Many breastfeeding mothers reduce feeds or wean earlier than they would like -- sometimes by choice, sometimes not. From herbal therapy and prescription medication to nursing and pumping, there are myriad ways to reestablish milk supply after having taken a lengthy break from nursing, or if a mother feels that her supply isn't as strong as it once was.
If you find yourself in this position, it is important that you recognize your comfort level with the therapy you choose and devise a plan according to what you will realistically want and be able to do.
Increasing Supply When Breastfeeding
To achieve the strongest milk supply possible, it is essential that you:
Breastfeed or pump at least 8 to 12 times a day
Offer both breasts at every feeding
Avoid timing your feedings. Instead, wait until the baby comes off the breast himself, then switch to the other side. This will ensure that the baby is getting the proper balance of foremilk and hindmilk.
- Utilize breast compression
This will help the milk flow better and encourage the baby to continue feeding.
- Avoid artificial nipples
Any time the baby needs either food or simple comfort, the breast should be the first choice.
If the baby seems frustrated by the nursing, especially if your milk supply is extremely low, a supplemental nursing system can really work wonders. The baby receives supplemental milk at the same time that she breastfeeds, so she stimulates the your supply while getting her required nourishment.
Increasing Supply with a Breast Pump
Often, a baby is not able to or not interested in going back to the breast. In these cases, you can stimulate your supply by using a breast pump. Expressing with a hospital-grade, double (automatic) pump, 8 to 12 times a day is ideal for reestablishing supply. Here are some tips for maximizing your breast-pumping capability:
- Elicit the milk ejection reflex first.
- Only use as much suction as necessary. You shouldn't feel any pain while pumping.
- Massage your breast in quadrants while you're pumping.
- Give yourself enough time so you don't feel any stress.
- Use inserts to get the optimal fit to your breast.
- Avoid lengthy stretches of uninterrupted vacuum.
- Discontinue pumping when the milk flow is minimal or nonexistent.
Increasing Supply with Medicinal Herbs
Research on medicinal herbs (also called galactagogues) to increase milk supply is scant. However, many mothers have reported overwhelmingly positive responses to herbal therapy, in addition to frequent stimulation of the breast. Here are herbal remedies that have been reported as boosting milk supply:
Try Mother's Milk Tea, which is said to promote "healthy lactation."
Take 3 capsules, 3 times a day for the first 10 days; drop to 2 capsules, 3 times a day for the next 10 days; drop to 1 capsule, 3 times a day for another 10 days. Mothers typically see an increase in supply within 72 hours. The most common side effects reported are profuse sweating and excretions that smell like maple syrup. Fenugreek is not recommended for women with diabetes (it may lower blood sugar) or asthma (it may aggravate symptoms). Speak with a lactation consultant and your health care provider before using fenugreek.
- Blessed thistle
Remember that it is important to drink at least 64 ounces of water a day to maintain a healthy supply. Oatmeal has also been known to boost supply slightly. Once again, this is anecdotal, but it can't hurt.
Increasing Supply with Prescription Medication
A few prescription medications that, when taken while continuing frequent stimulation of the breast, have been found to raise prolactin levels. This, in turn, increases milk supply
Here are the details on two of the most common medications used for this purpose:Domperidone
This is the option with fewer side effects; it has been approved by the American Academy of Pediatrics for use in breastfeeding mothers. Unfortunately, it is not available in regular pharmacies in the United States. It is used in Canada and other countries, but it is legal in America; a mother can obtain it by ordering (with a doctor's prescription) from compounding pharmacies in the United States. Outside of the U.S. (Mexico and New Zealand), no prescription is needed. The typical dosage that is recommended is 20mg, four times a day.
This medication has been shown to increase milk supply anywhere from 72% to 110%, depending on how many weeks postpartum a mother is. The recommended dosage is 10mg, three times a day for 1 to 2 weeks. Once supply is stable, dosage should drop by 10mg per week. Mothers with a history of depression are cautioned against taking Reglan. Other side effects include headaches and fatigue.
The process of relactation is intense. It is important for you to take care of yourself. If stress levels are too high, attempts to establish a full milk supply will be futile. Any kind of help, whether it's physical, psychological (or even domestic!), will aid the process of relactation. You will be on her way to a strong supply yet again.
The Breastfeeding Answer Book, LLLI, Third Edition.