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increase milk supply breastfeeding Esali Birth

Many breastfeeding mothers of the western and modern world wonder how to increase milk supply.  Maybe you were given a nipple shield quickly after birth or you use a pacifier (for any reason).  Maybe you're just trying to keep baby on a routine schedule, night weaning or feel overwhelmed and need a break.  These are some of the most common reasons for a decrease in milk supply.  Increasing milk supply is often a matter of putting baby on the breast at the first sign of hunger.  However, sometimes for known or  unknown reasons you need a little support to increase milk supply, especially when time is of the essence.

Is my Breastmilk Supply Low?

So many moms not only feel like their baby's need to nurse regularly is an indicator of low supply, but that comparing to bottle-fed babies, they might be pumping much less.

  • Breastmilk supply is an average of 2 ounces between BOTH breasts per feeding.
  • Pumping is NEVER an indicator of the storage you have nor the supply you can create - no matter how good your pump.  (Sometimes manual expression works more efficiently than pumping, but it still doesn't compare to baby at the breast).
  • Some moms can store more milk than others (like having a smaller cup of water than someone else).  A mom with a smaller storage tank will need to refill more often, but the source of the supply is still the same amount.  So, some babies will need to nurse more often to be satisfied with the flow.
  • Breast size is NOT an indicator of storage capacity or supply you can create.  Some moms have more or less breast and fatty tissue, which can vary widely.
  • Breastfed babies rarely every drink more than 4-5 ounces at a time.  (Even during growth spurts, a baby will temporarily increase milk supply because they need the extra nutrients for whatever developmental change they are experiencing, but after this, the supply goes back to the normal average - no matter how old their baby is - 4 months, or 4 years)
  • Babies will drink more from a bottle, especially if bottle feeding isn't mimicking the breastfeeding relationship (lots of breaks, switching sides, bottle parallel to the floor just enough to fill the nipple)
  • Babies like flow.  If there is a concern for supply, it is often related to latch, positioning, and flow of the milk.  Rarely would it be the supply itself, especially in the early weeks when the supply is getting established.

Causes of Decreased Milk Supply

In cultures where breastfeeding is not the norm, especially beyond 3-6 months - low milk supply quickly becomes a common reason mothers stop breastfeeding.  In reality, low milk supply is rare when we're talking the biological function of making milk and otherwise is often birth and provider caused through lack of knowledge, lack of biological birth support and overall lack of adequate care for breastfeeding families.  Breastfeeding is a biological function that was typically shared through visually seeing others breastfeed and listening to the stories of your culture.  When your culture only knows bottle feeding and pacifiers, it makes it really hard to have this innate understanding of breastfeeding and breastfeeding remedies.  Decreased milk supply is often caused from the following:

  • Engorgement surrounding the birth where adequate latch was not achieved
  • Early supplements surrounding the birth
  • Stressful birth
  • Stressful postpartum/life (including simply lack of a LOT of help)
  • Returning to work (early or later)
  • Limited Nursing (length of feeding and extending times between nursing especially over 2-3 hours)
  • Nipple Shields
  • Pacifiers
  • Bottles & Supplements (including formula samples, pacifiers and nipple shields handed out in hospitals)
  • Thumb Sucking
  • Less than ideal pregnancy and birth position of the baby (baby's development influences how their soft and hard tissue develops which can not only cause baby to not be able to move their head or jaw/tongue in the necessary positions, but may also mimic tongue tie)
  • Tongue and/or Lip Tie
  • Plugged Ducts
  • Unbalanced Food Choices
  • Dehydration
  • Low Food Intake

Lifestyle Choices to Increase Milk Supply

  • Eat within 30 minutes of Waking (this can be an herbal cup of tea and then a full meal within an hour)
  • Hydrate
  • Eat in general to be sure you have enough sustenance to make the milk (which takes about 500 extra healthy calories - more than what you needed during pregnancy)
  • Eat plenty of greens, including wild foods and herbal foods.  Nettles is excellent for tea and soup and omelets and any way you would use spinach (only more nutrient-packed).  Red Raspberry Leaf and Strawberry Leaf are other great green herbal teas.
  • Lactation Cookies I will note here because they are heavily marketed.  While they can be tasty many boxed options and recipes are loaded with sugar, and not what we're looking for with health.  They aren't really going to do a lot for supply, unless you don't eat well, you don't eat fiber, or you don't eat enough in general.  So, if this is how you eat healthy, then by all means find a low-sweetened option, or just go for a bowl of steel cut oats, nuts, seeds, and fruits and wash it down with a few glasses of water.  You can also use these banana-sweetened recipes to get in some healthier snacks if you need to improve your nutrition.
  • Move daily - Movement gets blood (nutrients) flowing where it needs to go.  Don't overdo it in the first few weeks, though
  • Rest.  Be sure you've planned, or change your plans, to allow for 3-4 weeks after birth of nothing but rest and breastfeeding.  Have a friend or family member live-in (dad needs rest, too) or hire a postpartum doula, or give people tasks to feed and clean for you or throw a frozen pre-prepped meal into a crock pot.  Be skin to skin as much as possible with baby to regulate baby's temperature, stress levels, and allow baby to be close enough to be properly positioned.  You can throw a picnic blanket outside or rest on the sofa, but you are healing from blood and fluid loss, a "wound" the size of a dinner plate on the internal part of your uterus, and learning a new task.  Exhaustion is stressful and reduces necessary hormones.  Rest is vital after birth, and anytime you're struggling with milk supply.
  • Do not limit nursing at any time.  If you need to stop a session to go pee or take a break, do so - but as soon as baby cues that they want to nurse, offer the breast or two, or three or four or however many it takes until they're satisfied.
  • Eliminate or significantly limit the coffee (even decaf), black tea and any other foods high in acids and tannins.  If this sounds like an issue for you, determine your stress load and adrenal health as both the stress and the coffee/black tea can be contributors to low supply.
  • Bed share.  Not just room sharing, not just co-sleeping with a co-sleeper.  I'm meaning actually sleeping right next to your baby.  Your baby's breathing and stress levels regulate when they are right next to you.  They will snuggle up close to you.  They may even latch on all by themselves without you even waking up, eventually.  This means everyone from baby, to you, to Dad sleeps much better.  Baby doesn't totally wake up to nurse.  You don't totally wake up to nurse.  Baby nurses longer at night when your prolactin levels are highest allowing you to make more milk (score for growth spurts!).  You can read this article for specifics on safely co-sleeping.

Physical Methods to Increase Milk Supply

Ways to increase milk supply can sometimes come from manual support.  Here are a few options:

  • Shake and massage your breasts before/during nursing.  This is especially helpful if your baby has a tongue and/or lip tie or you deal with plugged ducts.
  • Use breast compression while nurse and while pumping where you squeeze your breast to help increase the flow of the milk (not necessary if baby is choking during nursing due to forceful letdown)
  • Get baby Osteopathic Therapy, Massage Therapy, and/or Cranio Sacral Therapy early and often (once is not usually enough). This helps baby's soft and hard tissue move into a supportive place so baby's jaw muscles can work the way they're intended and baby's tongue can reach the necessary milk sinuses.  Also seek support of a qualified provider than can assess for tongue and/or lip tie (not just your pediatrician, and not just any IBCLC - know their history of diagnosing this issue).  If a revision is necessary, be sure to continue the bodywork as the tie will only release tissue - it will not fix underlying osteopathic/tissue complications.
  • Pump one breast while nursing the other or pump between nursing sessions.  Follow these breast pumping tips for more guidance.  Hands-free nursing bras and pumps like the Freemie are great for being more discrete while pumping in any location.  If  pumping full or part-time, always pump as much as baby drinks from a spoon/SNS/cup/bottle in a 24 hour period.
  • Hand express your milk which may be helpful especially when engorged or when you aren't responding well to a pump (or don't have one nearby and need to prevent too much milk from building up in your breasts).
  • Remove (or significantly limit) artificial nipple use including pacifiers, nipple shields and thumb sucking.  Artificial nipples change the latch (hard and soft tissues of the facial structure) which reduces baby's ability to efficiently drain the breast causing the supply to drop.  Additionally, if baby wants to suck it means they actually want to be at the breast or comforted by you/someone in some way.  When there are milk supply issues, at least, all sucking/nursing should be at the breast.  Perfect way to increase supply.
  • Nurse when baby has a cue (long before crying) like smacking lips, putting their hand towards their mouth, turning their head towards your breast.  In the early weeks, and during developmental changes like growth spurts, teething and learning new things, this will feel like it is all the time.  Get emotional and house support to help you through these times.  The longer milk sits in your breast, the more proteins, that signal the body to slow production, are present.  Going longer than 2-3 hours between nursing sessions (especially in the first 3 months) can significantly decrease supply and effect the rest of breastfeeding making it more difficult to increase supply as needed later.
  • Reduce stressors.  Get more sleep.  Get more help for you AND dad.  Say "No" more to scheduled tasks.  Go to bed, nurse all day, take an herbal lavender bath, rest and drink tea.  Oxytocin is the love, calm, and trust hormone and is also the hormone that causes contractions (which you likely remember from birth and after).  Stress hormones (like adrenaline) suppress oxytocin.  Stress of any kind - from doing too much to going back to work or feeling depressed will decrease oxytocin.  Oxytocin allows the alveoli that hold the milk in the breast to contract and express milk through the ducts as baby stimulates the breast or you are otherwise triggered to release oxytocin (such as orgasm, strong feelings of love and intimacy, or hearing a baby coo or cry, for example).

Herbs that Increase Milk Supply

Other than food in general and herbs like nettles and red raspberry leaf to increase milk supply (which can often be enough on their own due to nutrient content) other herbs are considered specific galactogogues - milk producing - herbs.  These herbs can be used on their own, though as with most herbs their effects are enhanced when blended together.  Note that the first three herbs can be blended together to total 5 ml per dose (plus additional Avena Sativa) which may enhance their efficacy.

  • Goat's Rue - Galega officinalis - *May increase the strength of hypoglycemic medications.  Otherwise, Infuse 1 tsp. per 1 cup of water.  Steep 10-15 minutes.  Drink 1-2 times daily.  Alternatively, take 1-2 ml of a 1:10 in 45% tincture three times daily.
  • Fennel - Foeniculum vulgare - *Slightly crush seeds.  Infuse 1-2 tsp. per 1 cup of water.  Steep10 minutes.  Drink 1-3 times daily.  Alternatively take 1-2 ml of a 1:5 in 40% tincture three times daily.
  • Blessed Thistle - Cnicus benedictus - Infuse 1 tsp. per 1 cup of water.  Steep 10-15 minutes.
  • Oat Straw - Avena sativa - This is useful for stress and nutrient-related low milk supply to be used with other supporting galactogogue-specific herbs.  *Infuse 1-3 tsp. per 1 cup of water.  Let steep 10-15 minutes.  Drink 1-3 times daily.  If you know nursing is linked to stress (busy schedule, working, exhaustion...etc.) use the tincture of Avena sativa when tinctured in its milky form - this is crucial.  The milky form is the only form of Avena sativa that actually provides direct calming support.  In this case, take 1-5 ml of a 1:5 in 25% solution three times daily.
  • Fenugreek - This is not one I typically recommend since it is not really indicated as a galactogogue and with its other effects on the body (particularly those with thyroid complications) it isn't my first choice.  However, it can be helpful so I am including this here for information sake.  You typically need to take enough to start smelling like maple syrup which is a surprising amount.  This is a demulcent herb which increases mucous and soothes the nervous system (like oat straw).  May lower blood cholesterol.  This herb should be taken in capsule form or tincture.

Infusion - Pour hot/boiling water over the herb - do not heat the herb in the water.  Cover.  Let steep (sit unbothered) as directed.

*Dosages from: Medical Herbalism: The Science and Practice of Herbal Medicine by David Hoffmann, FNIMH, AHG.

Prescription Medications to Increase Milk Supply

According to Dr. Jack Newman, Domperidone (a category L1 and a drug used to increase intestinal peristalsis) is the most useful prescription medication to increase milk supply.  Though not its direct-use, off-label Domperidone does increase prolactin levels - the hormone needed to produce milk.  This is not a first-approach and often not easily available in the US.  In fact, it typically has to be purchased online from international pharmacies as it is unavailable through your provider in the US - which is unfortunate.  For more specific information about Domperidone safety and dosages visit the Dr. Jack Newman website.

Reglan (a category L2) is the prescription medication typically used in the United States to increase milk supply, according to KellyMom.com.  Unfortunately Reglan has strong links to severe depression.  Sulpiride is another option in some countries with limited safety data.

Have you managed low milk supply?  What did you use to increase milk supply for you and your baby?

Looking for breastfeeding support via web or locally in the Mid-Ohio Valley?  Check out my breastfeeding support services or attend the monthly Breastfeeding, Birth, and Parenting Social.

Esali Birth Breast Pumping Tips

Mothers going back to work or wanting a few hours away from their baby often have questions about pumping and feeding their baby while they're away.  How do you get started?

BreastPumpingTips

Is pumping necessary?

This really depends on your situation.  If you're going to be away from your exclusively breastfed baby for more than 2-3 hours, yes you'll likely need to leave some expressed milk.  If your baby is supplementing with solids, then you might be able to stay a little longer without expressing milk.  Keep in mind that introducing solids too early or too late can cause digestion and immune system complications, so be cautious about doing this.  When baby shows all the signs of being ready (sitting up on their own, able to pick up food with a pincer grasp and feed themselves, move tongue to all folds of their mouth, and types of teeth dictate types of food) this is the best time to start introducing solids in very small amounts, not as a replacement - to prime the gut and the body for new textures and experiences.  Remember that breastmilk digests very rapidly, and as long as the majority of their nutrition comes from breastmilk, they'll need access to it often.  A breastfed baby will rarely ever drink more than 4oz at a time (granted the baby isn't spurting or changing developmentally or a life change isn't occurring like mom returning to work), no matter their age, but every baby is different.  Some babies may go shorter or longer between nursing sessions, so it is always good to pay attention to your baby and their specific needs.

If you're just going out for dinner, you can usually just nurse the baby right before you leave, and you'll often have enough time to go out to dinner (be sure to get call ahead seating if possible) and be back by the time they want to nurse again.  Keep in mind that many babies cluster feed and comfort nurse more in the evenings, so altering your times out can be helpful.  You may also consider having the care giver drop you off and then take baby to a local park for a walk so they can be close by and bring you the baby whenever they need you (which helps reduce your anxiety about checking your phone constantly and possibly missing dinner).  That first evening out can be a little bittersweet, but it is nice to take some time off every once in a while.  If this just doesn't work for you or your baby or you're not ready to leave baby with a care giver, wrapping your baby in a woven or stretchy wrap (any simple piece of cloth like a long sheet) is easy peasy.  For those first few months, a snug wrap keeps a new baby calm *much* better than those uncomfy car seats (often used as carriers).  And, if baby does wake at dinner, grocery shopping, or walking in the park, just loosen up the wrap a bit to drop them closer to nipple level and nurse them right back to sleep or into calm bliss without ever skipping a beat.

If you're going to work, being close to your baby's care giver helps and may mean that you can leave work on your breaks and/or lunch to simply nurse your baby rather than pumping.  Some businesses allow moms to work from home, or partially work from home, or you may bring your baby to work with you while they’re very small.  Don’t hesitate to ask if this is an option, the worse they can do is tell you no.  However, if you do need to express milk, know that Federal Law requires businesses to provide moms with a clean space (not a bathroom) and enough time to pump milk for their baby.  They can apply for a hardship and cases will be reviewed individually.  For more information on the working while pumping laws, visit here.  Additionally, most insurance companies are now required to pay for breast pumps, but be cautious because they don’t always cover quality pumps.

Does the pump really matter?

Yes!  Which pump is best for you depends on your situation.  Most importantly, get something that works for you and your situation.  If you’re going to be pumping regularly, a double electric pump will usually save you time and energy.  If you just want a pump to express milk for a night out here and there, then a single manual pump may be all that is needed.  Pumps can get pricey, but they are often worth the cost.  If you respond better to manual expression, then you may not need a pump at all.  Bottom line, if you need to pump, this isn’t a piece of baby gear that you want to skimp on.  A lot of moms are stressed because their $20 pump isn’t meeting their full time pumping needs.  Save your money - $25 a week will get you a great pump in no time.  But again, check with your insurance company to see if they cover a quality pump

A quality pump needs to be closed system.  A closed system pump means that all parts that have the potential of coming in contact with the milk can be fully sterilized.  Open system pumps, like personal use Medela, cannot be fully sterilized and because of such are known to have mold built up in the system.  Hygeia and ARDO are the only breast pump manufacturers, that I'm aware of, that completely comply with the World Health Organization’s (WHO) breastmilk substitute marketing code.  Both Ameda and Lansinoh make quality closed-system pumps, but either they or their parent companies don’t comply with the WHO code.  There are a variety of new companies offering more discrete pumping options great for when you want to pump anywhere.  I personally used an Ameda Purely Yours and loved it (purchased prior to their parent company deciding not to follow the WHO code).

Additionally, get a pump with adjustable speeds, cycles, and flanges.  You need to get a flange that correctly fits for comfort and efficiency, and the cycles and speed help you mimic the suction to resemble a baby’s patterns at first – short and shallow in the beginning to trigger your let down, and then long and deep once let down has occurred.  You’ll have to play around with it to see what pattern works for you.  The cycling and flange size can be the difference in a mom being able to express milk or not, so research this a little.

How does expressed milk affect the baby?

Being at the breast is optimal for baby.  Beyond the bonding aspect of breastfeeding, the contact between the baby and your breast allows you to pass antibodies most efficiently.  If for whatever reason baby can’t be at the breast, do lots of snuggling when you are together and keep the milk as fresh as possible so that your baby gets the most amounts of antibodies possible.  The longer your milk is stored, the more of these properties are reduced.

Depending on how your baby gets expressed milk can affect your experience when baby is at the breast.  Even for a baby that does “fine” between an artificial nipple and the breast, their latch is still changed and this can cause sore nipples or inefficient milk transfer (not to mention changes in the palates and musculature of the face).  A baby squeezes and sucks on an artificial nipple, whereas they massage the areola and lactiferous sinuses to squirt the milk out the breast – two very different mechanics.  When baby is away from the breast, a supplemental nursing system (SNS) is the least likely to interfere with breastfeeding.  If you’re supplementing while mom is nearby, an SNS is incredibly valuable at keeping baby at the breast to stimulate milk production, keep baby learning how to latch, and helping to avoid breast refusal and nipple preference.

You can purchase an SNS, or make your own with a milk storage bag or a bottle and a #5 feeding tube.  Use this as a finger feeder, so the baby sucks on your finger and at the same time gets milk, which allows the baby to work a little (mimicking breastfeeding) to get their nourishment.  Or, latch baby on to the breast, and once they’re not actively sucking any more after using breast compression, insert the SNS for any necessary supplementation.  Using an SNS in this manner helps prevent nipple preference while stimulating milk production.

If an SNS is not your choice, a spoon, dropper, cup, or your hand can be used to transfer milk to the baby.  However, if bottle feeding, be sure to mimic the breastfeeding relationship as much as possible.  Hold the bottle so the baby works for the milk and it doesn’t stress the baby out by pouring too fast.  Check out the Best for Babes foundation guide to bottle feeding for some excellent advice.

Milk Supply & Pumping Efficiency

After your milk matures, milk supply works by supply and demand.  Whatever you remove from the breast, your body will replenish. You never stop making milk, even though we often refer to the breast as being “drained.”  Even once you decide to stop nursing, or your baby weans, you’ll often still have milk for months.  In the first few days after birth, active and unlimited nursing let’s your body know that baby is breastfeeding and your alveoli multiply for enhanced milk production and storage.  The longer you go between nursing or expressing, the less milk you make, but as long as when you’re with baby, you’re not limiting nursing (especially with pacifiers), then milk supply is rarely an issue.

EB Breast Pacifier

Let me repeat this.

PACIFIERS AND ARTIFICIAL NIPPLES AFFECT BREASTFEEDING - ESPECIALLY YOUR SUPPLY AND COMFORT. 

Likewise, you cannot spoil a baby that has biological dependencies for care givers.  They need to know that you're going to provide them with nourishment, stability, and comfort.  Pacifier use as a parenting tool is your choice, just like starting solids, birthing naturally, getting an epidural, using a bouncy seat, eating well in pregnancy, choosing a care provider, and every other parenting choice you'll make.  It isn't my business (unless you're asking me to help you) but, I'm not judging you. What I want you to understand is just because your baby does "fine" going from artificial nipple to breast, doesn't mean the discomfort you feel during latch is a part of the normal process of breastfeeding, and doesn't mean your supply won't be affected.  If you truly want to have the best supply you can have, especially when you're running into supply issues or weight gain issues in the baby, you need to get rid of the pacifiers.  Don't stress yourself out with techniques and galactogogues if you're not going to try unlimited nursing first.  If you need a break, try a birth ball to soothe your baby and babywearing.  Parenting is supposed to be involved - despite what our culture may have you believe.  I know, I know, a lot of moms use pacifiers and their babies are "fine" - I used a pacifier for a few weeks with my daughter while I was going nuts with every other soothing technique without having much support at all (ask me about it sometime) - but I refuse to jump on the bandwagon that pacifier use doesn't cause problems - especially when a lot of mom's breastfeeding experiences aren't fine.  Almost every single mother that has ever asked me for support for pain or milk supply while nursing is using a pacifier.  While I understand the reasons they want to use a pacifier - they simply change the musculature of the face, tbe bone structure, and the latch.  If you're having pain.  Get rid of the artificial nipples.  If you're not having pain and your supply is excellent and you're not experiencing milk supply issues...  that's one thing... if you are, you cannot expect someone to help you fully if you're unwilling to remove some of the barriers causing problems.  Until our breastfeeding rates increase to a significant level, I'll adamantly promote the biology of the body and baby and let you make the decision. I digress...

Have as close to a biological birth as possible, keep baby skin to skin and near the breast often and especially immediately after birth, and don’t limit or schedule nursing sessions.  A baby that has a poor latch and unlimited access to the breast, will stimulate the breast and get milk and eventually latch better.  That doesn’t mean don’t get help with latch, it just means that all the time limits and scheduling we do for babies (including birth experience and induction), and the pacifiers we use, are causes of milk supply issues.

Babies weren't meant to sleep in cribs away from their mothers.  They were meant to be close to mom at all times, and within a coo's distance for the first few years.  Bedsharing, when done safely, helps everyone sleep better and is the best way to get baby calmly attached to the breast, get more sleep, and promote an amazing supply of milk.

During the first few weeks, when milk supply is really amping up, is the easiest time to increase supply.  If you know you’ll be returning to work early, pump a few extra ounces a day.  Don’t let this interfere with resting and bonding with your baby postpartum, and don’t pump everything you’re making because this can trigger oversupply, which isn’t always the amazing thing that it sounds like.  If, however, you have a bit of time before going back to work, you can slowly build your supply over the next months making sure to start no later than a week before going back to work.

Pumping tips:

  • Relax, de-stress, and eat well.  It is hard to let down your milk when you’re stressed and it takes around 500 extra calories to make milk (vs. about 300 to gestate a baby... you need to eat and drink).  Our hormones just don’t work optimally with stress, especially oxytocin, which is what contracts your alveoli and creates the "let down."  Smell your baby’s clothes, listen to their coos on a recording, look at a picture, take a bath, do some yoga, say a prayer.  Whatever helps you take a deep long breath, stimulate oxytocin, and cleanse the stress out of your body, do it.
  • Prolactin (hormone that makes milk) levels are highest at night.  Pumping at night will help increase supply.
  • Don’t go more than 2-3 hours between pumping sessions when you’re away from your baby or the proteins in the milk will trigger your body to decrease supply.
  • You usually have more milk available in the mornings when baby has gone a little longer between nursing – pump when you wake up.
  • Use the 24 hour rule.  It usually takes about 24 hours for your supply to change.  Don’t focus so much on pumping as much as baby eats at each session, but focus on pumping as much as baby eats in a 24 hour period.  So, if it takes 8 pumping sessions to get the amount of milk your baby eats while you’re away, then do that.  If it takes 3 pumping sessions, then do that.  You are a human, not a robot – do what works for your body.
    • My full time work days looked like this:  Roll over in the morning and nurse baby, eat breakfast/get ready, pump (put milk in bottle on counter to be fresh for first feeding), nurse, pump about every 3 hours at work (for 9 hours), nurse, cook dinner, take a shower, pack lunches, go to bed and nurse every 1-2 hours throughout the night.
    • My part time work days - My son has been exclusively breastfed so I drove home every 2 hours or took him to work with me.  At 16 months, I only drive home once or twice a day to nurse.
  • Pump one side while you nurse the other to allow baby to trigger let down.  You can buy a pumping bra, or you can simply cut a hole in a sports bra big enough to fit the tube of the flange in to help hold it in place if you have trouble maneuvering baby and pump together.
  • Use breast compression.  There are lactiferous sinuses close to your areola that are basically like little storage tanks for the milk.  These sinuses are what your baby’s tongue needs to reach to squirt the milk out of your nipple (hence the necessity of a deep latch).  If you squeeze these sinuses while nursing and/or pumping, more milk comes out.  If baby stops actively sucking, you can squeeze your breast to wake them and get them to suck more to stimulate milk, and you can squeeze these while pumping to get milk faster and help increase supply.
  • Use lanolin or similar while pumping to reduce friction and get more milk.  Of course, be sure your flanges are the right size first.
  • Switch pump (like switch nursing) and pump often.  If you are pumping on one side, pump (with breast compression) until the milk stops flowing, then switch to the other side and repeat.  Once that breast stops flowing, switch back to the first side and repeat.  Do this for as long as it takes to get the milk you want or for as long as you have time.  If you’re double pumping, after the milk stops flowing (with breast compression), then pump for about 15-20 minutes longer and/or wait 15-20 minutes and then pump again. Both of these trigger your body to make more milk, but they also give your breasts a little time to build up the storage supply so that it is simply easier to get more milk out with a pump.
  • Learn the art of manual expression – it is invaluable, and some moms respond better to manual expression than any other method.

Storing Breastmilk

Breastmilk, being a live substance, is amazing.  For a healthy baby, you can leave it fresh on the counter for up to 10 hours, then put it in the fridge for up to a week, then put it in a freezer for up to 3 months, and then in a deep freeze for 6 months to a year.  When in doubt, smell it or taste it to see if it is still good.  The longer you store milk, and the more you heat it, the more of the properties are diminished, but it is still the healthy option for your baby.

Store in containers made for breastmilk in small increments – 2 to 4 oz – a breastfed baby, no matter if they’re 3 months or 15 months, will rarely ever eat more than 4 ounces at a time.  You can always add more, but you don’t want to warm up too much milk and have to waste it.  If you’re using bags, lay them horizontal so they are easier to store once they’re frozen and take less time to thaw (which means less heat) when you’re ready to use them and thaw them in warm running water to be sure you don't overheat.  Be sure to label the expression date, and put their name on it if they will be cared for by someone with more than one baby.  Talk with the baby’s care givers about breastfeed babies and be sure they know the differences in breastfed baby’s demeanor than that of a formula fed baby.

Pumping can work!  Talking with your work about your desire to breastfeed before taking maternity leave will help the transition once you return to work.  Be open and honest and know that most employers meet moms with respect for their wishes.

Do you have questions not listed here?  We’ll keep updating.  Let us know!

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