Whether you’re currently working to reduce or eliminate formula supplements, or you stopped breastfeeding some time ago and wonder whether you could re-start, you’ll probably need some practical tips for increasing your milk supply. Sometimes people refer to this as re-lactation, if there has been a gap where you haven’t breastfed for some time. Whatever you call it, read on to find tips and resources to support your journey.
Firstly, I want to say that this is a non-judgmental, practical, and supportive article. People have many different journeys with breastfeeding. Yours is intensely personal and I respect you deeply for considering trying again. Please make sure that you have the support crew you need around you, including skilled lactation support.
You can find the video which is a summary of this blog here.
Why you might want to increase your milk supply?
There may be many reasons you’re reading this post. Perhaps you got off to a difficult start with breastfeeding, and you’re on an ongoing journey to build your milk supply back up and reduce formula. Maybe you stopped before you felt ready and want to give it another go. Sometimes there is huge peace in knowing you tried everything before calling it a day. Or maybe your baby is only having a minimal amount of formula and current supplies are low, or finances are stretched and you wonder whether you might be able to just eliminate that small amount of formula. Whatever the reason, I hope you find some practical tips and resources here.
Your milk supply potential depends on…
There are many things you’ll need to bear in mind:
- How old your baby is. Younger babies are often more willing to try breastfeeding again. Also, if you’re still in the early days, you have a good chance of being able to get those milk-making cells working again.
- How much milk you were making before. If your supply was full, or nearly full, there’s a good chance you can get back what you had before, with some time and patience. If your milk supply was fairly low, then you may still be able to increase it, but it may take a bit longer, or you may need to try some different strategies.
- Whether you had an underlying medical issue that made your milk supply low. While this is more unusual (see my earlier blog here) if you had a specific hormonal, health or physical problem that made milk making more challenging, then these issues may need to be managed first.
- How long you have not been breastfeeding. Milk making cells involute (stop working) after you stop breastfeeding, so this can affect how easy it is to bring back your milk supply.
In the majority of families I’ve worked with over the last 10+ years, the main reason for a low milk supply and a desire to build it back up again, was that breastfeeding did not get off to a good start. Often, people end up triple feeding (breastfeeding, expressing and topping up with formula). See my blog on triple feeding here for more tips on this particular scenario…
Realistic expectations of increasing milk supply
Dear reader, please be kind to yourself if you’re trying to increase milk supply. It is almost certainly do-able, to a greater or lesser extent, but you will need to set realistic goals, have lots of support and encouragement, probably some individualised support, as well as patience and commitment. Be kind to your body, your baby, and your mind. Plan lots of nice treats for yourself, and prepare for this to take some time. Your baby also needs time, calmness and gentleness to get back to the breast – remember that breastfeeding is a relationship between 2 people, and both of you are going to need to do something new and different.
Bear in mind that a full, established milk supply for a full term baby of 1-6 months is about 750ml per 24 hours (about 25oz). Breastfed babies drink about the same amount of milk (lower than formula fed babies) between 1-6 months, so depending on how much milk you’re currently making, this may be an amount that feels a long way off, or you may be nearly there. Either way, having realistic expectations of how much milk you’re aiming for will help you to set achievable goals, in a realistic timeframe. Your body definitely can’t ramp up milk production overnight – you’ll have to work at it.
How to increase your supply…
Ok, here comes the practical help! I’ll start with the easiest and most achievable strategies, and work down. You might decide you’re going to try everything, or you might try ramping things up slowly. It’s entirely up to you. Here we go…
- Try lots of skin to skin time, cuddles, massage and co-bathing. Simple, risk-free, and lovely. This is a no-brainer! There is literally nothing that could go wrong with this. I would recommend this for anyone, even if they did not necessarily want to make more milk. Having said that, if your milk production is very low, then this alone will almost certainly not be enough.
- If your baby will breastfeed, then go ahead! Nothing makes milk like a baby. This may work particularly well if you are already mostly breastfeeding, and your baby is willing to feed frequently. Just watch nappy output and check their weight gain. This is a good example of what effective feeding looks like.
- You may also want to try breast massage. Remember that this is not to be thought of necessarily as something that is relaxing (like a back or foot rub!). It is mostly to give your body the messages that it needs to make more milk. Your milk-making hormone, prolactin, is stimulated by touch. Here is a fantastic video by IBCLC Maya Bolman.
- You’ll also want to start with hand expressing. This is far more effective at low milk volumes, and research by Dr Jane Morton IBCLC has shown that hand expressing, especially in combination with pumping, yields the highest milk volumes. Here is a good video from Global Health Media demonstrating how to hand express.
- Pump frequently, with a good quality breast pump (double electric ones are ideal) and use a technique called ‘hands on pumping’, as demonstrated in this video. Make sure you pump about as often as your baby would feed – ideally 8-12 times in 24 hours, including at least once at night.
- Once you’re making more milk, you can start to very slowly and safely reduce the formula. I normally suggest doing this very carefully – just by 30ml or 1oz in 24 hours. This will challenge your body to make more milk, without putting your baby at risk. Keep an eye on nappies, and remember, your little one will want to feed more frequently. Go with it! It will get better in 2-3 days. Then reduce again. Slowly and steadily, you’ll get there. Just be sure to keep track of how much formula you’re reducing so you keep going in the same direction, and also so that you don’t reduce it too quickly. Don’t be afraid to press pause if you need to stop at any point. That’s ok too.
- People are also often interested to know if there’s anything they could be eating to increase their milk supply. In general, eating and drinking normally, and certainly not drinking more than you feel you need to, is all you need to do. There may be a few foods that might help, including oats, fennel, flaxseed, and red raspberry leaf tea. You could also try some moringa – it’s a super food that has been shown to increase milk supply. If you want more specific recommendations I strongly recommend you work with an IBCLC who can take a full personal history and make a bespoke plan.
It’s not just about the milk, it’s also the baby…
So, while it’s usually easier to get a baby back to breastfeeding if there is a milk supply there waiting for them, at some point you’re going to need to get your baby back to the breast. Sometimes if your baby is already breastfeeding at least a little bit, then this is relatively easy. Other times, if your baby has become very used to have a bottle, then they can find this harder. It’s not just the feel of the bottle, it’s also the flow rate, and what they’ve got used to, in terms of assocaiting the feeling of fullness and contentment with the bottle, not the breast. Some tips to help:
- Make bottle feeding more like breastfeeding – practice paced bottle feeding (more help here)
- Bottle feed skin to skin, bottle near breast
- Finish at the breast – start on the bottle and finish with breastfeeding
- You could try making your breast feel firmer by compressing the tissue either side of your nipple, to make a ‘breast sandwich’. If you do this, make sure the sandwich fits your baby’s mouth – align your thumb nearest your baby’s nose, and your fingers near their chin.
- You may want to consider using a thin silicone nipple shield which may persuade your baby to go back to the breast
- Try a supplemental nursing system – this is a a system where milk can be given to your baby simultaneously alongside breastfeeding via a tiny tube taped near your nipple. This keeps all their feeds at the breast, so they learn to get better at breastfeeding by breastfeeding.
Finally, you’ll want to set yourself a target time to re-evaluate and reassess where you are. You may get to the end of the week and decide that you’ve made a little progress, and want to persevere. After a certain point you may decide you’re no longer seeing an increase, or you’ve got a compromise point that you’re happy with. Perhaps that will be one bottle feed per day. Or perhaps you’ll be happy to just get one breastfeed per day. Or one small 30ml bottle of liquid gold pumped breastmilk per week. Your success is your own, and every drop of breastmilk is worth celebrating.
You may want a little more help, in which case the following resources may be useful:
Making More Milk, by Diana West and Lisa Marasco
Why Breastfeeding Grief and Trauma Matters, by Prof Amy Brown
International Lactation Consultant Association information
Baby Friendly infographic on relactation
Lyndsey Hookway is a paediatric nurse, health visitor, IBCLC, birth trauma recovery practitioner and holistic sleep and behaviour coach, and is also a respected International speaker and the Co-founder and Clinical Director of the Holistic Sleep Coaching Program. You can purchase Lyndsey’s books or downloadable guides & classes here on her website. If you would like to join Lyndsey’s mailing list you can do so here.