Our one-month-old doesn't seem to be gaining as much weight as he should. How can I increase my milk supply?
Remember the three B's of breastfeeding: the breast, the baby, and the brain. To increase your milk supply, the breast needs more stimulation from the baby and making that happen will require some adjustments in your brain. To increase your milk supply, you have to make breastfeeding a priority.
Increase feeding frequency. Breastfeed your baby at least every two hours during the day. If your baby has been napping for more than two hours, wake her up for a feeding. (See Waking the Sleepy Baby.) Consider waking your baby for at least one extra night feeding, too, especially if you have a baby who sleeps for more than a four or five hour stretch at night.
Don't wait for your breasts to "fill up" to determine when it's time for another feeding. There is always milk in your breasts for your baby, and more milk is made while you feed. Studies have shown that fat levels in milk are higher when the time between feedings is shorter. This means when you offer the breast again minutes after the last feeding (when your breasts may still feel "empty"), your baby is getting high-fat milk that will help him gain weight.
Offer the breast more often. The "law of supply and demand" that governs milk production implies that babies will demand the milk they need. Yet, this does not always work. Some babies, especially sleepy babies and those with mellow personalities, may not breastfeed as frequently as they need to without mother doing a bit of prodding. If this sounds like your baby, you need to take the lead and give your baby more frequent opportunities to nurse. Skin-to-skin contact, nap and night nursing, and sling feeding will help to stimulate longer, more frequent feedings.
Nurse longer. Don't limit the length of your baby's feedings to a predetermined number of minutes on each side. Allow your baby to finish the first breast before switching to the other side. This gives baby an opportunity to fill up on the high-fat hindmilk brought down by the milk-ejection reflex. If you switch your baby to the second side too soon, he'll fill up on the watery foremilk, which will make his tummy feel full but may not give him enough calories to grow.
Try switch nursing. The advice in the previous point about finishing the first breast first may not work well for babies who suck at a leisurely pace or who fall asleep a few minutes into a feeding. Switch nursing will encourage a baby to suck more vigorously for a longer period of time so that he gets more of the creamier, high-fat hindmilk. In switch nursing, you let the baby feed on the first breast until the intensity of his suck and swallow diminishes. Before he drifts off into comfort sucking, sit him up and switch him to the other breast and encourage him to nurse actively again. When his sucking slows, go back to the first breast, and finally, finish feeding on the other breast. Burp him or change his diaper between sides, if that will help to wake him.
Try double-nursing. This is an alternative to switch nursing. After you feed your baby and he seems finished, hold or carry him upright and awake for 10 to 20 minutes, allowing any trapped air bubbles to be burped up. This makes room for more milk. Then feed him again on both breasts before you let him go to sleep. Double nursing, like switch nursing, stimulates more milk ejection reflexes, thus increasing the volume and calorie content of your milk.
Undress baby during feedings. Skin-to-skin contact helps awaken sleepy babies and stimulates less enthusiastic feeders. Undress baby down to his diaper. To maximize skin contact, take off your bra and wear a shirt that you can unbutton all the way down the front. To prevent baby from getting chilled, place a blanket around his back.
Nap and night nurse. One of the most powerful ways to stimulate increased milk production is to "take your baby to bed and nurse." This relaxes both you and your baby and stimulates longer and more frequent nursings. It also increases your milk-producing hormones and reminds you that breastfeeding your baby is the most important thing you can do at this stage of your life together.
Sling feed. Naturally, keeping baby inches away from his favorite cuisine will entice him to eat more. Wear your baby in a baby sling between feedings, even when he is napping. In fact, some babies feed better and more often when on the move.
Get focused. Take inventory of your lifestyle. What activities and worries are draining away energy that could be better spent in caring for yourself and your baby? Are you trying to do too much, so that you're not taking enough time to sit down and feed and enjoy your baby? To make more milk for your baby, you have to make breastfeeding and taking care of yourself a priority. Let go of other responsibilities for a while. Have your partner share in non-feeding infant care, so that you can rest, take a walk, or take a shower.
Get household help. Get help with laundry, dishes, cooking, and cleaning. If you have a demanding toddler, hire a teen to come to your house after school to entertain your older child and give you a few hours of relief so you can sit and relax and nurse your baby.
No pacifiers, no bottles. When there are concerns about weight gain, all your baby's sucking should be done at the breast. Bottles of formula will interfere with the balance between your milk supply and baby's need, so will satisfying baby's sucking need with a pacifier. If it is medically necessary to give your baby supplementary feedings, try alternatives to bottles that don't involve artificial nipples.
Think baby, think milk. While you are feeding, stroke and calm your baby using a lot of skin-to-skin contact - a practice called grooming. Enjoy his sweet face and the feel of his skin. This will help your milk ejection reflex. The milk ejection reflex squeezes the milk you make out of the milk glands and down into the ducts and milk sinuses where it's available to the baby. Between breastfeedings and immediately before a feeding, imagine your infant nursing at your breast and your breasts pouring out milk to satisfy your baby.
Try herbs to increase your milk supply. There are no scientific studies that show that certain herbs will make you produce more milk, but some mothers and lactation consultants believe that certain herbs can stimulate your body to make more milk. (See "Galactogogues" for more information.) Remember, though, that an herbal tea or other concoction can not substitute for more frequent nursing as a way to tell your body to make more milk.
Get professional help. Contact your local La Leche League Leader and/or a professional lactation consultant for tips on increasing your milk supply. A lactation consultant can help you evaluate your baby's latch-on and suck so you can be certain that baby is nursing effectively. Support from a La Leche League Leader or the other mothers in a La Leche League Group will help you feel more confident about your ability to nourish your baby.
Trust that nature's system works. If you're nursing often enough, and baby is sucking effectively, you will make enough milk. It's rare that a mother is unable to produce enough milk for her baby. And while it may seem that your life is stressful, mothers throughout history have breastfed their babies through war, famine, and personal tragedies. Your body nourished this baby through pregnancy. There's no reason to think that you won't succeed at breastfeeding.
Massaging your MER. Giving your breast just the right touch can help trigger your MER, especially if your breasts are engorged, your nipples are sore, or your baby is impatient.
1. Apply a warm compress to your breast, such as a warm towel or cloth diaper soaked in warm water. Then, with your fingertips, stroke from the top of the breast down and over the nipple, using a light feather touch. This helps you relax and helps stimulate your oxytocin.
2. Using a motion similar to the one you use when examining your breasts, massage the milk-producing glands and ducts by pressing the breast firmly with the flat of the fingers into the chest wall, beginning at the top and working in a spiral down toward the areola. Massage in a circular motion a few strokes at a time before moving to another spot.
3. While leaning forward, gently shake your breasts, allowing gravity to encourage the stimulation to release milk.
AskDrSears.com is intended to help parents become better informed consumers of health care. The information presented in this site gives general advice on parenting and health care. Always consult your doctor for your individual needs.