How can I increase my breastmilk supply?

How to Increase Breastmilk Supply

To increase breastmilk supply, the most effective methods are frequent breastfeeding (8-12 times per day), ensuring proper breast emptying, and using medications like metoclopramide or domperidone as galactagogues when necessary. 1

Primary Strategies for Increasing Milk Production

Optimize Feeding Frequency and Technique

• Breastfeed 8-12 times per day (approximately every 2-3 hours) to stimulate milk production through frequent breast emptying 2
• Ensure proper latch and positioning to effectively drain the breast, as incomplete emptying can signal the body to reduce milk production 2
• Breastfeeding 9-10 times per day is associated with lower bilirubin concentrations and better milk production compared to fewer than 7 feedings per day 2

Breast Pumping Strategies

• Use a properly fitted breast pump to ensure effective milk removal when direct breastfeeding isn't possible 3
• Pump after breastfeeding sessions to ensure complete breast emptying and signal increased demand 4
• Double pumping (pumping both breasts simultaneously) is more effective than single pumping for increasing milk production 3
• Ensure proper breast pump fit to prevent nipple injury and optimize milk removal 3

Medication Options (Galactagogues)

• Metoclopramide can be used as a galactagogue to increase milk supply 1
• Domperidone is also effective as a galactagogue and may increase milk supply with low levels transferred to breastmilk 1
• Both medications work by increasing prolactin levels, which stimulates milk production 5

Additional Evidence-Based Strategies

Skin-to-Skin Contact

• Practice skin-to-skin contact frequently, which promotes milk production through hormonal responses 2
• Early and frequent skin-to-skin contact after birth helps establish successful breastfeeding and milk supply 2

Maternal Self-Care

• Ensure adequate rest and stress management, as stress can inhibit the let-down reflex 6
• Maintain proper nutrition and hydration, though evidence does not support that extra fluids beyond normal physiological needs increase milk production 7

Common Pitfalls to Avoid

• Supplementing with formula can reduce breastfeeding frequency and subsequently decrease milk production 1
• Inconsistent pumping schedules can lead to decreased milk supply; maintain regular expression even when separated from infant 4
• Waiting too long to address milk supply concerns; early intervention is more effective 6
• Using pumps that fit poorly or are ineffective at milk removal 3

Special Considerations

• For mothers of premature infants, more frequent pumping (8-12 times/day) may be necessary to establish adequate milk supply 2
• When supplementation is necessary, use expressed breastmilk rather than formula when possible 1
• If milk supply doesn't improve with non-pharmacological methods, consult a healthcare provider about galactagogues 5

Monitoring Effectiveness

• Track infant weight gain to assess adequacy of milk intake 2
• Monitor diaper output (6-8 wet diapers per day indicates adequate intake) 2
• Observe infant satisfaction after feeds and sleep patterns 6