957 North Plum Grove Road • Schaumburg IL 60173 USA 847.519.7730 • fax 847.969.0460 • 800-LALECHE

to eat more than your have stored up at the moment, he will keep nursing and draining your breasts until production speeds up to meet his needs. If you are making more than he wants, the leftover milk he leaves inside signals your to make less and less until your supply matches what he needs. How often your baby feeds ultimately is determined not by his age but by Increasing your milk storage capacity—the size of the warehouse in your milk factory. The babies whose can store lots of milk may take larger feedings less often, while the babies of mothers with less storage space get smaller meals and may One of the most common feed more often. reasons mothers give for sooner than they had planned is concern about milk supply. How Do You Know if Your Living in a culture that is used Milk Supply is Low? Baby behaviors like fussing after to measuring everything, it can nursing, feeding often, or feeding Yourbe difficult for mothers to trust for short or long periods of time, the breast when they cannot within two to four days, milk production kicks or changes such as softer breasts or less into high gear. From that time on, the factory leakage, may or may not indicate a low milk see how much milk is inside it —your breasts—determine how much milk to supply. These behaviors are often just part of or going into the baby. When make by how much milk your baby takes out. the normal course of . Whereas Milkdoubts begin to set in, mothers That puts your baby in charge of your milk in the early weeks the breasts are full and supply! sometimes hard, this is related to additional often receive well-intentioned fluids in the breasts as well as extra milk over but poor advice that may even and beyond what your baby needs. As the When a full-term, healthy baby is allowed fluid is lost and your breasts settle into milk make the situation worse. to nurse as often and as long as he needs, production that matches your baby’s needs, a good supply of milk is usually established. Fortunately, there are ways to the breasts will feel softer—even though Most babies eat 8-12 times a day. If the baby know if you are making enough there is plenty of milk in them, and more on is unable to do the job due to premature the way! Sometimes an increase in frequency milk and ways to help increase birth, separation, illness, or another condition, of feeding is an indication of an increase in milk must be removed from your breasts it, if needed. Understanding your baby’s need for “mommy time,” and does by other means or else the milk factory will how milk supply works and the not reflect a supply problem. The best way begin to shut down. If you and your baby find to tell is to look at your baby’s output things that can cause problems yourselves in this situation and taking into and weight gain. In the first 6-8 weeks, most consideration how may times a day your baby is key to finding the best way to babies have at least 5-7 good wet and nurses effectively at the breast, pumping up to increase your milk. at least 3-4 stools larger than a US quarter 8-12 times each 24 hours will help to ensure (2.5 cm). As they get older, they have fewer a good milk supply. If your baby is not feeding but larger bowel movements. From the time How Milk Supply Works directly at the breast, a good goal for the their mothers’ milk comes in until four to six During pregnancy, the breasts build a milk amount of milk you pump per day is at least months of age, the babies should gain around factory in preparation for feeding your baby. 25 to 30 ounces (750-900mls). 5-7 ounces (150-210 grams) per week. Hormones from the placenta aid this process, Weight gain slows down gradually for the and for mothers carrying multiple babies, extra Your milk factory is always making milk. rest of the first year. Your baby’s health care hormones create an even bigger milk factory. When your breasts are drained often, they provider can tell you if he is continuing to gain Once the baby is born and the placenta comes make more milk faster. If milk builds up and appropriately or if there is cause for concern. out, the milk factory opens for business and isn’t removed often or for a while, they make milk more slowly. If your baby decides he wants © February 2010, La Leche League International This informational sheet may not be reproduced in any manner For more information No. 10245 without written permission from La Leche League International. llli.org 957 North Plum Grove Road • Schaumburg IL 60173 USA 847.519.7730 • fax 847.969.0460 • 800-LALECHE

Fixing a Problem it can occasionally cause loose stools and a maple syrup odor in urine and sweat. Mothers Understanding the cause of a who have diabetes or low blood sugar should be will help you figure out the most effective way especially cautious. There are a number of other to increase it. Any time a baby is nursing less good herbal galactogogues, as well. Check with than 8 times per day, offering the breast more someone with expertise in herbal preparations frequently sends the message that more milk for suggestions. Your LLL Leader or is needed. If a baby is not draining the breast consultant may be able to provide some more well because of a poor (as may be the information about specific herbs that you can case when nursing is painful), correcting the share with your health care provider to decide latch will help the baby do his job better and what is best for you. stimulate production in the process. If the problem is the baby’s suck, getting help and doing some extra pumping in the meantime • You may want to discuss prescription can help bring your milk supply back up to galactagogue options with your health where it is needed. Certain medications or care provider. The availability and legality hormonal birth control may also decrease milk of prescribing and purchasing prescription production. More rarely, there can be problems galactagogues varies from one country to with ’s breasts or hormones. If it seems another. like you and your baby have been doing everything right but milk supply still is low, seek • Acupuncture and chiropractic help are two help from your local La Leche League Leader or therapies that have helped some mothers a qualified lactation professional who can help • Get your rest. The milk-making hormone and babies. More information on these and you figure out where the problem lies. rises naturally when you sleep. Nursing other ideas can be found in The Breastfeeding while lying down may help you to get the rest Mother’s Guide to Making More Milk by Diana you need. West, IBCLC and Lisa Marasco, MA, IBCLC, Tips to Make More Milk available in the LLLI online store at store.llli.org. • Extra nursings, extra pumping sessions or • Eat lactogenic (milk supportive) foods and pumping after nursing to remove any leftover spices. Historically, most cultures have special • Knowing whether you are making as much milk is a great place to start. The more milk foods for nursing mothers. While there is milk as your baby needs requires a combination removed, the more milk your breasts will make. not a lot of scientific evidence yet, years of of knowing your baby, trusting your breasts experience suggest that certain foods like to do their job, and trusting your instincts. If barley and oatmeal, or cooking spices such as • Use the best pump that you can afford, something doesn’t seem right, contact your anise, dill, caraway, coriander and fennel, really preferably a high quality consumer or rental local LLL Leader. She can help you evaluate can help some mothers. For more food ideas, pump. There are many inexpensive pumps on whether there is a problem and help you work read Mother Food by Hilary Jacobson or visit the market that don’t remove milk very well or through it if there is. quickly. You want your time and effort to count! the MOBI Motherhood website: http://www. mobimotherhood.org/MM/default.aspx.

• Encourage your baby to get all of his suckling needs met at the breast. Avoid pacifiers and • Drink to thirst. More effective milk removal, unnecessary supplements. If the baby has not increased water consumed, stimulates milk While other lactation experts been getting more than two to three ounces production. As your breasts make more milk, and organizations suggest of formula daily, reduce the amount gradually however,you may find yourself becoming thirstier complementary and alternative while you build up your milk supply. and needing more liquids. treatments for a mother’s consideration, it always is best to • Compress your breast with one hand while • Is a medicinal herbal galactogogue right for check first with your health care nursing or pumping to get more milk out and you? There are some herbal preparations that provider. stimulate milk production. Rotate your hand and have helped many mothers build a milk supply, feel for any firm, undrained areas to compress. including fenugreek. It is important to consult with your doctor before trying any medicinal galactogue, as even an herb such as fenugreek • Hand-expression after pumping will often that is listed in North America as a Generally get milk out that the pump cannot, further Recognized As Safe (GRAS) can have serious stimulating milk production. side effects. Fenugreek is considered a GRAS spice herb, but when taken in larger quantities

© February 2010, La Leche League International This informational sheet may not be reproduced in any manner For more information No. 10245 without written permission from La Leche League International. llli.org