Feeding your baby can look a lot of different ways. Many mothers today return to work and are able to continue their breastfeeding relationship by pumping at work. This provides milk to leave with the baby when separated but to nurse when they are together. Other breastfeeding parents choose to exclusively pump. There is no one right way to feed your baby. It all comes down to what works for you and your family.
Establishing your milk supply is driven by hormones during the early weeks after birth. Regular and frequent milk removal sends the signal to keep making more milk. The feedback you give to your body during this time helps establish your milk supply and after the first few weeks your supply becomes regulated and will be mostly driven by demand.
Prolactin is the hormone responsible for making milk. In addition to being released when milk is removed, it has its own circadian rhythm and is highest during the middle of the night and early morning hours. So, removing milk during that time has a big impact on overall milk supply. The more times milk is removed when prolactin levels are high, the more milk that is made.
What’s normal?
Babies breastfeed an average of 8 - 14 times a day (or more). In the beginning, your baby will want to nurse every 1.5 - 3 hours. As they grow and become efficient feeders, it may be closer to every 2-3 hours and up to 4 hours overnight. When you follow your baby’s cues for nursing, you will discover there is no exact or set schedule. They may nurse several times getting a “full” meal while other times they are just up for a snack. Offering to nurse is always ok and it is great to offer before your baby is very hungry. Think about when you wait a little too long to eat, you can be a little more irritable and have a hard time thinking clearly, grabbing cookies instead of nutritious whole foods. If your baby is hungry, they will nurse, if they aren’t, they won’t.
Whether you are pumping to replace one feeding for your baby or you are exclusively pumping, you want to send the message loud and clear to make a full milk supply to support your baby's needs. Pumping to remove milk every 2-3 hours around the clock with a 4 hours stretch at night seems to hit the mark for most parents. Each of us is different and once your milk supply is established, you can play around with the times a little more to see what works best for you. Some people have a larger storage capacity for milk and can go a little longer between pump sessions without it decreasing their supply, while other folks can’t wait so long and need to stick closer to every 3 hours. Remember, each breast may produce different amounts of milk. This is totally fine as long as the total combined from both sides is enough to feed your baby,
How to increase supply
- Middle of the night pumping is still a must. If you have eliminated your middle of the night pump time or stretched the time between sessions in the middle of the night, you may need to add them back in.
- Stress is a big supply buster. When you are stressed, it raises cortisol which is the hormone responsible for telling us it is time to run for the hills and not time to feed the baby. When we are relaxed, oxytocin, the love hormone, is released. Oxytocin tells the milk to flow. Oxytocin is responsible for the let-down reflex. It may be helpful to listen to soothing music or a meditation while you pump, gaze at photos of your cute little one, put on a comedy or anything else that helps you de-stress and relax.
- Apply heat to your breasts before you pump. Heat helps get milk flowing more easily. In one study, 39 mothers used a compress to heat one breast only and then pumped milk from both breasts. The side that had heat applied had significantly more milk output than the breast that didn’t have heat applied.(1)
- Hands-on pumping is a method of gentle massage that can help kick start milk flow and remember, the more milk we remove, the more room there is for milk to refill. After you finish pumping, you can hand express to get more milk out. This can help fattier milk down your milk ducts. The fat molecules are stickier and larger and move slower than the water molecules.
- Power pumping or cycle pumping involves pumping for a short time, taking a break and then repeating. It can be divided into amounts of time that make the most sense for you. The break is important, so once you begin pumping again you trigger another let-down. Try pumping 10 minutes and taking a break for 10 minutes and repeat that cycle. Some people pump for 10 minutes, break for 5, pump for 5, break for 5 and pump once more for 5 minutes. You can experiment to see what works best for you.
- Replace pump parts to ensure they are working their best. Duckbill valves which many parents find removes more milk during pumping than traditional valves, need to be replaced monthly. Backflow protectors should be replaced every 3 months. Connecters and tubing may need to be replaced every 6 months or so if buildup is reducing the effectiveness of your pump.
- Flanges or breast shields that are too big or too small can cause nipple damage and reduce the amount of milk you are able to pump. Your flange size may change during your pumping journey or for your next baby. It is a good idea to check your flange size every so often to ensure the best fit possible.
- Make dietary changes and drink plenty of water. Our gut health plays a key role in milk production. Many of our hormones are affected by our diet which has an influence on our supply. Choose as many whole foods as possible and limit processed and sugary foods.
So many factors influence our milk production and the amount of milk we pump. Keeping the above basics of milk production in mind and trying some of the tips and tricks for increasing supply is a good start. If you find you still need to increase your milk supply, get in touch with your local IBCLC to dig deeper and co-create a care plan to meet your pumping goals.
Footnotes:
Resources:
https://pubmed.ncbi.nlm.nih.gov/16510619/
https://exclusivepumping.com/how-much-milk-do-breastfed-babies-eat/
https://kellymom.com/mother2mother/exclusive-pumping/
https://livingwithlowmilksupply.com/how-to-stimulate-let-down-reflex
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