How do I increase my breast milk supply?

Q: I have a 3-month-old son, and recently returned to work. When I pump I only produce 4 to 5 ounces for the day.

So while my son is with the sitter, he drinks one bottle of breast milk and three to four bottles of formula. While he has no problem with formula, I prefer him to have breast milk. What can I do to increase my production?
A: Maria, it’s great that you’re giving your baby the best start in life by breastfeeding. This will significantly help his nutrition, development and protection from illnesses. If you can continue to provide him breast milk for at least six months, and ideally for a year or more, the health benefits for him will be even greater.

Many women find that it’s challenging to pump when they return to work. But once you develop a successful routine, it can be a wonderful way to stay physically close with your baby and help protect him from catching some of the illnesses in childcare. It’s OK to give your baby formula in addition to breast milk if necessary, but the more you can build up your supply, the better it is for your baby.

There are two basic principles of increasing your breast milk supply: increasing the stimulation of your breasts by breastfeeding and pumping, and increasing your body’s ability to make milk by eating well, drinking plenty of fluids, getting enough rest, reducing stress and thinking about your baby. Here are some specific suggestions:

1. Breastfeed as much as possible: Do so before you go to work, when you come home and during the nights and weekends.
  • Breastfeed more frequently: On the weekends, try to get family members to run errands so you can breastfeed your baby every two to three hours during the day. Don’t wait for your breasts to “fill up” to know when it’s time for another feeding. You will make milk as your baby feeds. Offer the breast more often rather than waiting for your baby to show signs of hunger. If your baby has been napping for more than two hours, wake him up for a feeding. At night, keep your baby in a bassinet next to your bed so you can breastfeed more easily.
  • Breastfeed for longer periods of time: Don’t limit the length of your baby’s feedings to a certain number of minutes on each side. If your baby tends to fall asleep quickly at the breast, try “switch nursing”: let him feed on the first breast until he slows down then stimulate him by burping him or changing his diaper. Then switch him to the other breast and encourage him to nurse actively again. When he slows down again, burp him and switch him back to the first breast and finally finish feeding on the other breast. Or, you can try “double nursing.” After you feed your baby and he seems finished, carry him upright and awake for 10 to 20 minutes to allow him to burp up the air bubbles and make room for more milk. Then feed him again on both breasts before you let him go to sleep.
2. Pump your breast milk most efficiently:
  • Rent or borrow a high-quality hospital-grade pump. Check with your local La Leche League, doctor’s office, WIC program or your employer’s human resources department. High-quality pumps can pump more milk faster.
  • Try to make time at work to pump more frequently, every two to three hours if possible. More frequent pumping sessions, even if they’re shorter, will help you produce more milk.
  • Try pumping both breasts at the same time with the special adapter kit for the pump. The double stimulation increases milk production and saves time.
  • Take a few minutes before pumping to prepare your breasts. Place warm compresses on them then massage them with your fingertips beginning at the top and working down toward the nipple. Also, think about your baby by looking at a photo of him, inhaling his scent from a recently worn article of clothing, listening to a tape recording of your baby’s cooing or calling your baby’s caregiver to ask about him.
3. Take care of yourself: Balancing work and family is often stressful. Be sure to eat nutritious meals and snacks, including sources of protein and calcium. Drink plenty of fluids by having a glass of water every time you nurse or pump. Also continue to take your daily prenatal vitamins while you’re nursing. Try to get at least eight hours of sleep at night and try to nap on the weekends when your baby naps. Ask other family members to help care for your older child and do household chores and errands so you can spend more time with the baby and relaxing.

4. Get professional help. Contact your local La Leche League leader and/or a professional lactation consultant for more tips on increasing your milk supply. Consider attending a La Leche League mothers’ group to share strategies and support. For more information about increasing your breast milk supply, and to find your local organization, visit www.laleche.org.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician