There are many considerations when talking about decreased supply (hopefully we've hit most on this page).  If you are struggling with supply, you must evaluate the following of mum; maternal medical conditions, illness, fatigue, medications, pregnancy, and also of babe; medical conditions, illness, position and latch.  If you have questions regarding any of the above please seek professional advice.  If you are pumping and struggling with supply you also need to consider the style, age and quality of the pump as well as the size of the breastshields.

A note regarding position and latch, if you have had and or currently have nipple pain and or trauma with your latch then this typically indicates a shallow latch and can be the cause of a lower supply, even if "it got better" with time.  If the pain improved over time it does not necessarily mean the latch got corrected.  A deep latch by a babe should be pain free.  If you have pain with the latch (even if it doesn't last) please consider a consultation with a lactation consultant to help remedy this.  Often a deep latch resolves a low supply over time (the breast is better drained).

You may contact me for counseling at:  breastfed2@yahoo.com if you desire.

With the above considered (and not a factor), below are a few suggestions along with some visuals that may help increase supply and or establish it.  

Set up a pumping & feeding station (see pic below) to make this as easy as possible.  I love the Medela Metro pump for the convenience and size of the actual motor.  It is the pump you see in the pic below.  You don't have to make room for the entire bag on your pumping station.  Have your burp cloths, nipple cream and nursing pillow as well as a strawed container of water all close at hand!

Good luck and happy feedings!

One of my favorite gurus in the lactation world says “If a breast can make milk, it can make more milk!”  It’s not too late!

Often more frequent nursing &  or pumping alone can improve supply in a few days.  However, some want to do all they can to help improve it.  Pumping and hand expression in additon to breastfeeding may do the trick.

Pumping needs to not be an added stress.  Make it doable.  If you can pump for 5-10 min, great, if you can only give it a few minutes, great.  If you can do it right after a breastfeeding, great.  Or if you can't get to it for an hour after feeding, great.   Babies don’t eat on a schedule – make pumping happen when you can give it a few minutes.  IF you are a numbers person a good goal would be to have breast stimulation 5-10 minutes (including hand expression time), at least 8 times a day (babe counts if latching well & draining breasts) –it is not necessary to wake extra at night to pump!  A great way to store your milk is with the milk tray freezing system. 

It is common to have less supply in afternoon and evening but it is important to still stimulate and pump regardless of how much you get out (frequent drainage ).

Try a day of marathon feeding and pumping (to empty as many times as humanly possible!).  Cluster feed and or pump all day long with brief breaks.  Supply comes from the rate of milk production of which is increased by frequent emptying of the breasts.  The empty part is the key and it doesn’t have to take long (5-10 min with a couple of minutes of hand expression after).  While pumping, deep breast compression helps.  You may find it invaluable to have a hands free bustier to help you free your hands!  Save and store any pumped milk you obtain. 

If you are able to breastfeed, you can do this deep breast compression (squeezing) once you have a good latch established that won’t slip if you move your hand back to the base of the breast. Encouraging this deep milk (fatter milk) to move forward and out to baby, may help them stay interested at the breast. If you have a helper, they could free the hand holding babe while you compress your breast or they could do the compression for you!  (see pic below)  With increased feeding be sure to take care of your nipples by keeping them moist with nipple cream after feeds.  Perhaps a chapped lip feeling may occur due to the increased use but it should NOT be painful or cause trauma (blisters or scabs).  My favorite nipple cream is Motherlove Nipple cream.  It is organic, does not stain and helps keep nipples healthy.

This Stanford study:  http://newborns.stanford.edu/Breastfeeding/MaxProduction.html reports some very compelling results in regards to emptying the breasts well to increase supply. The Menu is on the Left side – particularly look at “Maximizing Milk Production”

Remember if the latch isn't pain free there may be a depth issue with it and therefore the breast won't be drained.  If this is the case, all the increased breastfeeding in the world won't improve supply.  Please have it evaluated.

Do this plan for 7-10 days and you should see a nice increase in supply and or a more interested baby at the breast!

Keep up the good work and hats off to you for your devotion!!!

Below are some pictures and clips to help you visualize the techniques mentioned.

Pictures Above
Pic 1:  Deep breast compression can be done by a helper. 
Pic 2:  When you can, it's helpful to have a "pumping area" set up to make things easier and less time consuming.
Pic 3:  Hand expression may make a big difference in overall supply in 3-10 days.  Be patient and persistent.  Notice how the breastshield has been set into the bottle to make the "target" bigger and less chance for wasting any.

Video Clips Below  Please note the first time loading the clip, it may take a little time (please be patient) but should load much quicker there after.  
Clip 1:  Breast compression during "hands free" pumping.  The helper is the bustier!
Clip 2:  Ending the hands free session.
Clip 3:  Hand expression.

If you have done the above for 7-10 days and do not see improvement in your supply you may want to consider a Galactogogue (milk increaser). 

Herbals are the best and most natural to way to take the next step in increaseing your supply.  I prefer and trust Motherlove herbals.  They are a proven safe source.  I like the idea of hitting all the known receptor sites with a variety of herbal enhancers (Fenugreek is just one of the herbs) which is what More Milk Special Blend does.  And it is in concentrated capsule form so it is easier to comply with.  If you have a history of PCOS or breast surgery, Goat's Rue may be something to consider alaternating with the MMSpecial Blend.  Goat's Rue is safe during the last month of pregnancy and definately something to consider taking at that time if you have had the history of PCOS or breast surgery.  Please refer to my handouts page for further information.