Many mothers wonder how to produce breast milk. There is not one way to achieve breast milk production. It depends mostly on milk removal. The more often milk is removed and the more completely it is removed, the higher the breast milk production will likely be. The opposite is also true. When breast milk is removed less often or an insufficient amount is removed, the breasts get the signal to slow milk production, and they make less. Breast milk removal occurs when a baby effectively breastfeeds or when you pump breast milk.
Effective breastfeeding requires effective sucking by the baby to transfer enough milk from the breast into the baby's mouth to be swallowed. To suck effectively, a baby must latch deeply onto the breast to create suction and also compress the areola (the area about 1 to 1 1/2 inches behind the nipple tip). Proper sucking signals the mother's body to release the hormone oxytocin, which results in the flow of the breast milk. This process is also known as let-down.
If a baby is not breastfeeding well, breast milk can be obtained by expressing the milk. When using manual expression, a mother compresses the breast by hand to remove milk. Breast pumps can also be used to express milk.
Ten steps to breast milk production:
1. Frequent feeds, not formula. The more often you feed, the more milk you make. If you give formula to your baby, he or she will feel too full to nurse frequently, so you’ll make less milk. The average newborn nurses at least eight times a day.
2. All you need is breast milk. The American Academy of Pediatrics and the American Academy of Family Physicians both recommend that your baby have a diet of purely breast milk for the first 6 months. No other food or drink is needed. After that, solids can be added, with continued breastfeeding for a year or more.
3. Feed early and often. Feed at the earliest signs of hunger: if baby’s awake, sucking on hands, moving his or her mouth or eyes, or stretching.
4. If baby didn’t swallow, he or she didn’t eat. Listening for the sound of swallowing will help you know whether your baby is getting enough. It’s normal for all babies to lose a little weight before your milk comes in, but that weight should be gained back within a few days. Get your baby weighed about two days after you go home. As your milk comes in, your baby should begin to have at least three yellow stools a day.
5. Say “NO” to pacifiers and bottles. If you use pacifiers and bottles when your baby is hungry, you may not be nursing often enough to make plenty of milk, and the nipples on pacifiers and bottles are different from your nipples, which can lead to latching problems during nursing. Nursing for comfort rather than using pacifiers can also help you make more milk.
6. Sleep near your baby, and nurse lying down. You can rest while you feed your baby. Remember to practice safe sleep habits.
7. Have baby’s mouth open wide like a shout, with lips flanged out. The tip of your nipple should be in the back of your baby’s mouth. Baby should be directly facing you, chest-to-chest, chin-to-breast. Proper positioning helps prevent sore nipples.
8. Watch the baby, not the clock. Feed your baby when he or she is hungry, and switch sides when swallowing slows down or baby takes him or herself off the breast.
9. Go everywhere. Plan to take your newborn everywhere with you for the first several weeks. You can nurse discreetly by covering up with a small blanket and lifting your shirt up from the bottom. You can start going out without your baby after the first few weeks when someone else can introduce a bottle of breast milk. You can even continue to breastfeed exclusively after you go back to work.
10. Don’t wait to ask for help. Learning any new skill can require patience and extra advice. If you wait too long to get the help you need, it may be harder to breastfeed. So as soon as you start having problems, talk with your doctor or a certified lactation consultant.