GOT MILK? How to Support Breast Milk Supply
If you’re reading this, you’re probably preparing for or already on the wild and rewarding journey of breastfeeding. And if you’re feeling nervous about establishing a good milk supply, you’re definitely not alone. So many parents have the same question early in their breastfeeding journey: Am I making enough milk? Let’s dive into some evidence-based strategies for supporting a robust milk supply so you can focus on connecting with your baby without being worried they are getting enough to eat.
Start strong: Frequent breast and nipple stimulation immediately postpartum is crucial to initiating a good milk supply. When your baby latches and sucks at the breast, two hormones essential to milk production are triggered. The first is prolactin. Prolactin tells the milk producing cells in your breasts to get to work making milk. It is released by the pituitary gland in response to nipple stimulation. The second is oxytocin. This hormone, also released by the pituitary gland, is responsible for the let-down reflex which allows milk to flow. Oxytocin is triggered by nipple stimulation but also by cuddling your baby (skin-to-skin!) or even thinking fondly of your baby. The more you can stimulate the production of these two hormones in the first few hours to the first few days after birth, the better. To promote this: hold your baby skin-to-skin as much as possible. Attempt to breastfeed within the first two hours of life: within one hour is even more ideal! If latching your baby at the breast is not possible, don’t be discouraged. Hand expression is a very effective form of breast stimulation and a great way to collect colostrum for your baby. If your baby is unable to be at the breast or has not latched within two hours after birth, spend a few minutes hand expressing each breast. It is normal for newborns to be sleepy in the first 24 hours after birth and you will likely have to wake your baby up to try and feed, please do! Attempt to breastfeed at least every 2-3 hours. If your baby does not latch, ensure you are getting adequate stimulation by hand expressing or pumping every 2-3 hours. Your baby will become more alert and eager to feed on their 2nd and 3rd day of life.
Feed often and on demand: Milk production is all about supply and demand. The more milk your baby removes from the breast, the more milk your body will produce. In addition, frequent feeds are more effective than longer feeds. Frequent feeding keeps prolactin levels high, resulting in a more robust milk supply over time. Do not feed your baby on a schedule and do not only feed your baby only every three hours. This, in all honesty, is not enough. Feed your baby when they are demonstrating signs of hunger and aim for at least 10-12 nursing sessions in a 24-hour period. If your baby wants to feed more often, especially during growth spurts or cluster feeding periods, rest assured it’s a natural and temporary part of boosting your milk supply to meet their growing needs.
Observe baby’s cues. Understanding newborn feeding cues is crucial for on-demand or baby-led feeding. Look for early signs of hunger such as rooting, lip smacking, sucking on hands, or sticking out the tongue to know when your baby is getting ready to feed. Crying is a late sign. Recognizing these cues and feeding promptly helps establish a healthy milk supply and supports the baby's growth and development.
What goes in must come out! One of the best ways to know if your baby is drinking enough is to keep an eye on their diapers. Newborns should have one wet diaper a day on day one of life, two on day two, three on day three, and so forth until they are a week old when they should continue to have six to seven wet diapers a day. Their stool will transition from black meconium, to brown/green, and then to a seedy yellow color. Breastfed babies should have four stool filled diapers a day once they are four days old. In addition to diapers, you will be able to check your baby's weight at your pediatric visits. If they are gaining weight, they are eating well. It is normal for all babies to lose weight the first few days after birth, but the pediatrician will likely want them to have regained their birth weight by two weeks of life. Lastly, a full baby will show signs of satiation such as falling asleep after a feed, even if they feed often. Focusing on these signs is an effective way to know your baby is drinking enough without needing to know the exact volume of milk you are producing.
Embrace night time feeds. Here’s a hard but important truth: night feeding is super beneficial for your supply. Why? Because prolactin—the hormone responsible for milk production—peaks during nighttime hours. This means those early morning feeds are little boosters for your supply. Even though getting up at night isn’t easy, it’s worth it. If it feels like a real struggle, consider ways to make night feeds more comfortable. This could mean setting up a cozy corner, trying side-lying positions, or sharing the nighttime routine with a partner when possible to make those wake-ups a little more manageable.
Focus on latch. A comfortable and deep latch is key for efficient milk removal and maintaining a good supply. When a baby has a deep latch and can suck effectively, they’re able to draw out more milk, which tells your body to keep producing. However, if the latch isn’t quite right, it can lead to discomfort and affect milk transfer, which may then affect supply. Signs of a good latch include: your baby is latched deeply, drawing some of your areola into their mouth, not just your nipple. The nipple is not visible or coming into and out of your baby’s mouth while they are sucking. Your baby's lips are wide and rounded out, not pursed tight like they are sucking from a straw. Your baby's cheeks are rounded and full while they suck, not dimpled. You hear swallows every few sucks which sound like a soft “ka” sound in the back of the baby's throat. You do not hear any clicking. The latch is not painful. If you are noticing soreness, pain, nipple breakdown, or your baby seems frustrated at the breast, consider connecting with a lactation consultant. Lactation consultants are trained to help adjust positioning and latch to make feeding comfortable and effective, which can do wonders for both your supply and your feeding experience.
Consider position. To help your baby achieve a deep latch, start with good positioning. Hold your baby belly to belly. Make sure their torso is turned towards you so they don't have to turn their head to the side to reach the breast. Nose to nipple: align your baby's nose to your nipple prior to latching, not their mouth to your nipple. The baby should have to tilt their head slightly up to latch so their chin is touching the breast and their nose is tilted slightly away from the breast. This will also help them latch onto enough of your areola under the nipple. Find a comfortable position and keep your shoulders and neck relaxed. Bring the baby to you, don’t bring yourself to the baby. Developing a neck crick or back pain from breastfeeding in an uncomfortable position will only hurt in the long run. Take a minute to get comfortable and prop yourself and the baby up as needed so you are both supported. Try different positions such as cross-cradle, football hold, side-lying, and reclined to see what works best for you.
Prioritize hydration and nutrition: Although there’s no “magic food” to boost milk supply, keeping your body well-nourished and hydrated can go a long way in supporting milk production. Breast milk contains a lot of water, in addition to essential protein, fat, and carbohydrates for your baby. Your body needs its own hydration and essential nutrients to make food for another human. Keep a water bottle handy, especially while feeding, and consider adding some hydrating snacks (think water-rich fruits and veggies like oranges, cucumbers, or melons) to your diet. Continue your prenatal vitamins. Most importantly, nutrient dense whole foods are your friend. A diet that focuses on protein, vegetables, fruits, healthy fats, and whole grains will keep you feeling fueled and energized. While you don’t need to eat huge amounts to support lactation, you do have an increased calorie and nutrient need while breastfeeding. Consider leaning on your support network for meal prep and planning. Ask your friends and family to bring over healthy meals and help prepare read-to-go snacks.
Rest when you can: This might feel like the most impossible advice of all, but rest is actually critical for milk production. High stress and exhaustion can impact the hormone levels that support milk supply. Getting rest while caring for a newborn often means asking for help, which can be hard for new parents. Whether it’s a family member pitching in with chores, or a friend holding the baby while you nap, let people help you. Even small breaks for rest or relaxation are beneficial, take every chance you can get to recharge!
Pumping is a tool, not a requirement. Pumping is a great way to stimulate and empty your breasts if you are separated from your baby, your baby is unable to latch, or you are purposefully seaking extra breast stimulation. It’s also a very helpful tool to build a stash of breastmilk or ensure your supply remains steady when returning to work. Pumping is not necessary, however, if you’re breastfeeding on demand and pumping in addition to nursing can sometimes lead to an oversupply of milk. In addition, low pump output does not always reflect your actual milk supply as babies are more effective at milk extraction than pumps are. So if you’re breastfeeding regularly and your baby is showing signs of being well fed, low pump output might not be something to worry about.
Hand expression helps. Hand expression is a highly effective and convenient method of expressing breast milk that can benefit mothers in various situations: before your mature milk has come in (better than a pump at expressing colostrum), relieving engorgement, encouraging your baby to latch, or when a breast pump is unavailable. It offers several advantages including being cost-effective, equipment free, easy to learn, and a simple way to provide adequate breast stimulation when direct breastfeeding isn't possible. Learning this technique can make a big difference in supporting your milk supply and your baby's nutrition in the early days of breastfeeding.
Avoid unnecessary supplements. There are countless supplements and teas marketed to increase milk supply, but it’s wise to approach them cautiously. Many galactagogues (substances thought to promote milk production) lack evidence to support their claims and some can cause issues if overused. Experts agree that consistent breast stimulation, hydration, nutrition, and rest are more effective than supplements.
When to seek help. If you’re still feeling uncertain, are concerned with your milk supply, are having trouble getting your baby to achieve and maintain a deep latch, or are experiencing pain or nipple breakdown, get professional help. A lactation consultant can observe a feeding session, review your history, and offer targeted and personalized advice. Breastfeeding is a learned skill and takes practice and support. In addition to lactation consultants, breastfeeding support groups and even online communities can be great places to find additional encouragement.
All you need is love- not breast milk. While the above tips are helpful, it’s important to remember there are factors that affect milk supply that are completely out of our control. Certain underlying medical conditions like thyroid conditions and PCOS, or birth complications like high blood loss can have a significant impact on milk supply. In addition, sometimes the cause of low milk supply can not be identified at all. Because of this, some women may find that no matter what they try, their milk supply simply isn't sufficient to exclusively feed their baby with breastmilk. Please know, this is okay!! Parenting is a long journey and breastfeeding is only one small part of it. Every feeding journey is unique and valid. Please do not be disappointed in yourself if your supply is not what you had hoped. Supplementing breast milk with formula or transitioning completely to formula are both wonderful ways to feed your baby. Choose the feeding method that allows you to enjoy your baby the most and whatever you choose- give yourself credit- feeding a baby is hard work and you are doing an amazing job.