Are you wondering how to increase your milk supply?
Are you tired of hearing "try this pill, this cookie, this drink that costs $15 a bottle?" Trust me, there are plenty of other things you can try that may actually work a lot better, and not cost a ton of money. If you can understand the basic brickwork of milk production, it'll help make some sense of what things can actually increase your supply.
Please note, that if you have an underlying health condition causing low milk supply, regular tips and tactics may not work. If you've exhausted all avenues and are still having issues, I encourage you to reach out to a lactation professional to be evaluated.
Also note- supply levels vary person to person. By definition, "under supply" is producing less than what your baby eats. "just enough" is producing just enough for your baby to eat. "oversupply" is producing more than what your baby eats- even by an ounce. One persons low supply is another person's oversupply, and it's important to not compare yourself to others. Example: Mom A produces 30 ounces and baby A eats 24 ounces. Mom A has an "oversupply" of 4 ounces. Mom B produces 30 ounces and baby B eats 30 ounces. Mom B makes "just enough". Mom C produces 30 ounces and baby C eats 34 ounces. Mom C has an "undersupply" of 4 ounces less than needed. Where all three moms produce the same amount of milk, the three babies have different needs!
A note: I am a Certified Breastfeeding Specialist. However, the advice and tips on my pages is not personalized individual medical advice and you should always discuss concerns with your healthcare provider or seek the help of a lactation professional. I do not currently offer consults or counseling, just general information and advice.
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Contents:
don't worry, each section has a recap you can skip to if you don't want to wade through the sea of mumbling. These will be highlighted in green.
Also: If you're looking for discount codes or my personal favorites of any of the brands/products referenced here, please visit this page! I only ever mention brands that I know and trust, and my opinions are 100% my own and never paid for.
Supply and demand, it's a factory. FIL is not your friend! Stick to your schedule!
The "golden rule" of milk production is actually SUPPLY AND DEMAND. If you have no other underlying issues or conditions causing a low milk supply, increasing the demand on your body usually results in more milk production. How does that work? Well I'll tell you. Stagnant, non-moving milk builds up a protein called Feedback Inhibitor of Lactation. FIL for short. FIL builds up, and tells the breasts to slow down production. When the breasts are frequently and effectively emptied, FIL doesn't have a chance to build up and send that 'slow down' message. Picture it like a factory. The workers are all around, producing products. Let's use clothes as an example. They're producing a ton of clothes, working very quickly. There may even be a surplus of clothes (picture engorgement here, in the early postpartum days when your body doesn't know how much milk you actually need to produce). Orders come in for clothes, and they're flying out the door. When all of the clothes in the factory are going out the door (FIL being removed in milk), the workers speed up production to create more. If the orders/demand slows down, of course the production would slow down as well! In the first 12 or so weeks postpartum, your body is in "what is going on?!" mode. Milk is produced almost entirely by hormonal (endocrine) control, and in part by supply and demand (autocrine) control. You're basically the copilot, helping guide your body along and tell it how much you'll need. Picture this as laying the groundwork, or writing the blueprint for the max capacity of the factory. If you start off with low demand, your body will know it's producing too much. This excess may continue to be produced (mostly by hormones, remember) until "regulation" time, at which point the hormones begin to subside and the supply can drop. Lots of times I hear about a "supply drop" at regulation- this lack of demand from few pumping sessions is almost always the cause. Additionally, colostrum removal within the first hour after birth is extremely important for milk supply. See a video on that here from Stanford. Let's recap before we go on:
When you leave milk stagnant (by few pump sessions, long gaps between, or both) this builds up with a protein called FIL that signals to the body to slow down production. When the breasts are frequently emptied, this protein does not have time to build up and milk production is increased/maintained.
This is CRUCIAL in the early weeks postpartum as you are laying the "groundwork" for what your supply "factory" will produce down the road. You even increase the number of prolactin receptor sites via frequent milk removals! In short, hard work in the beginning will pay off in the long run. If you slow down or slack off in the beginning, it's much more difficult to try to catch up later.
That's why it's extremely important to make a good schedule and stick to it the best you can. In the early postpartum days, it's become a common recommendation to pump 8x a day for 30 minutes each time. It may seem like a lot, but it's way easier to get out ahead than to have a slow start and try to get your head above water later on.
Nutrition matters, and don't over hydrate!
So now that we know how important frequent milk removal is, let's talk about increasing supply with that in the forefront of your mind. Not "eat these cookies, take these magic pills, or drink this fancy coconut water cocktail." Granted, consuming the appropriate amount of calories is also extremely important. Lets use cookies as an example here, as they're packed with calories (and occasionally, 'lactogenic' ingredients such as flaxseed, brewers yeast, etc) When you're lactating, you burn anywhere from an extra 500-800 calories a day on average. This is just from producing milk! You have to keep in mind also that you need to be consuming a regular amount of calories while making up for that deficit, so if you're quite behind on eating or eating empty calories, your milk supply may take a toll. This is where high calorie snacks can come in, and people credit them for "increasing their milk supply" when the missing piece was just calories. Looking for a breastfeeding or pregnancy specific calorie calculator? Try this one here from The Lactation Nutritionalist. It's free to use and can help you get a sense of where your daily caloric intake should be at.
A quick note- obese lactating women are at a higher risk of vitamin and mineral deficiencies. If you suspect you have a deficiency, please speak to your doctor! Iron deficiency can be a common cause of low milk supply, for example. What should you be eating, if not a dozen lactation cookies a day? General recommendations for a 'healthy diet' during lactation are as follows-
Fruits, vegetables, legumes (lentils/beans), nuts, whole grains (oats, wheat, rice, millet etc)
At least 400g (1 cup portion, 4x daily) of fruits and vegetables, but not potatoes/starchy vegetables.
Less than 10% of total energy intake from added sugars (equal to 50g or 12 tsp) but ideally less than 5% for 'best health benefits'. Naturally present sugars can be found in honey, syrups, fruit juices etc.
Less than 30% of total energy intake from fats, unsaturated is preferable to saturated. Unsaturated fats: Fish, avocado, nuts, sunflower, canola, olive oils. Saturated fats: Fatty meats, butter, palm/coconut oil, cream cheese, ghee, lard. Industrial trans fats (NOT part of a healthy diet): processed food, fast food, snack food, fried food, frozen pizza, margarines, spreads, pies, cookies etc.
Less than 5g of salt (equal to 1 tsp), use iodized salt.
To sum this up a bit more easily- in general, at each meal you should be consuming a:
Vegetable OR fruit
A grain or starchy vegetable
A protein
And your snacks should be small, pick one combination of:
Fruit & protein
Vegetable & protein
Grain or starch & protein
(good sources of protein are: nuts, seeds, legumes, eggs, meat, dairy products) Only a small number of vitamins and minerals have a recommended daily allowance (RDA) greater for lactating mothers than non-lactating. Those are: Vitamin A, Vitamin C, Chromium, Copper, Iodine. They are needed in quantities nearly double that of non-lactating mothers. Where can you find those?
Vitamin A: sweet potatoes, carrots, pumpkin, squash, spinach, lettuce, kale, dried apricots
Vitamin C: most fruits, especially pineapple, kiwi, orange, lemon, lime, grapefruit, potato, broccoli, bell peppers, spinach, strawberries, tomatoes, Brussels sprouts, berries, and green leafy vegetables
Chromium/copper: whole grains, brown rice, green leafy veggies
Iodine: iodized salt, seaweed
So what does that have to do with milk supply? If you're eating a bunch of easy access, whatever-I-can-get-my-hands-on snack foods, your body won't be at its "peak performance." and NO, this does not mean your milk will be of poor or lesser quality. It means you may not be able to produce as much as you could if you were meeting all of your caloric intake needs. "Also note, prenatal vitamins do not have the correct mix of vitamins/minerals for lactation and should be discontinued postpartum. With a well balanced diet and absence of nutrient deficiency, supplements and vitamins are typically not needed."[source: Breastfeeding and Human Lactation, 6th edition Karen Wambach]
However, that's pretty hard to achieve as busy mothers. I recommend a postnatal vitamin (with 'lactation support' if you can find it) to hit all the marks. I like this brand. On the topic of intake, let's briefly touch on water consumption during lactation. I've seen advice online given in groups and forums that say "Drink as much as you physically can. A gallon a day. Two if you can manage. It'll all turn into milk!" NO, please do not do that.
Overhydration is not your friend. "If the mother drinks enough to sustain her own thirst, she will drink enough to sustain lactation." [source: Breastfeeding and Human Lactation, 6th edition Karen Wambach]
One more time for the people in the back- DRINK TO THIRST. If you overdo it, you can see a decrease in milk supply. The average amount of water to consume in a day is about 64 ounces, but varies person to person. I've heard you should drink half of your body weight in ounces, meaning if you weigh 160 pounds, to drink 80 ounces etc. However, this depends also on milk supply. If you produce a lot of milk, you may have extra thirst!
Often times when someone sees a "huge increase" after drinking XYZ (coconut water, body armor, gatorade or what have you) it's because they were not adequately hydrated, and it was not the "special drink" but just hydration and perhaps electrolytes as well.
Influence of macronutrients on breastmilk composition? In simple terms- macros provide the energy/calories that lactating mothers need to "exist, expend effort, and synthesize milk." This is carbs, proteins, and fats.
"Healthy dietary patterns include: 30% of calories from fats, 15% of calories from proteins, and 55% of calories from carbs".
How can you tell if an ad for "milk supply boosting ____" is a cash grab? Does it have pictures of close to empty milk bottles, and then full milk bottles, stating "how I got my supply from this to this overnight"? Does it link to a product that's on a "FLASH SALE, ENDS SOON!"? Does it have all gleaming five star reviews, and not a single bad one? Every single review saying how their supply doubled or more? Lots of pictures of milk bottles from full to empty? They might just be a cash grab. Might just be marketing. Hard to know for sure! Always use caution when purchasing anything promising to "boost your milk supply".
A note: the herb fenugreek has been used for centuries as a galactagogue, and recently there has been more and more information out there about how it actually can be harmful to a milk supply, especially in those with thyroid conditions.
Alright, let's recap because that was a LOT of mumbo jumbo (which you don't need to remember, necessarily)
Nutrition is important during lactation. You need to be sure you're keeping up on your calories, good calories, to keep your body in tip-top milk production state. (again, this does not mean the QUALITY of the milk, but the quantity you can produce can be affected negatively if you're not consuming enough calories.) Protein is also very important
Do not over hydrate, this can cause a decrease in supply (and hide signs of hunger, therefor lowering your calorie intake even further). Average to consume is 64 ounces per day but varies person to person. Drink to thirst, aim for about half your body weight in ounces. This may vary if you have a higher supply, and are more thirsty.
Do not be fooled by "this cookie/pill/drink doubled my milk supply overnight!" posts or ads that have empty to full milk bottles, they're not a guarantee and often times you can purchase ingredients or similar foods for far less and try it if you really want to. You can see an increase in supply if you consume something you're missing, such as calories or hydration, but these products may not be the magic solution themselves and often cost way too much money. Milk removal (supply and demand) is the NUMBER ONE way to increase milk supply!
Fenugreek can LOWER supply in those with thyroid conditions (or even those without- I do not have any thyroid issues that I know of, and fenugreek completely destroys my supply.)
Proper gear makes a huge difference. HUGE.
If you use good gear (pump, flanges, hands free bra) you can see better results than if you used lesser quality or poor fitting ones. For example: If you depend on only a wearable pump such as elvie, willow, any kind that sits in your bra, or using cups hooked up to a regular pump, you may see issues with output or supply. These are not intended for use as a primary pump, but of course they won't SAY that on the box. Some people are 'unicorns' and can use anything and empty just fine, but 9 times out of 10 that isn't the case. These pumps are designed for convenience, and occasional use (like 1 or 2 times a day, and especially not your first or last pumps of the day.) What you're taking from these pumps in convenience and portability, you're losing in efficiency and practicality. They're often far overpriced for their capabilities as well. What I recommend using is a "real pump" (again for majority of your sessions, especially the first and last of the day) with flanges that fit you and feel comfortable. A "real pump" does not mean specifically one that plugs into the wall, I mean one that's got a motor and tubing to run onto your flanges. Some people enjoy wall pumps, some use portables.
Some of the most commonly used "real pumps" are Spectra s1/s2 (the blue s1 has a rechargeable battery, the pink s2 does not) Synergy Gold, Medela symphony/sonata/pump in style with max flow, Lansinoh smartpump, Motif Luna, Pumpables Genie Advanced/Super Genie, Baby Buddha, and many more. Some of these are wall plug only, and some are portable with batteries. They are "good" pumps that can be used with flanges and are typically more efficient than wearable pumps.
Note: there are a ton of other pumps on the market, I have just listed some of the most popular brands. Everyone will repsond differently to different pumps, so what may work for you may not work for someone else, and vice versa. I have a Master List of all pump brands here.
You also want to make sure that your vacuum level is not too high. More suction does not equal more milk! Keep things at a comfortable level. You can swap between letdown mode and expression mode to try to trigger more letdowns (this is when milk starts to flow, triggered usually by nipple stimulation or other things such as looking at your baby, hearing your baby cry, etc.)
Do not forget to replace your pump parts often! Replace your duckbills/membranes and backflow protectors every 3-4 weeks or so, or when you notice decreased suction or performance. Tubing and flanges typically only need to be replaced if damaged.
In addition to a "real pump", comfortable and well-fitting flanges are beneficial if not crucial. Using flanges that are too large or too small can cause pain, discomfort, and even ineffective emptying (swelling in large flanges for example can constrict the milk ducts and make emptying more difficult/impossible- this is why some brands/sources say their flanges can 'increase milk supply.') With the proper fit, you can be comfortable, empty effectively, and in turn you may produce more milk if that emptying 'message' is being sent! Don't know your flange size? Print out this free measuring tool and try for yourself. Note you can add anywhere from 1-2 to 2-3mm to your size for a good fit, but to each person comfort is different. You can try hard plastic flanges, silicone flanges, or hard plastic flanges with silicone inserts. You may have to fiddle around to find what's the most comfortable for you!
No printer? No problem. I offer mailed rulers within the US for a small fee (to cover materials) here.
What kinds of flanges are out there? Well, there's no shortage of them it seems. And new brands continue to pop up and produce more types and styles of them! I'll list off a few brands here that you can peruse and see what works for you.
A note: I personally noticed inserts inside of plastic flanges did not work as well for me as a solid silicone flange did- I have elastic tissue that would extend past the end of the insert and literally bulb out and get stuck. The difference in milk output between using inserts/solid flange was DRASTIC. It's always worth trying something different if you're stuck in the "how can I increase my supply" loop? Solid Plastic flange: Amazon has good cheap options from brands such as maymom and nenesupply, a cost effective substitute for overpriced spectra, medela, etc flanges that only go down as small as 21. These brands carry smaller sizes.
Silicone flange: Popular brands such as Lacteck and Pumpin pal are quite often used, newer brands are coming out with silicone flanges like Idaho Jones and Bare Motherhood
Silicone insert: Again from amazon, maymom has silicone inserts, nenesupply may also. Lactation hub also carries them, among other manufacturers like individual pump brands who may have their own intended for use in their wearable pumps. Silicone 'liquid' flange: Pumpables and Legendairy Milk produce these funky flanges that are thin silicone flange 'inserts' that go into a hard outer casing. They wear out rather quickly- sometimes in as early as 2 weeks. They are very comfortable and well loved, but often pricey to keep up with replacing as they won't work properly if they're worn out. Pumpables is the only brand to produce sizes 19 and smaller. Again it boils down to what feels the most comfortable for you, and performs the best. Pumping should NEVER hurt. You can lubricate your flanges with coconut oil, olive oil, flange spray etc for some comfort if you're having issues with friction. However, it's been mentioned that with elastic tissue you should not lubricate as they'll stretch farther.
And for a hands free bra- this can also vary person to person and body type to body type, everyone has their favorites. Trust me when I say it makes a WORLD of difference, holding the flanges the entire time is just miserable and you can't do anything else. Using a bra, you can use both of your hands for other things and forget you're even pumping (maybe). Trust me when I say 'hacking' your nursing bra is not as comfortable as just easily putting flanges into holes they're meant to go into, especially half asleep at 3am.
Some of the most popular brands are:
Davin & Adley (Amelia cami is the most popular, there are many other styles though)
Sarah Wells Bags Journey Bra
Kindred Bravely (I believe the sublime is the most popular, again many styles available)
Love and Fit (everyday luxe is growing in popularity)
Simple Wishes (from Amazon)
Let's recap:
Use a GOOD pump, a "real pump" rather than relying only on wearable cup pumps, and flanges that fit you well.
Replace your pump parts often. For exclusive pumpers, every 3-4 weeks (or when you notice decreased suction) you should replace all soft parts such as duckbills and back flow protectors. Tubing only if damaged, same with silicone flanges (with the exception of pumpables or legendary milk silicone flanges, those require replacement every 2-4 weeks or so)
Don't overdo the suction. If you use wearable pumps, keep it to 1-2 times a day and not for your first or last pumps of the day.
If something hurts, find what it is and fix it. (flange size, suction level, etc.) Pumping should NEVER hurt.
Get a hands free bra. You'll be much happier with two free hands, trust me. Are they expensive? Sure, but quality products often are.
Hand expression or massagers to help empty
Did you know that hand expression (during and even after pumping) can help get more milk out, and in turn perhaps increase supply?
Here is an excellent video on the importance of hand massage during pumping from Stanford.
Hand massage works wonders for some, but others can have trouble with it (myself included!) You can also purchase vibrating or warming massagers that some people swear by.
Some of the commonly mentioned massager brands are:
Lavie (they have not one but three different kinds, vibrating, vibrating and warming, and a newer model of vibrating and warming.
Momcozy (they have two kinds, a warming/vibrating and a kneading/warming one)
Overall, I believe hand massage is typically more effective. Keep in mind if you're having engorgement or clogged ducts, or mastitis, to avoid using heat. The protocol has changed to using cold relief and anti inflammatories, warmth can make inflammation worse.
Recap:
Hand massage and hand expression can be extremely beneficial for emptying and increasing milk supply, especially when done often.
Massagers can help too, it's always worth a shot to see if it makes a difference for you.
Avoid warmth if you have clogs/mastitis
Power Pumping: Mimic a cluster feeding baby
What is power pumping?
A 'Power pump' is an hour long pumping session, tailored to mimic a hungry cluster feeding baby. Here are the basic instructions-
Pump 20 minutes
Rest (no pumping) 10 minutes
Pump 10 minutes
Rest (no pumping) 10 minutes
Pump 10 minutes
This is the same thing that a nursing baby would do during a 'cluster feed'- which is when they come back again and again looking for more milk, which signals your body to produce more milk.
It's important to remember this does not yield instant results. If you do this for a few days, you should typically begin to see some results. I recommend if you're trying to kick production up a notch, to power pump once a day for a few days and see how it works.
Recap:
Do a power pump daily for a few days (replace one of your regular sessions with a power pump) to send an urgent "please, make more milk!" message to your body.
Results are not immediate, they can take days or longer. Have patience! Don't panic.
Patience, patience, patience. And be kind to yourself.
Changes do not happen instantly.
Struggling with milk supply, on top of everything else we struggle with as mothers, can be the straw that breaks the camels back.
Take your time in learning your way around. If you were 'forced into exclusively pumping' because of nursing issues, you're already probably having conflicting feelings about everything - and to struggle with not making enough milk can really push you over the edge.
Increasing milk supply doesn't happen instantly or within a matter of a few hours. You have to put in some work to see some results, and that's okay!
Some other things: Time of the month, stress, etc
During or before your period, you may experience a drop in supply. There is some information about taking calcium magnesium and helping with that supply drop. You can read more about that here from Kellymom.
Stress can also be a factor in milk supply issues. Especially stress during pumping, that can hinder or stop a letdown. It's important to try to relax while pumping, to the best of your ability. Hormones released while you're stressed (cortisol) can interfere with the oxytocin during a letdown. I know it's hard, but it's important! If you find yourself stressed at the amount of milk that's in (or not in) your pump bottles, cover them with socks. You may be surprised that it helps to not watch the drops. A watched pot never boils, my grandma says! Did you know that you produce the most prolactin while you sleep? Prolactin is the milk making hormone- so yes, you read that right, you produce the most milk while you sleep! Prolactin levels slowly taper off over the course of the day, which is why evening pumps are lower yielding than morning pumps!
It can be beneficial for supply and putting away extra ounces to wake up for middle of the night pumps, empty completely, and go back to sleep to fill up again.
This is why middle of the night pumps are so important, especially in the early days postpartum! Let's recap:
Your period can cause a drop in supply. Calcium magnesium could possibly help! Read more about that here.
Stress is not a friend of milk supply! Try to relax, especially during a pump session. Cover your bottles if you find yourself watching them anxiously.
Prolactin (and milk production) is highest at night while you sleep. Prolactin levels in the body taper off over the course of the day, and this results in lower yielding pump sessions in the evening. That's totally normal!
Middle of the night pumps can be extremely beneficial for supply and getting extra ounces put away.
Overall, there's quite a bit to try when looking to increase milk supply. In the end, if all else fails, it may be time to see a lactation consultant to look for a missing piece or underlying condition.
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