Keeping Your Milk Supply Up

The first few days of nursing are critical for determining whether or not a mother will have a good supply of milk going. Consider using an automatic breast pump - it can be more reliable in keeping up your milk supply than your baby in some instances.

• Make sure your baby is nursing (or you are pumping) frequently, at least 8 times in 24 hours. 
• Listen for the sound of your baby swallowing. 
• Nurse at least 20 minutes, making sure that the baby empties at least one breast every few hours. 
• Avoid supplements like bottle nipples, sugar water, pacifiers. 

Some babies may be at risk for underfeeding; they will have a hard time emptying the breasts adequately. Babies at risk include:

• babies who are born 3 or more weeks early
• babies who weigh less than 6 lbs at birth
• babies with poor muscle tone (such as a Down Syndrome baby)
• babies who have a short frenulum (see the "tongue tied" baby in the link listed), a recessed lower jaw, a high palate, or a cleft palate (see more on these issues here: What Your Baby May Experience During the 1st Week of Nursing)
• babies whose mothers have large nipples (as large or larger than a quarter)
• babies who aren't yet latching on or keeping good suction 24 hours after birth
• if you have had previous breast surgery and the incision was around the nipple or areola
• if you have breasts that are underdeveloped, with a space of 1 1/2 inches or more between them (called hypoplastic breasts)

Be sure to: 

• Weigh your baby 10 - 12 days after birth, or sooner, if you suspect that your baby isn't getting enough milk. At this point, if your baby has regained his birth weight, you wont need to pump extra throughout the day. If your baby is below his birth weight at this age you should continue pumping and supplement the nursings with the pumped milk.
• Weigh your baby at 3 - 4 days if you had previous breast surgery or suspect that your glandular tissue is damaged in some way. You'll want to make sure your baby is gaining and ounce a day. If your baby loses 10% or more of her birth weight or doesn't gain an ounce a day after 5 days old, your baby will need supplemental breast milk or formula feedings.

"Insurance Pumping"

• Day 3 after birth: pump for 5 minutes on each breast right after each daytime and evening nursing. This should assure that you have an abundant milk supply; you can freeze any unused milk for later. 

If your supply is dwindling: 

• Increase the number of pumping sessions a day. The most common cause of a dwindling milk supply is pumping fewer than 8 times a day. 
• While pumping, as soon as you notice the flow slow down, switch to the other breast - do this several times during each session. This can be very helpful for increasing your supply.  
• Double pump. 
• Take fenugreek capsules.

Stress can temporarily decrease your milk supply. You can try the following: 

• Keep pumping or nursing every 2 - 3 hours
• Take a short nap or a warm bath just before pumping or nursing
• Apply some moist heat to your breasts before pumping or nursing
• Massage each breast while you are pumping or nursing
• Ask someone to rub your back between your shoulder blades while you pump or nurse