The best way to increase your production of breast milk is to ensure that baby is nursing frequently and effectively. As milk is drawn down from the breasts, your brain is stimulated to produce more milk to meet the high demand, and your baby will meet this supply, demand more, and so the cycle continues. At some times, it might mean that you will need to nurse every one and a half to two hours in the day, and every three hours at night, in order to re-stimulate your milk supply. It’s just as important that you position baby for an effective latch, so that they are drawing down well from the breast.
If your baby has tongue tie or gets used to feeding when sleepy, this can affect the latch, which in turn can affect a good feed. Nipple shields and other instruments may also affect latch. While any of these issues are being addressed, you might want to consider expressing your milk alongside breastfeeding if the latch is less than ideal. Pumping after nursing or in between can be helpful. You could try pumping for 5 minutes or so after a session and there is no more milk coming out, to maximise stimulation.
Offering each breast at every feed is important: first, let baby finish on one side, and then offer the second side. Minimise distractions when you are nursing and avoid letting baby nurse while they are sleepy. At the time when you are trying to increase milk supply, avoid things like dummies, bottles and formula, because the more time away from the breast, the less stimulation your breasts receive to trigger more milk production. Breastfeeding is thirsty work, so make sure you stay well hydrated, resting when you can, maintaining a good nutritious diet and trying to keep a handle on anything that causes you stress or anxiety. Breastfeeding can be sensitive if any of these things are lacking.
Addressing these things can make the biggest difference, and most people don’t need supplements or medication to produce more milk. Diet additives called galactagogues that help to increase milk supply. Herbal options include fenugreek, alfalfa and blessed thistle. Fenugreek is available as leaves or as a supplement. One teaspoon of fenugreek seeds can be steeped in a cup of boiling water for 15 minutes and taken a couple of times a day, or alternatively, you can take three to four fenugreek capsules three times a day. It usually works within three days, but some may take up to two weeks for you to notice a difference. Everything – natural or not – carries the risk of side effects and fenugreek may make cause nausea, vomiting and diarrhoea. There are other food remedies on the market that boast benefits, or you might come across recipes for lactation cookies.
Domperidone or metoclopramide are two medications that can be used to increase a mother’s milk supply. These work by blocking a hormone called dopamine in the brain, which inhibits another hormone called prolactin from working. This results in higher prolactin levels, which encourages more milk production. These work best for women who, for a variety of reasons, may have a low level of prolactin. They are not suitable for everyone. In the UK, doctors are reluctant to prescribe you these medications, as they are off-licence, which means that this use is not what the manufacturer intended. You also risk significant side effects such as depression, seizures and heart problems. If it is something you are considering, it will be worthwhile discussing with your doctor or a lactation expert for more advice. But remember that poor latch and ineffective feeding are the most common causes for insufficient milk production, so these must be addressed.