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Tips to Increase Milk Supply When Pumping – Children's Health

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Moms who pump – whether they are heading back to work, caring for a baby who cannot breastfeed or wanting to build a freezer stash – are quick to know when their milk supply drops. And when that decrease is consistent, they may begin to worry they aren't providing enough milk for their baby.

Dawn Schindler, RN, BSN, IBCLC, is a lactation consultant at the Level IV Neonatal Intensive Care Unit (NICU) at Children's Health℠ and regularly works with pumping moms who want to increase their breast milk supply. She shares how moms can boost supply and answers some of the most commonly asked questions about pumping.

Can pumping decrease milk supply?

Pumping itself does not decrease your breast milk supply. In fact, it can help boost it. But if you are having trouble with low milk supply, the first step is to check that you are using the right breast pump.

"When a mom comes to us with pumping or supply questions, often the first thing we check is the mother's pump," says Schindler. "It's important that the pump being used not only works properly but that the pump parts also fit correctly." A lactation consultant can help assess that a breast pump is working for the mother to increase and support milk supply.

How to choose the right breast pump

Moms who pump regularly or exclusively should use a quality electric breast pump. If possible, choose a hospital-grade double electric pump that can effectively pump both breasts at once.

"A hand-held pump may not express enough milk and it takes more time to pump one breast at a time," Schindler explains.

Pay attention to the breast pump flange size

Breast pumps aren't one size fits all. The flange, or breast shield, is the portion that fits over the nipple. The flange should fit comfortably, covering the nipple and part of the breast with no gaps around the cup.

Select appropriate suction settings

Most breast pumps have several suction levels. However, higher suction doesn't mean you will extract more milk. "Breast pumps set too high can cause damage to the nipple and ultimately affect milk supply levels," says Schindler. "Make sure you are using the setting that is right for you."

Tips to increase breast milk supply when pumping

Beyond choosing the right breast pump, there are other ways moms can improve a low milk supply while pumping such as increasing pumping frequency, hydrating and eating well, having skin-to-skin contact with baby and creating a comfortable pumping environment.

Increase pumping frequency

Generally, moms should be pumping every 3 hours. Pumping more often can help stimulate breasts to produce more milk. Moms can try pumping both breasts for 15 minutes every two hours for 48-72 hours. Then moms can return to their normal pumping routine. Pumping for longer than 30 minutes may not be beneficial. This may just lead to sore nipples.

If pumping that often isn't feasible, Schindler and her team also suggest power pumping.

Power pumping lets moms maintain their regular pumping schedule but incorporates one hour of power pumping. Moms pick one hour in the day – usually in the afternoon when supply isn't naturally high or low – and pump 10 minutes on, 10 minutes off, for one hour.

"You may not get any additional milk after the first 10-minute session, but it's important to continue throughout the hour," Schindler says. "After moms do this once a day for 4-5 days, they may notice a small increase in their overall milk supply."

Moms can receive extra stimulation from the breast pump by changing the speed of the pump from stimulation or "massage" to milk removal or "expression" every 5 minutes while pumping. This may stimulate more milk production.

Hydrate and choose the right foods to increase milk supply

Getting enough rest, drinking plenty of fluids and eating a healthy diet high in protein are the best ways to help improve and protect milk supply.

Certain foods, called galactogogues, may help to increase milk production. Common foods used as galactogogues include oatmeal, brewer's yeast, garlic, spinach, fennel and almonds. However, a well-balanced diet is the best approach to stay healthy while pumping.

Schindler often advises mothers to avoid pills and supplements marketed to improve supply. "There's no magic pills moms can take to boost their supply," Schindler cautions.

"Herbal supplements aren't always monitored by the FDA so we can't know exactly what's in them. It's best to talk with your pediatrician about what's safe for you and baby and stick with the basics."

Research has shown that several foods and substances can negatively impact milk supply. Schindler encourages moms to avoid:

  • Smoking
  • Caffeine (limit to 1-2 servings per day)
  • Cold and allergy medicines that contain Sudafed (Pseudoephedrine)
  • Certain prescription medicine

Your pediatrician and obstetrician can help you find medicine that is safe to take while pumping and that won't impact your supply.

Make time for skin-to-skin

Skin-to-skin contact, also called kangaroo care, is when a mother or father holds a baby on their bare chest. This simple act has several benefits, including:

  • Maintains the baby's body temperature
  • Slows baby's breathing and heart rate
  • Relaxes and comforts baby
  • Promotes bond between baby and parents

Another important benefit for moms is that skin-to-skin also helps improve milk supply. Spend time snuggling with your little one and soak up important benefits for you and baby.

Set up a comfortable pumping spot

Make pumping as comfortable as possible. "Find a quiet spot where you can lay out your pumping equipment," Schindler suggests. "Arrange supplies, including bottles and caps, so you're not reaching for anything. Have a snack and bottle of water ready and put out a picture of your baby. When you're comfortable, you will be able to relax, which ultimately helps your milk supply. "

It's important for moms to know that supply levels naturally go up and down throughout the day and over the course of time.

"Try not to get too discouraged if you notice a drop in milk supply," Schindler says. "A lactation consultation can help get to the bottom of your supply issues and offer more tips to increase supply."

Learn more

Through our highly trained lactation consultants and Pediatric Milk Lab, Children's Health is dedicated to supporting breastfeeding moms in caring for their children. See more tips for safely storing breast milk when pumping.

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How to Increase Milk Supply When Pumping: 10 Tips

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The dawn of the breast pump brought many new opportunities to nursing mothers. Moms now have the ability to be away from their baby for extended periods of time while maintaining breastfeeding.

Pumping isn’t always intuitive, and for some women, it can be difficult to maintain. If you need to pump so you can be away from your baby, you may want to find ways to increase your milk supply to ensure you have enough milk. Pumping may also be a way to increase milk supply when nursing.

Read on to learn some tips for things you can do to try to increase your milk supply while pumping.

The number one way to increase your milk supply when pumping is to increase how often you pump.

Cluster pumping is a technique of pumping every five minutes to give your breasts repeated stimulation. When your breasts are full, your body gets the signal to stop making milk. Empty breasts trigger milk production, so the more you empty your breasts, the more milk you’ll make.

Cluster pumping may not be practical for a work environment, but you can try cluster pumping in the evenings at home or over the weekend. Try a few sessions of cluster pumping until you see a noticeable increase in your supply. And remember to stay hydrated when you’re nursing or pumping.

Another way to pump more often is to add in an extra session during the day, especially if you’re at work. For example, if you were pumping twice a day, pump three times.

If you’d like to increase your supply but you’re usually with your baby all day, use the pump to add in a session in addition to the day’s usual nursing.

Milk supply is regulated by hormones and your circadian rhythm, so many women have the most volume of milk in the morning. You can pump in the morning before your baby wakes up, or pump shortly after nursing.

If mornings don’t work for you, you can also try pumping at night after baby’s bedtime.

Over time, your body will regulate to supply more milk during the extra pumping session. For the best results, take your additional pumping session at the same time each day.

Sometimes your breasts may still feel full after baby has stopped nursing. You can try pumping or hand expressing one or both breasts after each nursing section to ensure that your breasts are completely empty. That signals your body to begin producing more milk.

Over time, pumping after nursing can lead to an increase in the amount of milk you produce throughout the day.

To get the most milk when pumping, you can pump both breasts at once. To make double pumping easier, use a pumping bra. These bras are made specifically to hold breast shields in place so you can be hands-free.

You can combine double pumping with cluster pumping if you’re trying to increase your supply or build a stock of milk in the freezer to keep on hand.

To get the most out of pumping, it’s essential that your pump is in good condition and works right for you. Everything from the size of the breast shield to the speed of suction will affect how much milk you can get. Some tips:

  • Keep your machine clean.
  • Replace parts as needed.
  • Get familiar with your pump manual.
  • Check out the manufacturer’s website.
  • Call a lactation consultant if you need help.

If you really want to focus on increasing your supply, you can also rent a hospital-grade breast pump for a week or a month. These are the highest quality pumps available, and may help you to extract more milk when pumping.

Lactation cookie recipes sometimes credit oats or brewer’s yeast for increasing milk supply. You can also find herbal supplements such as fenugreek, milk thistle, and fennel advertised as galactagogues, or substances said to increase milk. However, experts say this may be due to a positive placebo effect.

A large meta-analysis of hundreds of studies found inconsistent data on whether or not supplements increase milk. Doctors and mothers can’t know for sure if or how herbs and supplements might help.

Talk to your doctor before trying any supplements while breastfeeding.

Remember to consume enough calories and to stay hydrated by drinking water and other clear liquids. Being properly nourished and hydrated can help you to maintain a healthy milk supply.

Breastfeeding women may need up to 13 cups or 104 ounces of water a day. Aim to drink at least one cup of water every time you pump or breastfeed, and then get your remaining cups throughout the day.

You should also plan to add about an extra 450 to 500 calories a day to your diet. That’s in addition to your recommended caloric intake. Just like when you were pregnant, the type of calories you add are important. Choose foods loaded with vitamins and other essential nutrients.

In breastfeeding, confidence is key. Don’t get down on yourself if your friends or co-workers seem to get a lot more milk out of pumping.

Two women can have the same size breasts but a different amount of milk storage cells. A woman with more storage cells will be able to express more milk faster because it’s readily available. A woman with fewer storage cells will be making milk on the spot. That means she’ll require more time to pump the same amount of milk.

The more you pump, the better you’ll know how much milk you can expect from yourself in a certain amount of time.

Also, a woman who regularly pumps and leaves bottles for her babies — during work, for example — will usually produce a lot more milk while pumping than a woman who nurses more often and only pumps occasionally, such as for a date night. This is because your body is very good at anticipating exactly how much milk your baby needs and your milk production syncs up to match your own child.

Once breastfeeding is well established, you won’t make much more milk than your baby needs. So, pumping in addition to a normal day of nursing won’t produce a lot of extra milk. It’s common for mothers who mostly nurse to require multiple pumping sessions to get enough milk for one feeding.

Try to relax while you pump. If you’re pumping at work, don’t respond to emails or take calls while pumping. Instead, use your pumping time to take a mental break. Try not to focus on how much milk you’re producing, which may cause extra stress.

One study found that mothers of preterm infants produced significantly more — and fattier — milk when they listened to a sound recording while pumping. This was a small study and we don’t know exactly what kind of music they heard. But it’s still worth a try to listen to something soothing while pumping, or to find other ways to relax.

Your body becomes very in tune with your usual breastfeeding environment and stimulus. For many women, milk comes in easy when at home, holding your own baby, and responding to hunger cues. It’s harder to inspire this milk production if you’re away from home and your child.

If you’re away, bring photos of your baby or watch videos of them while you pump. Anything that reminds you of your baby can trigger your hormones, which may help your milk production.

Never hesitate to call your child’s pediatrician or a board-certified lactation consultant if you want help increasing your milk supply. It’s important to have a supportive community when breastfeeding.

A doctor and lactation consultant can tell you if your baby is thriving and if you can do anything to improve your supply. They can also check your pump to make sure you’re using it correctly and that the fit is right.

There are three main considerations for increasing your supply while pumping:

  • Know how milk is made. Breast tissue takes nutrients from your blood to make breast milk. Empty breasts trigger milk production, so it’s important to empty your breasts as efficiently and as thoroughly as possible. The more often your breasts are emptied, the more cues you send to your body to make milk.
  • Know your goal. You can use a pump to maintain your supply while you’re away from your baby, or to increase your overall supply by pumping in addition to nursing every day. In both cases, you want to empty your breasts as thoroughly as possible each time you pump. If you want to increase your supply, you’ll also want to increase how often you pump.
  • Practice. It takes time to know your body and to get comfortable using a pump. The more you practice, the more you can get out of each pumping session.

Are you already producing enough milk?

Initially, your baby will take increasing amounts of milk each day as their stomach grows. But after a few weeks, breastfeeding babies level off at around 25 ounces per day.

Over time, breast milk changes in composition and calories, so the same volume of milk is sufficient for a baby as they continue to grow. This is different than formula, which doesn’t change in composition. So, babies require more and more of it if they only take formula.

You’ll know you’re pumping enough milk if you divide 25 ounces by how many feedings your baby usually has. For example, if your baby feeds five times a day, that’s 5 ounces per feeding. If you’re going to miss all of those feedings, then you need to pump 25 ounces. However, if you’re only going to miss two feedings, you only need to pump a total of 10 ounces.

It’s common for women who regularly nurse at home to get the same amount of milk from a pump when they’re away. Doing the math can give you a helpful idea of how much you actually need to pump while you’re gone.

Talk with your pediatrician before supplementing with formula. While it’s common to be concerned about milk volume, most women produce enough milk to feed their baby.

However, you can give your baby the benefits of breast milk while supplementing with formula if you need a few extra ounces. Ultimately, a fed baby is best.

When it comes to pumping and increasing your supply, frequency is key. A few changes to your routine and equipment can make your pumping more comfortable and potentially more productive.

The most important thing for a healthy milk supply is taking care of yourself, pumping often, and emptying your breasts frequently in order to trigger increased milk production. And if you’re concerned about your milk supply, talk to your doctor or healthcare provider.

Expression of breast milk | Medela

Eglash, A. ABM clinical protocol #8: Human milk storage information for home use for full-term infants (original protocol March 2004; revision #1 March 2010). Breastfeed Med 5, 127–130 (2010). - Eglash A., Simon L., "AVM Clinical Protocol #8: Home Storage of Milk for Term Infants" (original protocol March 2004, first revised March 2010) Brestfeed Med ( breastfeeding medicine) 5 , 127-130 (2010)

Eteng, M. U., Ebong, P.E., Eyong, E.U. et al. Storage beyond three hours at ambient temperature alters the biochemical and nutritional qualities of breastmilk. Afr J Reprod Health 2001;5:130–134. - Eteng M.W., Ebong P.I., Eyong I.W. et al., "Storage at room temperature for more than three hours affects the biochemical and nutritional properties of breast milk." nine0004 Afr J Reprod Health 2001;5:130–134.

Hill, P.D., Aldag, J.C., Chatterton, R.T. Initiation and frequency of pumping and milk production in mothers of non-nursing preterm infants. J Hum Lact . 2001;17(1):9–13 - Hill P.D., Aldag J.S. and Chatterton, R.T., "Onset and frequency of expression and milk production in mothers who have given birth to premature babies and have not breastfed them." J Hum Lakt (Journal of the International Association of Lactation Consultants) 2001;17(1):9-13.

Hill, P.D., Aldag, J.C., Chatterton, R.T., Zinaman, M. Comparison of Milk Output Between Mothers of Preterm and Term Infants: The First 6 Weeks After Birth. J Hum Lact . 2005 February 1, 2005; 21(1):22–30. - Hill P.D., Aldag J.S., Chatterton R.T., Zinaman M., "Comparison of the amount of milk in mothers of full-term and premature babies in the first 6 weeks after birth." J Hum Lakt (Journal of the International Lactation Consultants Association) February 1, 2005, 21(1): 22-30. nine0004

Human Milk Banking Association of North America 2011 Best practice for expressing , storing and handling human milk in hospitals , homes , and child care settings ( HMBANA , Fort Worth , (2011). - North American Association of Breast Milk Banks. nine0004 Fort Worth: SGBM; 2011.)

Kent, J.C. et al. Importance of vacuum for breastmilk expression. Breastfeed Med 3, 11-19 (2008). - Kent J.S. et al., "The Importance of Vacuum in Expression of Breast Milk". Brestfeed Med 3 (Breastfeeding Medicine). 3.11-19 (2008).

Meier, P.P., Engstrom, J.L., Janes, J.E., Jegier, B.J. & Loera, F. Breast pump suction patterns that mimic the human infant during breastfeeding: Greater milk output in less time spent pumping for breast pump-dependent mothers with premature infants. J Perinatol 32, 103-110 (2012). - Meyer P.P., Engstrom J.L., Jaynes J.I., Jaegier B.J., Loera F. "Pumping patterns that mimic the behavior of a breastfeeding baby: more milk and less time for constant pumping mothers of premature babies". Zh Perinatol (Journal of Perinatology) 32, 103-110 (2012).

Morton, J., Hall, J.Y., Wong, R.J., Benitz, W.E. & Rhine, W.D. Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. J Perinatol 29, 757–764 (2009). — Morton J., Hall J.I., Wong R.J., Benitz W.I. and Rhine, W.D., "Manual pumping combined with an electric breast pump increases breast milk production in mothers of preterm infants." J Perinatol (Journal of Perinatology) 29, 757-764 (2009)

Parker, L.A., Sullivan, S., Krueger, C. & Mueller, M. Association of timing of initiation of breastmilk expression on milk volume and timing of lactogenesis stage II among mothers of very low-birth-weight infants. Breastfeed Med (2015). - Parker L.A., Sullivan S., Kruger S., Kelechi T. and Muller M., "Association of the time of initiation of expression with the amount of milk and the timing of the second stage of lactogenesis in mothers of children who had extremely low birth weight" . Brestfeed Med (Breastfeeding Medicine) (2015)

Prime, D.K., Garbin, C.P., Hartmann, P.E. & Kent, J.C. Simultaneous breast expressionn breastfeeding women is more efficacious than sequential breast expression. Breastfeed Med 7, 442-447 (2012). - Prime D.K., Garbin S.P., Hartmann P.I. and Kent, J.S., "During the breastfeeding period, pumping both breasts at the same time is more productive than sequential pumping." Brest Med (Breastfeeding Medicine) 7, 442-447 (2012).

Torowicz, D.L., Seelhorst, A., Froh, E.B., Spatz, D.L. Human milk and breastfeeding outcomes in infants with congenital heart disease. Breastfeed Med 10, 31–37(2015). - Torovich D.L., Silhorst A., Froh I.B., Spaz D.L., "Breast milk and breastfeeding outcomes in children with congenital heart disease." Brestfeed Med (Breastfeeding Medicine) 10, 31-37 (2015).

Solving five breastfeeding problems after the first month

Expert advice on solving the top five breastfeeding problems that may arise after the first month.

Share this information nine0015

Cathy Garbin, child health nurse, midwife and lactation consultant:
Cathy Garbin, mother of two, was a seven-year research fellow at the renowned Human Lactation Research Institute, founded by Peter Hartmann, providing support to breastfeeding mothers in clinics and at home. Today, she still works as a family counselor, and also conducts seminars for attending physicians and speaks at international conferences.

You and your baby are now well into the process of breastfeeding and know what to do and how to do it. It seems that all difficulties are left behind. However, some more surprises await you. The following are suggestions for dealing with breastfeeding problems that may arise later. nine0015

Issue #1. I need to be away from my baby

Whether it's social events, travel or medical treatment, at some point you may need to be away from your baby for a while.

Solutions

  • Express milk so that someone else can feed the baby. Now that breastfeeding is established, you can express and store your breast milk in the refrigerator or freezer. Try different options to find the most convenient time for pumping in your daily routine. Some mothers manage to pump more breast milk in the morning when the baby wakes up after a long night's sleep. For others, it's best to express 60 minutes after feeding. Remember that everyone is different. Don't be discouraged if you don't get enough milk the first time: it's possible that you'll be able to express enough for one feeding in just two or three pumpings. As with feeding, it may take time for your body to adjust to pumping. nine0277
  • Take your pump with you, , if you plan to skip a feed. Even if you leave your baby with expressed milk, but will be absent for more than two hours, you will need to empty your breast. Pump at the same frequency as you would breastfeed your baby. This will support milk production and prevent discomfort. Express milk regularly throughout the day without waiting for your breasts to overflow. 1 Most electronic breast pumps are battery operated, so you don't have to find a power outlet nearby. nine0277

Problem #2. How to continue breastfeeding after returning to work?

You will likely have to leave your baby more often and for longer when you go to work, so it's especially important to find ways to continue breastfeeding and pumping that work for both of you. As mentioned above, you can build up a supply of breastmilk before you go to work and then pump regularly to support milk production, prevent discomfort, and make sure your baby has enough pumped milk the next day. Many companies now provide dedicated pumping rooms, and modern breast pumps work efficiently and reliably. If you have a regular work schedule or work part-time, you can still breastfeed your baby before and after work and at night. nine0015

Solutions

  • Express as often as you would feed your baby. This will help maintain milk production and prevent discomfort, as well as reduce the risk of clogged milk ducts, mastitis and breast swelling. 1
  • Try double pumping. Double pumping not only takes half the time, but you get an average of 18% more milk than pumping from each breast in sequence. Milk is more nutritious and has a higher fat content. nine0281 2
  • Assemble and bring to work the set, which includes a breast pump, milk storage bags and, if desired, a bustier top for hands-free pumping. You will also need a cooler bag to carry your expressed milk.
  • Know your rights. In many countries, the law allows women to express and safely store breast milk at work. Discuss these options with your employer before returning to work. This will get you both ready. nine0277

Problem #3. It seems to me that the baby suckles only for pleasure

Sometimes it may seem to you that the baby takes your breast in order to calm down, and not to eat. However, do not forget that breastfeeding is not only nutrition, it is also comfort for your baby. "Soothing suckling" (when the baby suckles but does not eat milk) helps the baby to calm down and relax. Remember that a sudden increase in the frequency or duration of feedings may indicate insufficient milk production. However, if the baby continues to gain weight and you use enough diapers a day, this is unlikely. nine0015

Solution

  • Be patient. The baby needs your care - listen to his needs and support him. Usually, the period of soothing suckling does not last too long, but it allows the child to feel your love and protection - and this is the best thing you can give him.

Problem #4. I want to switch from mixed to exclusive breastfeeding

Breastfeeding is so good for you and your baby that it's worth trying to fight for it. However, if you have rarely fed lately, your milk production may have been reduced. If your baby has only been mixed-fed for a couple of weeks, you will most likely be able to restore enough milk. Contact a lactation consultant or medical specialist who will help you and give you the necessary advice. This is a very individual process that depends on many factors. In any case, do not despair, because every drop of your milk is important for the child. nine0015

Solutions 1.3

  • Increase milk production. Try to put the baby to the breast more often, because the more milk the baby consumes, the more milk is produced. You can also express milk additionally. As mentioned earlier, double pumping in particular helps increase milk production.
  • Be in physical contact with your baby as much as possible. As in the first days after childbirth, close physical contact with the baby promotes the production of the hormone oxytocin, which in turn triggers milk production. It will also make both of you feel more calm and relaxed. nine0277
  • Reduce the number of formula feedings gradually. Resist the urge to stop supplementing with formula right away. If you gave your baby formula after each breastfeed, start giving it every other time until milk production rises. Keep a close eye on the number of soiled diapers and weight gain during this transition period. It is likely that at first the child will ask for the breast more often, and this is absolutely normal.
  • Speak with a lactation consultant or healthcare professional. nine0260 He will be able to help you and strengthen your confidence that your baby gets everything he needs.

Problem #5. My child has lost interest in the breast

If your child, who always ate with appetite, suddenly began to refuse the breast for no apparent reason - this is a false refusal, the so-called "strike". You may assume that he is ready to switch to solid foods, or that he does not like your milk anymore, but this is most likely not the case. It's just that the child develops vision, and now he is more distracted by the world around him. Or maybe something frightened the child during feeding, or he reacts to a violation of the regimen, perhaps he has a stuffy nose or teething. What you take for lack of interest may actually mean that your baby has simply learned to breastfeed more effectively and therefore takes less time to suckle. nine0015

Solutions

  • Be patient. False rejection is usually a temporary phenomenon that resolves after a few days. To provide the baby with the necessary nutrition during this period, give him expressed milk.
  • Find a quieter feeding area with as few distractions as possible. Baby is more likely to eat better if he can relax and focus on his chest.
  • Check in which position you feed. nine0260 The baby may refuse to breastfeed if he is uncomfortable or unable to move his head to breathe during feeding.
  • Express milk to keep it flowing . You can try feeding your baby with expressed breast milk using the Medela Calma smart pacifier.
  • Do not start formula or solid foods. Supplementing with formula can lead to reduced milk production and will only make matters worse. If your baby is regularly fed with expressed milk and is growing well, and the number of soiled diapers is normal, try not to worry. If the baby is less than six months old, you should not give him solid food: his digestive system is not yet strong and may not be ready for such a load. nine0277
  • Do not force-feed. Try to relax and be in skin-to-skin contact with your baby as much as possible, hug him and often offer the breast so that he can take it on his own. The release of oxytocin that body contact triggers will also help you pump. 4

Related content: Breastfeeding: what to expect after the first month

Literature

1 Kent JC et al. Principles for maintaining or increasing breast milk production. J Obstet , Gynecol , & Neonatal Nurs . 2012;41(1):114-121. - Kent J.S. et al., "Principles for Maintaining and Increasing Breast Milk Production".

Learn more