How to Initiate a Full Breast Milk Supply: Your Comprehensive Guide
As an International Board Certified Lactation Consultant (IBCLC), I often get queries from new moms concerned about initiating and maintaining a full breast milk supply for their newborns.
The task can indeed be challenging, but don't worry; there are various strategies to help you succeed. This post aims to address some common scenarios, such as having a premature baby, multiples, a baby with jaundice, or a history of low milk supply.
Basic Steps for Initiating Full Milk Supply
- Early Initiation
Start breastfeeding as soon as possible after birth, ideally within the first hour. Skin-to-skin contact can stimulate hormonal changes that kick start milk production.
Hand expression within the “golden hour,” also known as the first hour after birth, can greatly improve your milk supply and breastfeeding outcomes as a whole.
- Frequent Feeding
Breastfeed on demand, or at least every 2-3 hours, to keep your milk supply up. Bringing your baby to the breast frequently and practicing latching, hand expressing and
- Correct Latch
Ensure your baby has a proper latch. An improper latch can lead to low milk supply and sore nipples. While some discomfort in the early days of breastfeeding can be normal, breastfeeding should NOT be painful. Feeding through pain can often lead to nipple damage and a shortened breastfeeding experience overall. It is important to get help early if you are experiencing pain. Depending on your birthing location you may receive one-on-one help in the hospital. It is also important to set up an appointment with an IBCLC after your hospital stay. Click here to book with one of our consultants.
- Breast Compression
Use breast compressions to keep your baby feeding longer. It is not uncommon for newborns to be very sleepy at the breast. Breast compressions can be one helpful tool to keep your baby awake through an entire feed. You may want to try breast compressions as your baby begins to slow down in their suck/swallow or is beginning to drift off. Compressions increase the flow of your milk.
- Pumping
If you’re separated from your baby or your baby has not been able to feed at the breast, it is important to pump every 2-3 hours or a total of 8 milk removals per 24 hours in order to build and maintain your breast milk supply. It is important to get one-on-one support to help you navigate pumping and create a sustainable schedule.
Common Concerns
- Preterm Babies
Kangaroo Care: Skin-to-skin contact can be even more crucial for preemies.
Specialized Nipple Shields: These can help premature babies latch better.
Pumping: If your baby is too weak to suck, start pumping immediately to stimulate milk production. Creating a sustainable pumping schedule can be vital to continue with pumping, building and maintaining a breastmilk supply. Click here to book with one of the IBCLCs on our team to help you with your breastfeeding goals.
- Multiples
Simultaneous Feeding: Learn how to feed both babies at once to save time. This can be especially helpful in the early stages of breastfeeding when your babies are breastfeeding very frequently.
Alternate Breasts: Make sure each baby feeds from both breasts to help stimulate an equal milk supply from both sides and keep babies heads round and help avoid a head turning preference..
Pumping: To maintain supply, consider pumping after feeds for a day or two until you can meet with an IBCLC. If your babies are struggling to feed at the breast or are not able to get full feeds at the breast, you will need to pump every 2-3 hours to build and maintain your supply. If you are latching both babies and also pumping and bottle feeding, what is referred to as triple feeding. Triple feeding is a very temporary solution it is important to build a plan with an IBCLC to support you through this time and find a sustainable feeding path forward.
- Baby with Jaundice
Frequent Feeding: More feeds can help to eliminate bilirubin more quickly. The more frequently you latch and feed your baby will also build and maintain your supply.
Monitor Weight and Diaper Output: These are key indicators of whether the baby is getting enough milk.
Consult Your Pediatrician: For severe jaundice, phototherapy or other medical interventions may be necessary.
- History of Low Supply
If you have a history of low supply or have risk factors for low supply such as: no breast growth during pregnancy and after birth, breast surgery, untreated hypothyroidism, Polycystic Ovarian Syndrome (PCOS), obesity, diabetes, smoking and high blood pressure, it is helpful to meet with an IBCLC prior to your birth. Click here to book
Supplemental Nursing System (SNS): This allows the baby to receive additional milk while breastfeeding, stimulating your breasts to produce more milk. You can begin to use this tool in the hospital. It can be a learning curve and having help can make all the difference when using an SNS.
Supplementation: breastfeeding is not an all or nothing sum game. You can choose to supplement with your pumped milk, donor milk and/or formula as you move through breastfeeding.
Galactagogues: These are substances that can help increase milk supply, like milk thistle, but always consult with a healthcare provider before starting any new supplement.
Track Feeds: Keep a log of how often you're feeding and for how long, to identify any patterns or issues. It can also ensure you are getting the adequate amount of milk removals per day to maintain a breast milk supply. For most mamas, they will need a minimum of 8 milk removals per day.
Additional Tips for Everyone
- Stay hydrated and maintain a balanced diet.
- Seek support from family and friends, and consider joining a breastfeeding support group. We host a weekly local support group. Click here for more information.
- Always consult your healthcare provider for personalized advice.
Building a full milk supply can be a challenging but rewarding experience. Every mother's journey is unique, but armed with the right information and support, you're more than capable of providing your baby with the best nutrition possible.
If you encounter any problems or have any questions, an International Board Certified Lactation Consultant (IBCLC) can provide you with expert guidance tailored to your needs. We would love to be a part of your breastfeeding experience. Click here to book an appointment with one of the IBCLCs on our team today.
Want a deeper dive? Read on
As an International Board Certified Lactation Consultant (IBCLC), I can tell you that the science behind initiating a full breast milk supply is a fascinating interplay between hormones and mechanical milk removal. The journey typically starts with the hormone oxytocin, which facilitates the "letdown reflex," allowing milk to flow from the alveoli into the milk ducts and out the nipple. Concurrently, prolactin, another hormone, is responsible for milk production and is released in response to nipple stimulation, whether that's from a baby latching or a breast pump in action. Frequent milk removal is crucial for both stimulating these hormone levels and preventing engorgement, which could otherwise signal the body to reduce milk production. The relationship between hormones and milk removal is a feedback loop; the more frequently and effectively milk is removed from the breast (whether through nursing or pumping), the more signals are sent to produce more milk. This process is particularly vital in the early days postpartum, where the transition from colostrum to mature milk (lactogenesis II) takes place. The body is remarkably responsive to the baby's needs, and this demand-and-supply mechanism ensures that most mothers are capable of producing adequate milk for their infants.