Ask Judy: How Can I Even Out My Milk Production?

Dear Judy, I’m feeling a little bit lop-sided lately and I was wondering if there was a good way to “even everything out?” My son typically only nurses from one side at a time.

It is not uncommong for babies to prefer one breast over the other. Most lactation consultants will tell you to start nursing your baby one the opposite breast each time that you nurse. This is because a baby sucks “harder” when they first latch on and will feed more vigorously on the side that they start on. Then if you switch sides, the 2nd side won’t get as much stimulation as the first. If you switch sides each time, then your breasts will get equal stimulation to produce milk and should have similar production and “fullness.”

Since your son only nurses from one side at a time, you should always switch sides with each feeding. If you are doing this and you are still feeling un-even, then try feeding from your “less full” or “smaller” side for 2-3 consecutive nursing sessions. After this, switch to the other side for one feed and then nurse from the smaller side for 2-3 consecutive sessions again. During this time, your “larger” or “fuller” side may get engorged. You can pump or hand-express this side to relieve the pressure, but do not completely empty the breast as this will send your body the signal to make more. After a day or two of “favoring” the smaller breast, you should notice a difference in your production on that side and you should be able to return to your normal routine of switching sides after each nursing session.

Did you ever have uneven milk production? What did you do to “even it out?” Please leave a comment on this post to share your experiences and give advice to this mom!

Ask Judy: How Do I Relactate?

Dear Judy: I want to start breastfeeding again, well pumping my breast milk for my 2 kids Jacob 3 years old, Danielle 2 years old. Do you think this is a crazy idea? My doctor is not supporting me, she says that I was done a year ago, and I should leave it that way… I just want the best for my kids, they are very picky eaters and I think going back to feed them with breast milk will really help them. Do you have any suggestions? Lucy A.

Hi Lucy,

I’m sorry to hear that your doctor is not supporting you. I think that you are the mother and you know what is best for your kids – so if you think that pumping your breastmilk will be what is best for them right now, then that is what you should do. The good news is, re-lactating is much easier after you have already breastfed, so while it will be difficult to get your milk supply back, it will be easier than if you hadn’t already breastfed a baby.

The first thing you will want to do is to start pumping. You should pump every 2-3 hours around the clock for the next month or so. You’ll also want to change your diet so that you can incorporate foods that lead to good milk production. Here are some suggestions for you.

1) Drink Mother’s Milk Tea: This will help to increase your milk supply.
2) Eat Oatmeal: Not the instant kind, the kind you have to cook – it is called “Steel Cut Oats” and it is great at increasing milk supply.
3) Take Fenugreek: read more here to find out how much to take.
4) Read this article for great pumping tips.
5) Drink 1/2 beer per day – the hops in the beer actually serves to increase milk supply – so you don’t need a lot – but a little will go a long way.
6) There is a drug that is fantastic at increasing milk supply and most moms who relactate use it. It is called Domperidone. It is not FDA approved and can not be purchased in US, but if you are in Canada you are in luck. There are potential side effects so you should read up on them. Here is an article to point you in the right direction. You do need a prescription to take it. You can get one from your own OB/GYN or you can email Dr. Jack Newman, he will write you a prescription which you can use.

Have you re-lactated? What tips worked best for you? Please share your tips and tricks by leaving a comment on this post!

Ask Judy: Does My Son Have Nipple Confusion?

My son has been supplemented with the bottle pretty much since birth. I let his dad help me with feedings. We have used the same slow flow nipples this whole time. He hates any other nipples. I had been pumping and he did pretty well latching on as well. At our night feedings and the first one in the morning while lying in bed he does great still, but any other feedings he gets so angry. He wont even try to latch on for more than a second. Sometimes I hand express to get it flowing, but even after it is flowing he is so angry he just wont take it.

I am working now, and pumping but I don’t make enough milk anymore to satisfy him completely so he is being supplemented with formula now. I am only able to get about 4 ounces pumped on a typical work day. He is probably about half and half on breast milk and formula right now.

Its just slowly but surely we add one more formula bottle and one less breast feeding about every week or so.

He gets so angry when I try to feed him that it stresses me out so much. I have tried so hard. In the beginning I had cracked scabbed nipples and had to use a nipple shield. It took me a while to get him to latch on without it, but finally he did. Then, my milk supply was slow and I pumped and pumped to get it up to enough for him, and now this. He seriously throws such a tantrum and kicks, and scratches and flails about when I try to put him on the breast. He screams bloody murder so I just give up because it is really hard to handle. I am just sadly giving up. I am going to try to breastfeed at night and first thing in the morning still, but the other feedings are just going to have to be what I pumped from a bottle and formula until my milk dries up completely. Do you have any advice or suggestions to help out?

You are doing such a great thing for your baby. The last thing you should feel is defeated. Be proud of all that you have done. Having to supplement isn’t the end of the world, but let’s see what we can do to get you breastfeeding again.

It sounds like he has nipple confusion. Lots of times babies will go back and forth to the breast and bottle when they are little, but they slowly develop a preference for the bottle. The milk comes out faster from the bottle than the breast and they don’t have to wait for a let down. I would recommend that you continue to breastfeed him during the times that he will accept it (night time, early morning). To get him to nurse more at your breast, I would say start using the nipple shield again. It is easier to carry around a nipple shield than a breast pump wherever you go – so if you can get him to start taking his daytime feedings using the shield, that will definitely make you feel better and should also help your supply.

I would start trying to use it when he isn’t super hungry – before he starts showing all of the classic signs of hunger – that way he will be more patient and won’t be so frustrated trying to get the milk. I would also hand-express or pump to get your milk flowing the first few times you use the shield with him so that he doesn’t get frustrated waiting for your let down. The shield will “feel” more like the texture of the bottle – so even though you spent a lot of time trying to get him off of using the shield – I think that using again is going to be your best bet for getting him nursing and being happy about nursing.

The more you can get him nursing, the better it will be for your supply (not to mention the convenience of not having to pump when you aren’t at work!). You can find some great tips for pumping and increasing your supply in my Pumping Tips article. I’d like to highlight a few of them for you:

• Pump for a full 15 minutes – even if nothing is coming out – the added stimulation is good for building up your supply
• When you pump – try pumping for 10 minutes, turn the pump off for 2-3 minutes, then pump for another 5 minutes. This ALWAYS gave me a second let-down.
• Be consistent about the times that you pump – try to pump at the same time every day so that your body realizes that this is a time to make more milk. You should start to notice an increase in production just because of regular pumping.

Since your supply is already low, I would also recommend that you take an herbal supplement. The best thing is a combination of Blessed Thistle and Fenugreek – you can buy it in liquid form at Whole Foods (or other natural food stores). It is worth it! You will know you are taking enough when your skin smells like maple syrup. Take a look at my blog post on fenugreek for more info.

I think you are doing a great job! Don’t give up and don’t feel bad – you are doing such a great thing for your son. Even if you always have to supplement – the breastmilk he is getting is so good for him and so good for you! I think if you try some of the tips above, you will notice an increase in your supply and hopefully you will be able to get your son latched on again. Don’t expect immediate results – it is going to take patience and time. And the best thing to do is to stop when you and your son are getting frustrated. You don’t want breastfeeding to be a negative experience for him. But keep trying and be persistent and eventually you will make progress and he will start nursing again. Don’t feel defeated and keep trying – those are the two most important things.

Please email me anytime and let me know how it is going. I will be sending positive milk vibes your way!

Judy

Has your baby had nipple confusion? How did you get them to nurse again? Please share your experiences!

How Much Fenugreek Should I Take To Increase My Milk Supply?

Lots of moms are worried about their milk supply, especially if they are pumping or returning to work. There are many ways to increase your milk supply without taking herbs, but if you decide that herbs are for you, fenugreek is a great choice. Always check with your doctor or a lactation consultant before taking any herbs.

If you are going to take an herb to increase your milk supply, we recommend taking a combination of fenugreek with blessed thistle. You can find this item at Whole Foods and other natural herb stores. The bottle of fenugreek that you get gives a recommended dosage. You will likely need to take much more than this recommended dosage to see an effect. Generally, most lactation consultants will recommend taking 3 to 4 pills, 3 to 4 times per day. You will know when you are taking enough because your skin will smell like maple syrup!

Fenugreek works great for some moms and makes less of a difference for others. Give it a few weeks, if it doesn’t improve your supply, check into other ways to increase your supply. Our Pumping Tips Article gives great tips for increasing your supply.

You can find more great information about fenugreek on Breastfeeding.com as well!

Have you used fenugreek? Please share your experiences!

Judy’s Advice: Nurse On Demand For Best Milk Supply

Hi all, I have to supplement when feeding my 4 week old. I have been using the Playtex slow flow nipple and it takes him an hour to drink 3 ounces. Sometimes he can’t even get any out. Is it too soon to switch to the medium flow nipple?

(posted on MamaSource message board)

Congratulations on your new baby! If you are supplementing in addition to breastfeeding, then you will want to stick with the slow flow nipple. If you switch to a faster flow, then your baby will be more likely to get nipple confusion and will start to prefer the bottle over the breast.

If you don’t mind my asking, why do you need to supplement? I would be happy to help you get to the point where you no longer need to supplement and can breastfeed exclusively. I have written two articles to help breastfeeding moms which you can see at http://breastfeedingtips.net and http://pumpingtips.com.

Judy,
I have been trying everything with a lactation specialist. I had a good supply, but a latch problem caused it to deplete. I have tried the supplement device around the neck, but saw no results. I am now pump exclusively, taking fenugreek and reglen. I am getting 8 oz. a day and having to supplement the rest.

Any advice?

Did you try using a nipple shield with your baby? Your baby is always going to be more efficient at getting your milk out than the pump is. Since your baby is so little, my best advice would be to get him to nurse directly on your breast as often as possible.

I had problems with latch with my son when he was born and the nipple shield saved us. I only recommend them as a last resort, but it may be something you will want to try with your baby. If you can get him back on your breast it will make everything easier.

Pumping and feeding is a lot of work – if you take some steps now to get him latched back on, you will have a much easier time in the long run. It may be a difficult few weeks to do it, but it will be so worth it! I went through this with my son too. My milk hadn’t come in, he was dehydrated, I tried the supplemental feeder. What we ended up doing was using the nipple shield (he wouldn’t latch without it) and then I fed him as often as he wanted to at the breast, but I never let him go more than 2 hours without eating (during the day – 3 hours at night) for about a week I would wake him to feed if he was sleeping and it had been more than 2 or 3 hours since his last feed.

This got my milk supply up and got him nursing successfully. We then kept nursing on demand and didn’t start trying to wean off of using the nipple shield until he was nursing regularly.. I also pumped after each nursing session for a week. I got almost nothing out, but the added stimulation was good for helping to build my supply. You can also go to Dr. Newman’s website and tell him you are having supply problems. He can write you a prescription for Domperidone. It is a prescription drug that increases milk supply. You can’t buy it in this country, but you can order it online from Canada. As long as you have a doctors prescription, they will send it to you. You can get a prescription from your own OB or from Dr. Newman online.

How much fenugreek are you taking? Where are you buying it? I found that the one at GNC isn’t very good, but if you buy the kind that they sell at Whole Foods (fenugreek and blessed thistle mixture) that works better. You will need to take about 3 to 4 pills 3-4 times per day. You will know you are taking enough when your skin smells like maple syrup.

My pumping tips article, that I mentioned before, is written for moms who are going back to work – but it has lots of great pumping tips – even if you aren’t worried about going back to work.

My biggest piece of advice is to stop the bottles as quickly as possible- they are hurting your supply. Read this blog post about a client of mine who had supply issues. Her Dr and pediatrician gave her bad advice and were hurting her supply.

Let me know if I can help in any other way.

Judy

New & Nursing Moms Need Lots Of H2O

Drink a LOT of water!

Breastfeeding can be extremely dehydrating.  You will need to make sure you drink a lot of fluids, especially water.  Keeping yourself hydrated will help your milk to come in stronger.

Keep a full glass of water by you at all times.

Put water in the nursery so that when you feed the baby during the middle of the night you can drink then too.  You can also prepare a cup of ice chips to set near your bed at night.