Ask the IBCLC: Increasing Your Milk Supply

If there's one shared common concern among breastfeeding parents, it's whether or not one is making enough milk for their baby. With solid support and proven methods for building milk supply, parents can enjoy breastfeeding with confidence. 

Where It Starts

Breast and mammary tissue begin developing while a baby girl is in utero, with dramatic changes happening during puberty and pregnancy. (1) During pregnancy the breasts make a small volume of milk called colostrum, but after giving birth (specifically, after the placenta is released) hormone changes signal the breasts to switch to a higher volume of milk production.(2) This is what is referred to when talking about someone's milk "coming in."

Hormonal, genetic, and certain physical factors can affect the ability a woman has to produce a full milk supply- that is, the ability to exclusively breastfeed without requiring additional nutritional supplementation for baby- which is why I strongly encourage a prenatal consult with an experienced IBCLC to create a feeding plan to optimize success. Parents struggling with breastfeeding and lactation have reported an increased incidence of PMADs.(3) 

Expert guidance can alleviate concerns and boost parental satisfaction with their infant feeding goals, whether that is exclusive breastfeeding or not. ​

What To Do First

Early, efficient, and frequent removal of milk are key to building a solid milk supply.(2) I've worked with clients who worried their ability to breastfeed would be marred by an immediate separation from their baby at birth, but please be encouraged to know that we lactation consultants are well-equipped to support families in all circumstances, and we know it's often about playing the long game and making short-term goals along the way.

If Your Baby Is Able to Feed at the Breast

1. Spend time doing skin-to-skin, especially in the early days after birth.
2. Focus on a deep, comfortable latch. A good latch means baby will compress the milk ducts to remove plenty of milk, which also signals the breasts to make more milk.
3. Breastfeed your baby as often as they show feeding cues. Babies are used to feeding 24/7 in the womb, are born with tiny tummies, and desire to be close to the breast as they transition to their new world.
4. Practice hand-expression. Hand-expression is incredibly effective at removing colostrum and helps to boost milk supply. You can spoon, cup, or syringe feed the expressed colostrum.

If Your Baby Is Not Able to Feed at the Breast

1. Enjoy frequent skin-to-skin time, as it has many benefits to parents and babies both, and specifically aides lactation by causing a release of oxytocin- which gets milk flowing.(4)
2. If separated from baby due to a NICU stay or work, look at pictures and videos of your baby and snuggle a blanket or onesie they have used. There's goes that oxytocin release again!
3. Listen this 20 minute relaxation recording at least once a day. Feher and his colleagues found women expressed an average of 63% more milk when doing so during their study.(5,6)
4. Utilize both hand-expression and hands-on pumping techniques.
5. Make sure you are wearing properly fitting breast flanges. The size often changes after the initial swelling in the breasts from labor IV fluids resolves. Pumping should not hurt and pain is a sign of ill-fitting flanges. Medela has a nice sizing guide, as does Pumpin Pals.
6. Express your milk at least 8 times a day and try power pumping.

What About The Cookies?

Look, lactation cookies and other frequently recommended foods can be delicious- but they aren't magic boosters for your supply. Various herbal and medicinal galactogogues exist, but please please work with an experienced IBCLC (and herbalist) before ingesting various herbal blends and teas with snazzy marketing on Insta. Many factors need to be taken into consideration before trying one that may be appropriate for your unique body and circumstances.(7)

Cultures around the world follow traditional postpartum healing practices, and this often includes special lactogenic foods to eat and drink as well. Science may not have answers as to why these practices are effective, but that doesn't mean new parents should relinquish their traditional diets. Eat well to nourish your body and enjoy the love and tender care your community surrounds you with.

The Bottom Line

Don't stress over spending $$$ on anything promising to be the magic trick to boost your supply. Meet with an IBCLC and get all your bases covered; make sure baby is breastfeeding well and you have a solid feeding plan with achievable goals in place.

You can drink all the so-called milk-making teas in the world, but nothing is as effective as properly removing milk from the breasts and signaling your body to keep up with the demand for more!

Sources:
1) Normal Breast Development and Changes, Stanford Children's Health
​2) How does milk production work?, Kelly Bonyata, BS, IBCLC
3) Breastfeeding struggles Linked to Postpartum Depression in Mothers, The Conversation
​4) Give 'Em Some Skin, Stanford Children's Health
5) An Audio Galactogogue, Academy of Breastfeeding Medicine
6)Increasing breast milk production for premature infants with a relaxation/imagery audiotape, Stephan Feher, et al
​7) Why you won't hear me suggest galactogogues, The Boob Geek