You have made the decision to exclusively breastfeed your baby for the first 4–6 months and assume that your breasts will fulfill their side of the bargain. However, this is not always the case. Although most women make approximately one third more milk than their baby needs, occasionally a woman will not make enough milk for her baby.
There are several factors that can reduce your milk supply:
- Premature birth
- Maternal obesity
- Poorly controlled insulin-dependent diabetes
- Pregnancy-induced hypertension.
Other factors include:
- Nicotine and moderate-to-heavy consumption of alcohol.
- Allergy and cold medications containing pseudoephedrine (Sudafed, Zyrtec D, etc.) (however, once your milk supply is well established, you may be able to take any of these without a significant decrease in milk production)
- Postpartum hemorrhage. This can inhibit early breastfeeding and is thought to be due to the traumatic birth and maternal stress.
- A low-functioning thyroid. This is also called “hypothyroidism” and it can interfere with milk production, as one of its main functions is to regulate prolactin and oxytocin, both of which are the main hormones involved in breastfeeding. In addition, a condition called postpartum thyroiditis, which can progress to hypothyroidism, affects between 4 to 9 percent of women in the first year after birth. If you suspect you have hypothyroidism, consult with your doctor.
- Hormonal birth control. In particular, medications containing estrogen can affect your milk supply and therefore birth control options with progesterone only are the preferred option when breastfeeding.
Formula supplementation can also reduce your milk supply, as a formula feeding equates to a missed breastfeeding session. But, in the event that you are simply not making enough breast milk, no matter how hard or what you try, supplementing or even replacing breast milk with formula should be considered. At the end of the day, a fed baby is the preferred outcome and formula is the best possible alternative for breast milk.
What does not upset your milk supply is pumping. As you will see in the following recommendations, pumping actually helps to increase your milk supply!
Recommendations for increasing your milk supply
Here are some tips to increase your milk production if you believe it is low:
- Breastfeed as soon as you can – preferably within the first hour after delivery.
- Breastfeed as often as possible. Aim for around 8 – 12 feeds per day – fewer feeds than this can contribute to a reduced milk supply.
- Try not to skip breastfeeding sessions. If you need to miss a session, pump your breasts to help protect your milk supply.
- Try and hold off with the pacifier for a few weeks after birth until you establish both a regular nursing routine and your milk supply.
- Try pumping your breasts at the same time – this double stimulation not only saves time but also greatly increases levels of prolactin, the hormone responsible for milk production.
- Try to have more short pumping sessions as opposed to a few big long ones.
- Switch sides while breastfeeding. Watch your baby for signs of their sucking slowing down and when this happens, swap them to the other breast.
- Make sure your baby is latched on to your breast properly. If your baby is latched properly, her tongue should stick out over her gums, her lips will be flared open and your nipple and areola will be in her mouth. If your baby’s latch isn’t good, pop her off (insert your little finger into her mouth to break the seal) and insert your nipple and areola again into her mouth. Repeat until she has a proper latch, as without a proper latch it is impossible for her to effectively drain your breast.
Can special foods or extra fluids increase your milk supply?
Fluid intake is correlated with milk supply. Make sure you choose water, juice, or milk over soda, coffee, or alcohol. It is a good idea to have a big container of fluid nearby when breastfeeding your baby. Oatmeal and yeast have been shown to potentially increase milk supply; however, evidence supporting this claim is limited. Eating a nutritious diet in general, including plenty of fresh fruit and vegetables, is recommended to help with milk supply. Carrots, beets, and yams are high in beta-carotene which is important for lactation and the minerals and vitamins found in dark green leafy vegetables also help with the quality of your breast milk.