1. Nurse nurse nurse: Your breasts will try to meet the demand of your baby. Nursing more frequently will help augment your production. Supplementing with formula especially during a growth spurt will negatively impact your breasts ability to meet the demand of your baby. That being said, sometimes you still may have to supplement in order to meet your baby’s needs.
2. When you are done nursing, pump, pump, pump. If you are going back to work, this is not easy! It essentially means you are either nursing or pumping every couple of hours. However, pumping regularly will allow you to produce plenty of milk for storage when you go back to work.
3. Hydrate!! About 2/3 of Americans are chronically dehydrated. You do not need to overdo it. Just make sure you are drinking fluids and staying hydrated throughout the day! If you are properly hydrated, your urine will have a clear, light yellow appearance. If it’s dark and yellow, then drink more!
4. Herbal options
A. Fenugreek: Fenugreek is an herb similar to clover and the herb most commonly recommended to help increase breast milk supply. Fenugreek is used as an herbal remedy to help with diabetes, painful menstrual cycles, exercise performance, male infertility, breastfeeding and many more indications as well. Studies have not shown a significant impact on breast milk production. However, anecdotally many mothers find that fenugreek (whether in capsules, seeds or tincture) can help increase supply. Side effect include sweat and urine smelling like maple syrup. Fenugreek is most commonly discontinued for causing loose stools. The amount of fenugreek transferred to breast milk is unknown. If your baby develops fussiness or loose stools, you may want to discontinue it and speak with your pediatrician. Please do not use fenugreek when pregnant as it can be a uterine stimulant.
B. Milk thistle: Milk thistle is a tall flowering plant from the Mediterranean. It is a common ingredient found in lactation teas and supplements to help increase breast milk supply. This herb is also commonly used in patients with liver disease or gallbladder issues. While there are no good studies showing increased breast milk production, it has been linked to breastfeeding historically.
5. Oatmeal? While there are also no good studies that show that oatmeal directly impacts breast milk production, many lactation consultants will encourage moms to eat oatmeal for breakfast. Its a good source of iron and nutrition, so why not?
6. Prescription medications
A. Reglan: Reglan increases milk supply work by blocking dopamine, which results in an increase in prolactin levels. This does not work for all women, and unfortunately reglan has lots of side effects. The most common is severe depression; other side effects include diarrhea, sedation, gastric upset, nausea, seizures and extrapyramidal effects (twitching, etc.). Even though it may be helpful in increasing production, because of all the side effects, especially in women susceptible to postpartum depression, it is generally prescribed very cautiously by providers.
B. Domperidone: This medication is associated with increased production and fewer side effects than reglan. However, it is available in Canada and not in the US as it has not been approved by the FDA. The FDA actually issued a statement against its use in 2004 as there was concern about its transfer into breast milk.
7. Lactation consultants! There are lactation consultants online (la leche leaugue), or you can meet with one of the lactation consultants at the hospital. If you call the hospital where you delivered, they should be able to help you make an appointment with one their consultants, even after you have been discharged from the hospital. Sometimes something as simple as poor latch can contribute to supply issues.
For those moms who are working hard to breastfeeding and are struggling with their supply, hopefully the tips listed above will help get you over the hump. If not, remember that breastfeeding isn’t always possible for everyone. While there certainly are some health benefits for baby, even if it doesn’t work out for you, that doesn’t make you a bad mother. Many healthy babies have been raised on formula, too :)