Increasing Your Milk Supply


By: Anne Smith

   Nearly all nursing mothers worry at one time or another about whether their babies are getting enough milk.  Since we can’t measure breastmilk intake the way we can formula intake, it is easy to be insecure about the adequacy of our milk supplies.  The “perception” of insufficient breastmilk production is the most common reason mothers give for weaning or early introduction of solids or supplements.  Although there is a very small percentage of women who can’t produce enough milk no matter what they do, this is very rare.

   The first thing to determine is whether your supply is really low or not.  Some mothers have unrealistic expectations, and feel that if their baby isn’t on a three- hour schedule, or sleeping through the night by six weeks, they must not have enough milk.  There is a tendency for a nursing mother to blame everything on her breastmilk – for example, if your baby spits up or is gassy, it must be something you ate…if he has a day when he feeds more often than usual, it must be because you don’t have enough milk…Be careful not to get into the habit of attributing everything your baby does to nursing. All babies, formula or breastfed, have laid back, easy, and fussy days. 

Often mothers worry about their milk supply if:

   To determine if you really do need to increase your supply, see the article on “How To Tell If Your Baby Is Getting Enough Milk”. If your baby is losing weight or not gaining rapidly enough, you need to determine why your milk supply is low, and take steps to increase it.

The following factors can contribute to an inadequate milk supply:

If your milk supply is low, here are some suggestions on how to increase it:

   There is one prescription medication available in the US that is often used to increase milk supply. It is usually reserved for cases where all other factors have been ruled out, and other treatments have failed.  It is often used for mothers who are nursing premature infants who are hospitalized for long periods of time, and who are under a great deal of stress.  Metoclopramide (Reglan) is most commonly prescribed to treat reflux in infants, and to prevent nausea in mothers after a cesarean birth. When given to lactating women, it stimulates prolaction production and will usually increase milk output.  Many studies have shown an increase of 66 to 100% in milk production, depending on the dose given and how much milk the mother was producing before taking the drug.  A dose of 30-45 mg per day seems to be most effective, with the average dose being 10 mgs taken 3 times a day.  If a mother responds to Reglan, she will usually see an increase in her supply within 2-3 days. Once she stops taking it, her supply will usually drop off again.  If you are taking Reglan, you should also work on addressing the cause of the problem, by correcting positioning or pumping frequently, or your supply will drop back to previous levels when you discontinue it.  Tapering off the dose over a period of several weeks is generally better than discontinuing it abruptly.

    Reglan is commonly used in pediatric patients, and no adverse side effects have been noted in nursing infants.  Mothers may experience cramping and diarrhea, and long- term use (more than four weeks) has been associated with depression.

     The most important thing to consider when dealing with an infant who is not gaining weight is your baby’s welfare.  You need to work closely with his doctor, and monitor his weight carefully. It is often necessary to supplement with formula while you are working to increase your supply.  Don’t have the feeling that giving formula is the ‘kiss of death’ for breastfeeding. Often, supplementing with formula is just what you need to put weight on the baby quickly so that he can nurse more vigorously and effectively.

    If you are one of those women who fall into the small group of those who can’t produce enough milk no matter what you do, you can always combine breast and formula feedings. Any amount of breastmilk that your baby receives provides nutritional and immunological benefits, and the special closeness that you feel while nursing your baby is not dependent on how many times a day he nurses.

NOTE: The text of this article was reduced for this publication. For more information on this topic, click here.

Anne Smith is an IBCLC – International Board Certified Lactation Consultant and La Leche Leader since 1978. More importantly, she is a mother to 6 breast fed kids with twenty plus years experience of counseling nursing mothers. Her site, www.BreastfeedingBasics.com , provides expert advice and solutions to breast-feeding problems and gives basic information on how to breast feed. Anne also features her recommended breast feeding products and breast pumps.

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