Breastfeeding–Increasing Supply

During World Breastfeeding Week this year, I’m answering a few questions, sharing my resources, and telling my story.

PLEASE note: I’m not a lactation consultant. I’m not a doctor. I’m just a mom. I’ve probably spent 5,000 hours breastfeeding in the last 2 years (well, maybe close), and I’m breastfeeding after breast reduction surgery, have breastfed through a pregnancy, and am now tandem nursing an infant and a toddler. I’ve only missed 2 La Leche League meetings since Anneliese was born, and I’ve read a few books and tons of websites about breastfeeding. I don’t know nothing, but I certainly don’t know everything. My advice and ideas aren’t medical advice, and you should seek the assistance of an international board certified lactation consultant (IBCLC) if you’re having trouble.

Jessica G. writes

I wanted so badly to breastfeed with my first two kids. When I have #3 I am going to look for anything I can do to try again. With #1 my milk took 9 days to come in, so he was already hooked on formula and wouldn’t touch breast milk. With #2 I took Mother’s Milk fenugreek and blessed thistle supplements, ate way more steel cut oats and flax seed than anyone would ever voluntarily eat, and even took prescription Reglan to try to produce more. I only produced about 4-6 oz. a week doing all of that. The only thing I didn’t try was my lactation consultant’s recommendation of Domperidone because it is not prescribed in the U.S. and expensive to buy from Canada. Do you have any suggestions of things that help increase supply?

Jessica, it sounds like you’re absolutely committed to trying everything you can, which is great! It never hurts to get another opinion… different lactation consultants might notice different things about your breasts, baby’s positioning or latch, and everyone has different experiences and specialties. You didn’t mention if you had had any previous surgeries (breast or otherwise) or a history of hormonal imbalance (like PCOS or thyroid disorders), anemia, or diabetes, if you’re a smoker or if you take any hormonal medications (including birth control)… all of these are things that can factor into the big picture of breastfeeding.

Since you mentioned a measurement of 4-6 ounces a week, that makes me think you were pumping (otherwise how would you know?)… babies are generally better than pumps at removing milk (with a few exceptions, like some premature babies, or babies with mouth/lip/tongue/palate deformities, etc.), so you were really making more than that. Still, that’s a very small number and I’m sure it was extremely frustrating. Were you pumping because you had gone back to work, or for another reason? You may have more success with a different pump, or a different flange size. Often, women need a size up from the “default” flange included with pumping kits. Some manufacturers have started to include multiple flange sizes, but you can usually order additional flanges even if your kit only came with one pair.

The more you can put your baby to breast, the better it will be for your milk production. If you’re working or attending school, think about “reverse cycling” (something a lot of babies will do naturally in that situation), which means to nurse a lot more when you’re at home — even if it means you’re nursing often throughout the night — so that the baby won’t rely as much on pumped milk while you are away. If you are supplementing while you’re at home, an at-breast supplementing system can be a good option, because it will help you and baby learn to nurse better and more efficiently, and stimulate more milk production since baby is at the breast.

Like you said, Domperidone is expensive to import, but I have only heard excellent things about its results. These are some really good notes about Domperidone by Dr. Jack Newman. Shatavari is an herb that doesn’t get enough recognition for its galactagogue properties, and it is another thing you could try before jumping to Domperidone if you’d like, since it is much cheaper.

The other galctagogue I’ve heard excellent things about is Motherlove’s more milk plus tincture. It’s a very concentrated mixture of fenugreek, blessed thistle, nettle, and fennel. While you might have to take tons of pills or drink gallons of tea a day for many days or even a couple of weeks to notice a difference, just a teaspoon or so (taken over several doses) of the tincture can be really effective within a day or two.

The book The Breastfeeding Mother’s Guide to Making More Milk has a ton of other ideas, and I definitely recommend reading it cover to cover.

Find support in a peer group like La Leche League or another mothering/parenting group, seek out another IBCLC or two, and know that any breast milk your baby gets from you is excellent! If you need to supplement, also consider a mother-to-mother milksharing program so you can use human milk for your baby.

I hope you have a better time of nursing this time around… don’t lose heart. Remember that your breasts develop and prepare with each pregnancy, so it could be a totally different ball game this time.