Supply Issues

One of the biggest issues that employed breastfeeding mothers who are separated from their babies face is low milk supply issues. In talking with other active-duty mothers, you may think that a low milk supply is inevitable because it’s such a common issue.  Some mothers find that while their milk supply is great on a Monday after a weekend of nursing, it is faltering by Thursday.  Or they hit a slump at around the three-or six-month mark. A low milk supply is not inevitable. But if your supply does dip, here are some possible reasons why and how to bring your supply back up. Download the Increasing Milk Supply handout for these and other tips, or check out the Handouts page for more topics.

 

Supply Busters

Supply Issues Breast Pumping
Used with permission.

The number one reason most moms don’t have enough milk?  Not draining your breasts often enough.  Your breasts are like factories, they work on demand and supply.  The more orders that are placed, the more milk that is put into production.  When you leave the milk sitting in your breasts, that tells the factory to cease production and shut down.  Here are some other common supply busters:

  •  Birth Control Pills can cause lowered milk supply, especially those with estrogen in them, as can Depo-Provera. Some mothers are even sensitive to the hormones in the mini-pill.
  • Decongestants used for the common cold, such as Sudafed, can cause lowered milk supply in up to 20% women who take it.
  • Growth Spurts can be a sneaky supply buster.  Is your baby asking to breastfeed a whole lot more than usual?  If so, he is building up your supply, but it can take a day or two for your breasts to catch up and meanwhile you can’t seem to pump enough for daycare and your stockpile is rapidly diminishing.  Growth spurts are normal at around 2 weeks, 6 weeks, 3 months, and 6 months. Be prepared and breastfeed as much as possible when you are together.
  • Illness – If you have you been sick lately with a cold or the flu, you may find that your milk supply is down a bit.  Increased breastfeeding, lots of fluids and rest should bring it right back up.
  • Sage, Peppermint, Wintergreen can also lower milk supply.  So watch out near Thanskgiving or if you eat a lot of Altoids.
  • Overfeeding is a common culprit, especially at child development centers and daycare.  Teach your provider to hold your baby, give small, frequent feeds and watch your baby for feeding cues. Here is a wonderful PDF handout to give your provider about How to Bottle-feed the Breastfed Baby.
  • Pacifiers – If you use a pacifier a lot when you are together you may be sabotaging your milk supply inadvertently.  Everytime you use a pacifier instead of breastfeeding, is one less time your breasts are stimulated to make milk.  Pacifiers should only be used when you are apart.  When you are together, pay attention to your baby and breastfeed!
  • Return of your period – If you have started menstruating again, the hormones can cause a lowered milk supply in the week leading up to your period.  Plan to increase your pumping during that time, and you may find yourself dipping into your stockpile more often during that time of the month.
  • Sleeping through the night – if your baby has started sleeping through the night you may find your milk supply has taken a nose-dive.  The hormones responsible for making milk are at their highest during the nighttime hours, and breastfeeding at night boosts those hormones which in turn boosts your supply.  If your baby is sleeping through the night you are missing out on that boost.  Consider pumping at least once at night, or waking your baby to breastfeed.
  • Stress- If you are stressed it can affect your milk supply, and who isn’t stressed in the military? Do your best to leave work at work and relax when at home.  Breastfeeding produces a naturally occurring relaxant hormone…enjoy that down-time with your baby and let the hormones do the trick to relax you both after a long day.
  • Trouble with your pump can also cause milk supply issues.  Check that all your valves and membranes are OK, look at your tubing to be sure it doesn’t have any pinpoint holes or cracks.  Take your pump to an IBCLC who can check the suction (especially if it is a used pump).

 

Supply Boosters

Supply Issues Breastfeeding
Used with permission.

It takes as long to restore your supply as it did to lose it…don’t expect results overnight.  But within a few days it should increase. The key to maintaining or increasing your milk supply is to NOT go longer than five to six hours without nursing or pumping. Milk left in your breasts tells them to make LESS milk.  It can be a challenge to keep your supply up, especially in the military, where you might work an odd schedule and certainly can’t just take a day off to stay home and breastfeed in order to boost your supply. Here are some tips that have proven helpful to other mothers (both in and out of the military) in maintaining and boosting their milk supply:

  • Breastfeed often and exclusively (no bottles or pacifiers) when off duty and at home. This includes evenings, nights, and weekends.  Remember: When my baby is with me, he gets the breast. When he is at daycare, he gets the bottle.
  • Try a nursing vacation every few weekends (or off-duty day) to super-charge your milk supply.  A nursing vacation means that you don’t do anything but breastfeed your baby very frequently, pump often, and rest as much as possible over a 24-48 hour period.
  • Try cluster pumping – pump during every commercial break or every 10 min for several hours instead of a regular nursing session.
  • Pump in the middle of the night – milk-making hormone levels peak around 0200 and your milk supply is highest then.
  • Double pump after breastfeeding.
  • Tandem pump by pumping one breast while your baby nurses on the other breast.
  • Pump more often by adding a session, either at work or during the night.
  • Power pump (a quick, five-minute pumping session) whenever you get the chance.
  • Pump at least every three hours while separated. This may not be practical, given your work environment. But try to aim for this goal if at all possible. The longer you go without pumping, the fuller your breasts will become. Full breasts signal your body to slow production.  It may seem like you get more milk to begin with, but over time it will lower your supply.
  • Use a high-quality, double-electric, fully automatic breast pump. Using a less-than-best pump may affect your milk supply in the long run. Switching to a better one may turn your milk supply right around.
  • Adjust your pump settings while pumping to stimulate a let-down. Do NOT turn the vacuum setting higher. This will not increase your milk supply. But it will most certainly give you sore nipples.
  • Pump for at least 10-20 minutes and continue for about two to three minutes after your milk stops dripping.
  • Try Hands-on Pumping (HOP).  Research has shown that is increases milk yield by up to 48%.  More info on HOP can be found here.   Even just doing some breast massage and/or breast compressions before and during pumping can be very helpful in increasing milk output during a pumping session.
  • Try different sized flanges or inserts (such as the Medela Soft-Fit®, Ameda Flexishield Areola Stimulator®, or Avent® petal massager insert) or rearrange the flanges after five to six minutes to help stimulate different parts of the breast and areola, which may result in more let-down reflexes, thereby increasing milk output.
  • Try Reverse-Cycle feedings with your baby (see Reverse Cycle on the Kellymom website). The combination of nursing more at night, and your baby not needing as much expressed milk during the day, can help you to maintain, if not increase, your milk supply.
  • Breastfeed your baby at drop-off and pick-up from the daycare provider and ask that they do not feed your baby within one hour of you picking him up.  It may not seem like much, but those one to two extra nursing sessions during the day may be just the ticket to boosting your supply. This is particularly helpful when there is a long commute between the daycare and home.  Once home, you can nurse him again, further boosting your supply.  Breastfeeding your baby at daycare will also lessen the amount of milk you need to pump and leave with your caregiver.
  • Drink to thirst (too much can actually decrease your milk supply) and eat a well-balanced diet.
  • Discuss galactogogues (prescription or herbal) with your IBCLC and HCP as options for boosting your milk supply.  These herbs and medications work best when combined with increased breastfeeding and pumping. They don’t work as well used by themselves.  Some of the more popular options include:
    • Herbs. Some all-purpose herbs for milk production include:
      • More Milk Tincture or More Milk Plus – one dropperful per hour until your supply increases, then decrease until supply levels off.  Use More Milk Two if you are pregnant.
      • Alfalfa – 2 capsules, 2 times a day.  Has a laxative effect.
      • Blessed Thistle – 3 capsules, 3 times a day.  Works best in combination with Fenugreek.
      • Fenugreek – 3-4 capsules, 3 times a day until you smell like maple syrup.  Works better with Blessed Thistle. Do NOT use if you are pregnant, allergic to peanuts, diabetic or have thyroid issues.
      • Oatmeal – not an herb, but a food that is well-known to boost supply.  Eat a bowl of rolled oats.
      • Others – Goat’s Rue, Nettles, Shatavari, Mulunggay
    • Medications. Domperidone (Motilium®) and Metoclopramide (Reglan®) are the favored prescription drugs for boosting milk supply.  Domperidone increases prolactin and has an excellent safety profile.  Unfortunately, due to the FDA review process, it is not approved for use as a galactogogue in the U.S. Metoclopramide also boosts prolactin levels, but it can cause depression in some mothers.  It is approved for use as a galactogogue in the U.S. Talk with your Primary Care Provider about using any drugs for boosting milk supply.

Pumping for your baby takes a huge commitment.  You should feel very proud of your accomplishment, no matter how little or how much milk you provide for your baby.  Remember, that while providing your milk IS important, your breastfeeding relationship is more important. And pumping allows you to be able to breastfeed when you are at home. If you are finding that you are having issues with persistent low milk supply, and the tricks and tips on this page aren’t enough to improve the situation, take a look at the website Low Milk Supply for many additional great tips on boosting your supply.


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