Methods of Increasing Supply—Pros and Cons

From LLL in VA/WV References

There are many factors that can directly or indirectly affect your success in building and maintaining your milk supply. Some of the best ways to increase your milk supply are hard to recognize, while some that are often recommended don't work at all.

This article looks at methods that are often tried for increasing milk production, identifies the pros and cons of each one, and gives suggestions on how best to make it work for you.

Breastfeeding Management

Baby at the Breast

Pros:

Spending lots of time with your baby at the breast is usually the most effective way to establish, maintain, and increase milk supply.
Suckling at the breast has developmental health benefits for baby beyond food (oral, visual, coordination, social).
Enjoyable for most mothers and babies.
Oxytocin is released during letdown, which can help boost your mood along with your milk supply.

Cons:

Some breastfeeding challenges lead to pain for the mother, or inadequate growth for baby.
Not always possible if you need to be separated from your baby.

Tips:

Breastfeed early and often.
Aim for at least 8–12 nursing sessions per 24 hours—nursing even more often is fine!
How frequently you need to breastfeed in order to maintain a good milk supply depends on a number of factors that are specific to you and your baby—one mom might breastfeed 6 times a day and have a full milk supply while another mom needs to breastfeed 10 times a day to produce enough (the "Magic Number").
Seek support from LLL or a lactation consultant if breastfeeding is not going well.

See Also:

Breast Massage

Pros:

Breast massage increases milk yield during pumping and nursing.
It's especially useful when nursing or pumping for a preemie.
Breast massage can help relieve engorgement during the early days of breastfeeding, and can help treat plugged ducts or mastitis later on.
Massaging during nursing can increase babies' milk intake if they're having difficulty at the breast.
When used after pumping, breast massage may yield additional milk.

Cons:

Constantly having to do breast massage may be tiring for mother.
It's difficult to do in public.
If performed incorrectly, breast massage can injure the breast.

Tips:

Become familiar with your breasts before baby is born.
Learn hand expression and breast massage techniques.
If milk expression is needed shortly after baby is born, try hand expression rather than pumping.

See also:

Positioning and Latch

Pros:

Positioning and latch are the most important factors in comfortable nursing for mom and effective milk transfer for baby—they can be essential to good milk supply.

Cons:

Effective and comfortable positioning and latch can be challenging to learn at first.
You may hear conflicting advice about the "best" position or method.
Baby may have latching challenges (sleepy, tongue tie, etc) that require a special approach.

Tips:

Before baby arrives, attend a LLL meeting, participate in a breastfeeding class, or read breastfeeding materials.
Remember: There isn’t one right way! What matters is that you're comfortable and your baby is getting enough milk.

See also:

Pumping

Pros:

Regular milk removal is the only proven way to increase milk production.
If baby is not able to nurse at the breast, pumping may help establish, maintain, and increase milk supply.
Some women report it contributes to their freedom while still meeting breastmilk feeding goals.
It may be a necessary skill to have if you're returning to work.

Cons:

Babies are generally more effective than pumps at removing milk from the breast and increasing milk supply.
Not all women respond well to the pump.
Pumps can be expensive to purchase.
Injury to the breast can occur with poor technique or fit.
Pumping can be tiring and add to the work of mothering.
Bottlefeeding can lead to overfeeding and a perception that milk supply is low, leading to supplementation which can, in turn, impact supply.
Philosophical concerns: Does it diminish woman’s breastfeeding status? Does it create an alternative to breastfeeding which is generally less successful? Does it remove the focus from the mother-baby relationship? Does it switch the focus to numbers and treat the mother’s body as a separate machine?

Tips:

If possible, begin pumping several weeks after breastfeeding is well established.
The goal is to feed the baby, not the freezer!
Pump whenever a bottle is offered.
Avoid oversupply: don't pump excessively in addition to breastfeeding.
Power pumping is an option in increasing supply.

See also:

Timed Feedings

Pros:

In the early days, you may need to wake your baby every few hours to nurse, to encourage intake, maintain milk production, or decrease engorgement.
If you have to pump instead of nurse for some reason, you'll need to pump regularly to maintain supply—at least as often as baby would nurse.
There's no harm to you or your baby in nursing "too frequently".
Small, frequent feedings (every 2 hours or less) can help prevent or lessen engorgement, spitting up, sore nipples, and a variety of other problems.

Cons:

Scheduled feedings that are too far apart can contribute to lower milk supply and slow weight gain.

Tips:

Watch your baby for hunger cues.
In the early days, be prepared for only very short breaks between the end of one nursing session and the beginning of the next.
If your baby is very sleepy during the first few days or weeks after birth, wake him or her every 2–3 hours to nurse whether hunger cues are present or not.

See Also:

Physical and Emotional Connections

Skin-to-Skin Contact

Pros:

Skin-to-skin contact has the most benefit for premature babies.
It may contribute to successful breastfeeding, especially if done immediately after birth.
Allows baby to self-latch in many circumstances, awakens reflexes.
Other health benefits for both mother and baby (temperature maintenance, calming, colonization with good bacteria, social, bonding).
Other trusted loved ones can also do skin-to-skin with baby.

Cons:

It may be difficult to do after a complicated delivery.
Not all hospitals support skin-to-skin contact.

Tips:

If possible, hold your baby skin-to-skin for at least an hour following delivery.
If a cesarean section is planned, ask about skin-to-skin options.
Make sure you have a partner or nurse with you during skin-to-skin contact for the first few hours, especially if you're very tired or distracted.

Family Support

Pros:

A partner’s support makes a big difference in breastfeeding success.
Having other adults around can lift your mood.
Family members can assist with household tasks, cooking, baby care.
Time to focus on breastfeeding can help you build and maintain milk supply.

Cons:

Visitors can interfere with good breastfeeding management, especially if you're uncomfortable nursing around them.
Visitors may cause stress and extra work for you.
Visitors may be more interested in holding baby and giving advice than supporting you in breastfeeding.

Tips:

Identify your support network before baby arrives.
Attend LLL meetings!
Ask a person close to you to assist in managing visitors.
Have a “to-do” list written out ahead of time that visitors can refer to when offering to help.
Ask visitors to bring healthy meals and snacks.
Plan ahead how to respond to visitors with negative messages.

Herbs and Supplements

Because of the lack of safety data, the experts at InfantRisk generally recommend that breastfeeding mothers avoid taking dietary supplements and herbal medicines.

According to Dr. James Abbey of InfantRisk,

“...Herbal products are not regulated by the FDA and there can be significant variations in the potency and purity between different products or even between different lots of the same product. Herbs can also interact with each other and with prescription medications, so we tend to advise not taking them at all. As a general rule, breastfeeding is a time for simplicity. Focus on eating a balanced, nutritious diet and minimizing your use of extraneous stuff.”

Herbal and nutritional supplements can have a wide range of side effects and drug interactions. Be sure to tell your health care provider about any supplements you're taking.

Herbs

Pros:

There are many anecdotal reports from mothers who believe herbs increased milk supply.

Cons:

There are safety concerns for some herbs; they must be evaluated the same as medications for impact on both mother and nursling.
Relying on galactagogues can interfere with good breastfeeding management.
If taking an herb in a tea, it's difficult to know the dosage and you would probably need to consume a large amount in order to achieve an effect.
There is little scientific evidence to support the effectiveness of herbal galactagogues.
Many herbal galactagogues can have adverse drug interactions with common medications.
In the US, herbal medicines are considered dietary supplements and are not regulated for quality, effectiveness, or safety.
The ingredients in herbal products often do not match what's on the label.

See also:

Dietary Supplements

Pros:

There are anecdotal reports from mothers who felt dietary supplements boosted milk supply.

Cons:

Relying on galactagogues can interfere with good breastfeeding management.
No scientific evidence exists to show dietary supplements work to increase milk production.
Taking supplements might lead to exceeding recommended dietary intake of certain vitamins.
Dietary supplements are not regulated for safety or quality.

See also:

Essential Oils

Pros:

There are a few anecdotal reports from mothers who felt essential oils increased milk supply.

Cons:

Little or no quality research exists on the safety and efficacy of essential oils for health.
No research has been done on the safety of essential oils during breastfeeding.
Essentials oils should never be internally ingested and should never be applied to the nipples or breasts. We know that breastfeeding babies "eat with their hands" and if something is applied to the breast, there is a high probability that an infant will ingest it. It is difficult to wash off EOs because they are oily!
Essential oils should not be applied neat (that is, without being diluted in a carrier oil). EOs are very concentrated and this can cause skin sensitization and do additional harm.
There are very few essential oils that can safely be used with children under the age of 2 and some, such as peppermint, may pose a significant health risk.
Breastfeeding involves many senses and EOs—due to strong scents and flavors—might contribute to a breast aversion for the infant.

Placenta Consumption

Pros:

There are anecdotal reports from mothers who believe placenta capsules increased milk supply.
There are anecdotal reports that it helps with postpartum depression and anemia.

Cons:

There is no scientific evidence of any benefits from placenta consumption.
No tradition of placenta consumption exists in any human society.
Ingesting the placenta may have health risks due to the placenta's role as a filter to protect the fetus from environmental toxins and pollutants.
The placenta may also retain pathogens that can cause infections in mother and baby. [1]
Relying on galactagogues can interfere with good breastfeeding management.
There are anecdotal reports from mothers who believe placenta capsules decreased milk supply.
Can be costly and a hassle to prepare.
No oversight for preparation (risk of contamination).
Legal issues (who has access to the placenta varies from state to state).

See Also:

Food and Drink

LLL philosophy states, “Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible.”

Drinking Extra Water

Pros:

Hydration is important to your health.
There are anecdotal reports from mothers who felt drinking lots of water boosted milk supply.

Cons:

Scientific evidence suggests that over-hydration doesn't increase milk production, and can actually lead to lower milk supply.
Even drinking water can harm milk production if you rely on it instead of good breastfeeding management.
Individuals have different hydration needs.

Tips:

Drink to thirst.
Look to many types of fluids for hydration.
Breastmilk is made from the milk compartment; extra fluids (beyond hydration) do not impact this and are unlikely to impact milk production.

See also:

Lactation Cookies

Pros:

They're tasty!
There are anecdotal reports from mothers who felt lactation cookies boosted milk supply.
Eating a cookie is relaxing!

Cons:

Relying on galactagogues can interfere with good breastfeeding management.
No scientific evidence exists to show lactation cookies work to increase milk production.
Lactation cookies can be expensive to purchase, time-consuming to make at home.
Lactation cookies may be high in calories, low in nutritional value.

Oatmeal

Pros:

Tasty, nutritious, healthy, inexpensive.
There are anecdotal reports from mothers who felt oatmeal boosted milk supply.

Cons:

Relying on galactagogues can interfere with good breastfeeding management.
No scientific evidence exists to show oatmeal works to increase milk production.

Beer

Pros:

There are anecdotal reports from mothers who felt beer or brewer's yeast boosted milk supply.
Drinking a beer may be relaxing.
An occasional alcoholic beverage is thought to be compatible with breastfeeding, if the mother waits for the alcohol to clear from her milk before nursing (InfantRisk).

Cons:

Relying on galactagogues can interfere with good breastfeeding management.
Scientific evidence suggests alcohol does not increase milk production. In fact, babies nurse more frequently but take in less milk in the 3-4 hours after mom has had a drink, and one study showed a 23% decrease in milk volume with one drink (Mennella & Beauchamp 1991, 1993; Mennella 1998, 2001).
Two or more drinks might inhibit letdown (Coiro et al 1992).
One study showed changes in the infant’s sleep-wake patterning after short-term exposure to small amounts of alcohol in breastmilk — infants whose mothers were light drinkers slept less (Mennella & Gerrish 1998).
Daily consumption of alcohol has been shown in the research to increase the risk for slow weight gain in the infant.
Daily consumption of alcohol (1+ drinks daily) has been associated with a decrease in gross motor development (Little et al 1989).
Alcohol could interfere with mother’s ability to care for her child.

See Also:

Sports Drinks

Pros:

Hydration is important to your health.
There are anecdotal reports from mothers who felt sports drinks boosted milk supply.

Cons:

No scientific evidence exists to show sports drinks work to increase milk production, nor have any plausible scientific explanations been suggested.
Relying on galactagogues can interfere with good breastfeeding management.
Sports drinks contain extra sugar, chemicals, dyes.
Sports drinks can be expensive.
Scientific evidence suggests that over-hydration doesn't increase milk production, and can actually lead to lower milk supply.
Individuals have different hydration needs.

Tips:

Drink to thirst.
Consider healthier beverage options with less sugar.
You can also get fluids from foods like fresh fruits, vegetables, soups, yogurt, etc.

Sources