What are the best methods to increase lactation in breastfeeding mothers?

From the Guidelines

To increase milk production in breastfeeding mothers, the most effective method is frequent nursing or pumping every 2-3 hours, ensuring proper latch technique, and staying well-hydrated and nourished, as supported by the Agency for Healthcare Research and Quality systematic review of 40 studies 1.

Key Recommendations

• Frequent feeding on demand, at least 8 to 10 times in 24 hours, decreases newborn weight loss, the need for supplements, and the risk of clinically significant hyperbilirubinemia, as noted in the study by the CDC Maternal Practices in Infant Nutrition and Care survey 1.
• Consuming a balanced diet with an additional 300-500 calories daily, and ensuring adequate intake of water, approximately 2.7 L/day for lactating women, supports milk production 1.
• Galactagogues (milk-boosting foods) like oatmeal, fenugreek, blessed thistle, and brewer's yeast may help some women, although the evidence for their effectiveness is largely anecdotal.
• Prescription medications such as metoclopramide or domperidone can be considered under medical supervision for significant supply issues, but their use should be carefully weighed against potential side effects.
• Power pumping (pumping for 10-20 minutes, resting for 10, and repeating for an hour) can stimulate production by mimicking cluster feeding.
• Skin-to-skin contact with your baby stimulates hormones that promote milk production, as supported by the study on breastfeeding and the use of human milk 1.

Nutrition and Supplementation

• Lactating women require additional nutrients, including protein, folate, vitamin A, vitamin D, and iodine, to support milk production and infant health, as outlined in the systematic review of current evidence and recommendations 1.
• The recommended dietary intake for lactating women includes:

• Energy: an additional 2.1 MJ/day (500 kcal/day) above pre-pregnancy requirements 1
• Protein: 19 g/day during the first six months, and 13 g/day after six months 1
• Folate: 500 mg DFE/day 1
• Vitamin A: 650 mg retinol equivalent/day, with an additional 1300 mg retinol equivalent/day for lactation 1
• Vitamin D: 10 mg/day (400 IU) 1
• Iodine: 250 mg/day 1

Conclusion is not allowed, so the answer will continue without one.

It is essential to consult a lactation consultant or healthcare provider to rule out underlying medical conditions that may be affecting milk supply, such as thyroid disorders or retained placental fragments. By following these recommendations and consulting with a healthcare professional, breastfeeding mothers can help ensure adequate milk production and support the health and well-being of their infants.

From the FDA Drug Label

EFFECTIVENESS A randomized, masked, controlled, laboratory effectiveness study evaluated the effectiveness of 1. 1 mg/kg EQUIDONE Gel administered once daily beginning 10 to 15 days prior to the expected foaling date Table 3 Gestation Length, Milk Production and Mammary Gland Development Treatment Group(number mares)Mean gestation length in daysPercent adequate milk production at foalingPercent adequate mammary gland development at foaling EQUIDONE Gel (13)337100% (13 / 13)100% (13 / 13)

The best method to increase milk production in mothers, according to the study, is the administration of domperidone. The study shows that 100% of the mares treated with EQUIDONE Gel (domperidone) had adequate milk production at foaling, compared to 33% of the vehicle control group. However, it is essential to note that this study was conducted on mares, not human mothers, and the results may not be directly applicable to humans. Therefore, the use of domperidone to increase milk production in human mothers should be approached with caution and under the guidance of a healthcare professional 2.

• Key points:
  • Domperidone may increase milk production in mothers.
  • The study was conducted on mares, not human mothers.
  • Results may not be directly applicable to humans.
  • Use of domperidone in human mothers should be approached with caution.

From the Research

Methods to Increase Milk Production

• Frequent and regular milk removal can help increase milk supply 3
• Galactogogues, such as domperidone and metoclopramide, may also play a role in increasing milk supply 4, 3, 5
• Domperidone has been shown to be effective in increasing milk production in mothers with preterm infants 6, 5
• Metoclopramide has also been shown to increase milk production, but with mixed results 4, 6, 5

Galactogogues

• Domperidone: a dopamine receptor antagonist that may increase milk production, but is not approved for lactation enhancement in the US 7, 6
• Metoclopramide: a medication that may increase milk production, but has limited efficacy data and safety concerns 4, 6, 5
• Fenugreek and milk thistle have anecdotal evidence of their ability to improve breast milk production, but peer-reviewed studies proving their efficacy are lacking 4

Safety and Efficacy

• Domperidone has been associated with serious cardiac arrhythmias, but has also been shown to be safe for use in lactating women in some studies 7, 6
• Metoclopramide has been shown to have limited efficacy and safety concerns, including cardiac risks 4, 6
• More research is needed to evaluate the effects of available galactogogues on breast milk production and to address the significant unmet medical need for lactation disorders 4, 7, 6