If you ask for advice on increasing your milk supply on a ‘mummy’ Facebook group I can guarantee that you will probably get about 10 recipes for lactation cookies and smoothies, 5 telling you the directions to the nearest pharmacy that sells some sort of milk boosting concoction, a few telling you to get a prescription for domperidone, plus numerous more giving instructions to drink more water and eat things containing oats/barley/malt.
What they probably won’t tell you is that your best bet for increasing milk supply is to remove the milk already in your breasts, more often.
Let me give you the run down on milk production – while you’re pregnant your milk ducts grow and start to make the first milk, also known as colostrum. From about 16 weeks your breasts will contain colostrum and if your baby was born at any point after this you will most likely be able to make ‘mature’ milk. This is called ‘Lactogenesis I’.
What stops you from making large volumes of milk while you are pregnant is a hormone called progesterone, which stops the action of prolactin. Once your placenta is removed from your uterus progesterone levels drop dramatically and prolactin can do its job.
For the majority, milk ‘comes in’ around 36 to 72hrs after birth. There is a whole process that happens here to allow this, but I’m not going to bore you with lots of scientific info. This will happen regardless of a baby suckling on a breast (or a breast pump expressing the breast). This is called ‘Lactogenesis II’ or ‘endocrine control’ (endocrine = hormone driven)
Lactogenesis III or ‘autocrine control’ of milk production is what happens for milk supply to be maintained, or increased, over time. Autocrine = self driven, meaning that you need to keep telling your breasts to make more milk. And you do this by removing the milk that is already in your breasts, often.
As soon as you start removing milk from your breasts your body receives signals that it needs to start making more milk.
Now, if you were only to remove a small amount your body might start to think that it doesn’t need to make that much more. And as your breasts fill up with milk there is a feedback mechanism that tells your breasts ‘hey we’re getting full, no need to make any more’.
If you repeat this process over and over, your breasts will stop making milk. This is how you should wean from breastfeeding.
So if you want to increase your supply you should do the opposite - drain the milk that is in there AS MUCH AS POSSIBLE, as often as possible.
Some may say that you need to ‘empty’ your breasts – but your breasts will never actually be 100% empty, so this is a bit of a misnomer. What they should be saying is to ‘drain your breasts well’ – that means remove as much of the milk as you can.
If your breasts are ‘well drained’ your breasts will make more milk, more quickly, until they fill up and then that feedback mechanism kicks in. If you repeat this process often you should make more milk in total. Now it might take some time (a few days to even weeks), but over time you can increase your supply just by removing the milk that is in there.
Now how do you do this?
Well, if you want to breast feed, then you need to put your baby to the breast as soon as possible after birth. Yes your milk might come in regardless of whether you do this, but you won’t know if that is going to happen or not until a few days later, so better to start ASAP.
Within the first hour is the recommendation if everyone is well enough. But if you have had a caesarean, or you or your baby aren’t well enough, then within the first 2 – 6hrs is OK. Don’t panic if this can’t be done – just express or feed as soon as you can