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The Science of Breast Milk Supply and How to Increase Your Supply

There are many misconceptions about milk supply.  Too much or too little milk can lead to feeding problems and conflicting information turns hard situations into nearly impossible. Added to this, many companies today prey on a mother’s insecurity regarding their breast milk supply. Companies might try to sell you a product that you don’t need.

 

Even the most confident of breastfeeders will have moments of doubt during their journey. Add in infant food allergies and changing your diet, and you’re even more concerned.  This article is meant to dissect some of the falsehoods around this topic as well as provide scientifically proven methods for increasing milk supply. 

Our #1 recommendation when you suspect supply issues is to contact a lactation consultant!  LCs can provide personalized support for exactly this and so much more.  Learn more about these amazing superheroes here!

Increasing Breast Milk Supply: The Facts

First, you must determine if you truly have a low milk supply. There are many reasons why mothers believe their supply to be low when it is not actually the case.  We highly recommend contacting an IBCLC for a personal consult to address possible latch or lactation issues which could be impacting your breastfeeding journey.  Check out this article by Breastfeeding USA for more details.

Breast Milk is Produced Based on Supply and Demand

Our bodies know how much milk to produce based on demand.  Removing more milk will inform our bodies that an increase in breast milk supply is needed.  There are a few methods that can help accomplish this:

  1. Nursing Vacation:  Spend a few days with your baby nursing as often as possible with a lot of skin-to-skin contact. [1] 

  2. Double pump: After the baby is done feeding, pump for 5-10 minutes.  This artificially increases the demand for milk which should enhance your supply.  You can do this after the same feed every day (the first-morning feed is best since supply is shown to be higher) or try after every feed.

  3. Power pump:  Spend an hour alternating between pumping and resting (pump 20 min, rest 10, pump 10, rest 10, pump 10).  Even if you don’t believe you are getting any additional milk during the last pumps, this mimics a growth spurt and will increase supply. 

 

The ways listed above are the best ways to increase your breast milk supply. Whether your baby has food allergies or not, your body still works based on supply and demand.

Avoid Supplementing With Formula and Using Pacifiers

This one is simple:  The more formula a baby gets, the less breast milk they will drink. [2] Likewise, if a baby’s suckling needs are being met with a pacifier, they may spend less time at the breast. Beginning supplementation with formula is a slippery slope that often ends breastfeeding altogether.  

 

One formula bottle a day quickly becomes two as breast milk demand dwindles down until you are no longer producing.  Some women are lucky enough to have this process extend out for a long period of time while others are not.  If you do decide to supplement, pump at the time of that feed to keep your supply up.

Rent a Hospital-Grade Pump for a Few Days to Increase Your Breastmilk Supply

These pumps are not as portable, but they’re more powerful.  They will allow you to remove milk more efficiently and therefore increase demand. These pumps are available for purchase, however, with an average $1000 price tag, most mothers prefer to rent. Use the pump in addition to your typical nursing schedule.

Medications Claiming to Increase Breast Milk Supply

 

Natural Galactagogues

Galactagogue is a broad term for substances that increase milk supply.  Commonly known herbal galactagogues include fenugreek, alfalfa, raspberry leaf, and stinging nettle. Some food substances which are promoted as galactagogues are oats, garlic, spinach, and apricots. Unfortunately, there is little scientific evidence to support any of these claims.  Companies that promote their supplements as the “magic bullet” for milk production are overstating claims with poorly designed or absolutely no research. 

 

Domperidone (Motilium)

Primary use: Increase stomach and bowel contractions

Domperidone is available in non-US markets as an over-the-counter drug that has been shown to increase milk supply. This medication is well-tolerated by breastfeeding mothers and is associated with an average daily increase of 75% when compared to a placebo. [3] 

 

The FDA pulled Domperidone in the US due to its link to cardiac disorders.  A recent study indicated that Domperidone increases the chance for cardiac death in patients over 60 but does not have that effect in patients younger than 60. [4] The fact that a clear majority of breastfeeding mothers are well under 60 explains why there are no reports of significant adverse effects to date.   

Metoclopramide (Reglan)

Primary use:  Heartburn, healing ulcers/sores in the esophagus, speed stomach emptying

Metoclopramide augments breast milk production by stimulating prolactin for women who have low volumes of lactation. [5] Unfortunately, this medication comes with a plethora of possible side effects including gastrointestinal distress, severe depression, seizures, and sedation.  This medication is also known to enter breast milk; however, the concentrations are low and the side effects are unknown. [6]

Sulpiride (Eglonyl, Sulpitil, Sulparex, Dolmatil, Equemote)

Primary use:  Schizophrenia

Sulpiride increases prolactin secretion through hypothalamus stimulation and has been shown to significantly enhance milk production. Similarly, this medication also enters milk in low doses which could impact central nervous system development.  Medical professionals have also recommended against this antipsychotic drug as a galactagogue due to its potentially harmful side effects.

Important Takeaways on Increasing Your Breast Milk Supply

Breast milk is all about supply and demand for a majority of the population.  To increase your supply, tell the body that there is a higher demand. While some women swear by natural remedies, there is little proof that any of these work beyond a placebo effect. 

 

Medication may be an option for the few women who have a medical condition that reduces their prolactin levels and you should speak to your primary physician or OB/GYN. 

 

Having a baby with food allergies and sensitivities gives you all the more reason to be concerned about your breast milk supply. When changing your diet, make sure to include nutrient-rich foods to give your body what it needs to keep producing breast milk. Read more on how to replace nutrient-rich foods when changing your diet for your baby with food allergies here.

 

Remember, you are not alone on this journey, and if you’re struggling we’re here to help you!

Sources:

 

  1. Aghdas, Karimi, Khadivzadeh Talat, and Bagheri Sepideh. "Effect of immediate and continuous mother–infant skin-to-skin contact on breastfeeding self-efficacy of primiparous women: A randomised control trial." Women and birth 27.1 (2014): 37-40.

  2. Kim, Eliane, et al. "Relationship between intention to supplement with infant formula and breastfeeding duration." Canadian Journal of Public Health 104.5 (2013): e388-e393.

  3. Osadchy, Alla, Myla E. Moretti, and Gideon Koren. "Effect of domperidone on insufficient lactation in puerperal women: a systematic review and meta-analysis of randomized controlled trials." Obstetrics and gynecology international 2012 (2012).

  4. Johannes, Catherine B., et al. "Risk of serious ventricular arrhythmia and sudden cardiac death in a cohort of users of domperidone: a nested case‐control study." Pharmacoepidemiology and drug safety 19.9 (2010): 881-888.

  5. Ehrenkranz, Richard A., and Barbara A. Ackerman. "Metoclopramide effect on faltering milk production by mothers of premature infants." Pediatrics 78.4 (1986): 614-620.

  6. Zuppa, Antonio Alberto, et al. "Safety and efficacy of galactogogues: substances that induce, maintain and increase breast milk production." Journal of Pharmacy & Pharmaceutical Sciences 13.2 (2010): 162-174.