sleep well.
  
  
• You do not feel or see changes in your breasts, such as fullness before feeding and softness after. You should see these changes within five days of giving birth.
  
  
• Your baby becomes jaundiced (skin and whites of the eyes are yellow).

Increasing your breast milk supply:

• Make sure you have proper breast stimulation and your breasts are emptied completely:
  
  
  • Using a breast pump after each feeding may help stimulate (increase activity of) your breasts to make milk. The breast pump also allows you to empty each of your breasts completely. If milk is not completely emptied from your breasts, the amount of milk you make may slow down.
    
    
  • You can use a breast pump if you are unable to breastfeed your baby. If you are away from your baby and not able to breastfeed, pump your breasts every 2 to 4 hours. Pumped breast milk can be stored and used for a later feeding. Breast massage may also help stimulate your breasts and increase your milk supply.
  
  
• Feed your baby 8 to 12 times each day or about every three hours: Feed your baby as soon as he acts hungry. You may need to breastfeed your baby more often if he acts hungry. Signs of hunger include putting his hand to his mouth, making sucking noises, and moving more than usual. You may need to wake your baby to breastfeed more often until your milk supply increases. Do not set a time limit for how long you breastfeed your baby. During each feeding, let your baby feed from each breast. Talk with your caregiver about ways to make sure your baby gets enough nutrition when your milk supply is low.

Caring for yourself when breastfeeding:

• Keep a diary: Write down each time you breastfeed your baby and when you pump your breasts. Make a note of how much milk you pump out each time. You can also write down when your baby has wet or soiled diapers. A diary can help you and your caregiver learn if you are making enough milk to feed your baby.
  
  
• Eat a healthy diet: Eating enough healthy food can help your body make enough breast milk. Your caregiver also may have you take vitamins, such as vitamin D. Talk with your caregiver before taking any vitamins or supplements. Do not diet to try and lose weight when you are breastfeeding. You also should drink at least 8 eight ounce cups of liquid each day. Talk with your caregiver about what foods you should eat and how much. Together you can plan the best diet for you.
  
  
• Manage your stress: Increased stress can decrease your supply of breast milk. Relaxation can help decrease your stress and help you feel better. Deep breathing, meditating, and listening to music also may help you cope with stress. Talk to your caregiver about other ways to manage stress.
  
  
• Talk to your caregiver before taking any medicines: This includes all prescription and nonprescription (over-the-counter) medicines. Some medicines may decrease the amount of breast milk you make.
  
  
• Do not smoke: If you smoke, it is never too late to quit. Smoking can decrease how much breast milk you make. Smoking harms your body in many ways. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. Talk with your caregiver if you smoke and need help to quit.
  
  
• Limit or avoid alcohol: If you choose to drink alcohol, breastfeed your baby before you drink it. Do not breastfeed your baby for at least 2 to 2 ½ hours after having one drink. One drink of alcohol is 12 ounces of beer or four ounces of wine. One ounce of liquor, such as whiskey, is one drink of alcohol.

CONTACT A CAREGIVER IF:

• Your baby is four or more days old and has less than six wet diapers each day.
  
  
• Your baby is four or more days old and has less than three bowel movements (BMs) each day. The BMs should be yellowish.
  
  
• Your baby is not gaining weight or looks as if he is losing weight.
  
  
• Your baby is feeding less than eight times each day or does not seem to be eating enough during each feeding.
  
  
• Your baby seems more fussy than usual or seems as if he does not have the energy to breastfeed.
  
  
• Your breasts do not feel full or swollen, or you are not leaking breast milk within five days of giving birth.
  
  
• You have pain and swelling in one or both of your breasts. Your breasts also may feel warm.
  
  
• You are taking medicine to increase your milk supply and feel dizzy, nervous, or very sleepy. You also may have stomach pain and diarrhea.
  
  
• Your baby has new or increased yellowing of his skin or the whites of his eyes.

SEEK CARE IMMEDIATELY IF:

• You are feeling very depressed (deep sadness).
  
  
• You are taking medicines to increase your milk supply and feel as if your heart is fluttering in your chest.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.