How to Increase Breast Milk Supply
The most effective strategy to increase breast milk supply is to breastfeed frequently—8 to 12 times per 24 hours—ensuring proper latch and complete breast emptying at each feeding. 1
Primary Strategies for Increasing Milk Production
Optimize Breastfeeding Frequency
- Feed on demand 8-12 times per 24 hours (approximately every 2-3 hours) to stimulate milk production through frequent breast emptying 2, 1
- Breastfeeding 9-10 times per day is associated with better milk production compared to fewer than 7 feedings per day 1
- Night feedings are essential and make an important contribution to total milk intake 3
- Infants naturally vary in feeding frequency (range 6-18 times per day), and this variation is normal 3
Ensure Proper Latch and Positioning
- Proper latch is crucial because incomplete breast emptying signals the body to reduce milk production 1
- Proper positioning improves latch and reduces nipple pain, which can interfere with frequent feeding 4
- Infants typically consume 67% of available milk in the breast at each feeding, so effective emptying is key 3
Maximize Skin-to-Skin Contact
- Frequent skin-to-skin contact promotes milk production through hormonal responses 1
- Early and frequent skin-to-skin contact helps establish successful breastfeeding and milk supply 1
Critical Pitfall to Avoid
Avoid supplementing with formula unless medically necessary, as this reduces breastfeeding frequency and subsequently decreases milk production 2, 1. When supplementation is truly needed, use expressed breast milk rather than formula when possible 1.
Pharmacological Options (Galactagogues)
If non-pharmacological strategies are insufficient, two medications can increase milk supply:
- Metoclopramide: Also functions as a galactagogue and may increase milk supply by raising prolactin levels 5, 1
- Domperidone: When taken orally, levels in milk are low due to first-pass metabolism; used as a galactagogue and may increase milk supply 5, 1
Both medications work by increasing prolactin levels, though they should be considered only after optimizing breastfeeding technique and frequency.
Special Considerations for Pumping
For mothers who need to express milk (such as those with premature infants):
- Pump 8-12 times per day to establish adequate milk supply 1
- Ensure access to a breast pump if there is any delay in feeding the infant 5
Monitoring Adequacy of Milk Supply
The best indicators that milk supply is adequate include:
- Infant weight gain tracked at wellness visits 1, 4
- 6-8 wet diapers per day indicates adequate milk intake 1
- Stool output monitoring during wellness visits 4
What Does NOT Work
Increasing fluid intake beyond normal physiological needs does not improve breast milk production 6. While mothers should drink to thirst, advising extra fluids has no evidence of benefit for milk supply.
Expected Changes Over Time
Between 1-3 months of lactation, breastfeeding becomes more efficient: feeding frequency decreases, duration per session decreases, but volume per feeding increases while total 24-hour milk intake remains constant 7. These changes do not indicate insufficient milk supply but reflect normal infant development and increased stomach capacity 7.