There are many reasons why you'd have to build up your supply. For example, if your baby is in the NICU or Special Care Nursery, if your newborn isn't able to latch or if you plan on exclusively pumping!
If your plan is to breastfeed or pump, it is very important to give your body the signals to start producing breast milk right away. The glands and ducts in your breasts work by supply and demand.
The more that is taken out of the breast, the more you produce!
In the beginning, right after the birth of your baby, there is colostrum in your breasts. Lots of people seem to think that colostrum is somehow not milk, but it totally is.
Breast Milk Is Extremely Valuable for Your Baby
Colostrum is the first milk. It is extremely nutritious for your baby with lots of antibodies and high in protein. Later, when the milk "comes in" the nutrients change and it becomes "thinner" with higher water content.
The colostrum is yellow. That's normal!
Breast milk and colostrum are basically medicine for your baby, especially if your baby has health issues or is in the NICU for any reason. It can even help to prevent or decrease the severity of bowel disease and other infections.
A Detailed Guide on Bringing Your Milk in Quickly
This blog post will describe in detail how to get your milk to come in efficiently and quickly. To achieve results you will have to follow the guide to a tee. It is very important to stimulate your breasts A LOT to make this happen. I mean a lot. Like a lot a lot. I can not stress how important stimulation is in the beginning!
The guide is for anyone starting to breastfeed or pump, but can also work if you want to increase your supply later on in your breastfeeding and pumping journey.
In regards to the newborn that isn't latching, I'd recommend following this guide and continue using it even when your baby is latching a little bit. This way you can be absolutely sure that your baby is going to get enough milk once that latch gets really strong.
Day One - Happy Birthday Baby!
Congratulations! Your baby is finally here. You should try to latch your baby within one hour after birth. Don't worry if he or she doesn't latch, oftentimes newborns are sleepy and lazy.
Your baby won't be able to latch right away if he or she is preterm.
If your plan is to feed your baby breastmilk (and I'm guessing it is since you are reading this post) you need to start stimulating milk supply right away if your baby isn't latching for whatever reason. So, whether your baby is in the NICU or isn't latching, you should start hand expressing within one hour of birth.
You might not feel well enough to do this on your own, especially if you had a traumatic birth. Ask your nurse to do it for you! All labour and delivery and postpartum nurses are trained to hand express and help with breastfeeding issues.
Oxytocin levels are at their highest right after delivery. It is the hormone responsible for releasing milk, which is why it's important to hand express right away. Research has shown that women that hand express within the first hour after birth and continue to do so in the early days will yield a higher volume of milk sooner than those who don't.
Hand Expressing: The Technique
Step 1
Start by washing your hands and getting into a comfortable position in a private area. It’s better if you’re sitting up so that gravity isn’t working against you.
Be sure to have a container ready that you can use to put the milk you express into. This can be a spoon, cup, syringe or anything clean really. My favourite is a syringe. It's the easiest to get every drop with minimal waste.
Step 2
Expose your breast or breasts fully and start by massaging one of them in a circular motion, working from your shoulder and all the way down to your nipple. This will stimulate the letdown reflex.
Take it slow!
There is no need to rush, and actually, being stressed and rushed can be counterproductive and hinder the letdown reflex and your milk won’t flow as well.
Step 3
Make a “C” with your thumb and forefinger and place your fingers about an inch away from your areola. Remember, you are expressing your breasts and not your nipple, there is no need to be super close to the nipple. Gently push your fingers back and then squeeze.
You are trying to emulate what the baby does when he or she feeds, so don’t bring your fingers too far forward close to the nipple, that might cause you to stop the flow.
Sometimes it takes a few squeezes for the milk to start to flow, so maybe nothing much at all comes out. That is totally ok, stick with the technique and remind yourself that you are stimulating your breast to make more milk.
Stay positive! Whatever milk you do express, collect into your container.
You do not have to stay in one place the whole time. Move your fingers all around the areola because there are milk ducts all around that you can express milk from.
Breast Massage
It can be helpful to massage your breast in between squeezes, to release more milk down. It’s up to you whether you hand express from both breasts or just one in each sitting. If you prefer to switch between breasts, that is perfectly ok. Usually, the recommended time is about 15 minutes for each session. If you’re exhausted you can teach your partner or family member and they can do it while you rest. Or ask your nurse.
Day One
On the first day, you want to hand express at least 6 times. That means you are doing it every 4 hours on the day you gave birth.
This is so important in the beginning, that you don't want to skip even one session. If you can hand express more times, go for it, but aim for at least 6 times.
Your breasts are going to be soft and you will only get drops of colostrum out. THAT'S OK! You might get more than just drops the first few times and then get nothing towards the end of the first 24 hours.
That's also ok!
The main thing is that you are stimulating your body to make lots of milk. You are doing work that is going to pay off down the road. Any milk you get you should give to your baby. Putting drops of milk inside your baby's cheek helps to build their immunity.
Research has shown that pumping is not as effective on the first day, so stick with hand expressing only in the first 24 hours. It wouldn't hurt to pump alongside hand expression but it's by no means necessary.
If you can only do one thing, HAND EXPRESS six times in the first 24 hours.
Day Two
Yay, you've made it to day two! Hopefully, you got a few hours to sleep at some point.
Now we are going to increase your hand expression and combine it with pumping.
You should use a double electronic hospital-grade breast pump. It will stimulate your body the best.
Get a pump to use while admitted to the hospital. Ask your nurse to properly explain how the pump works and to make sure you are using the correct size flange. Don't hesitate to ask for help!
Don't start with a suction level that is uncomfortable. Increase the suction level steadily as your breasts adapt to the sensation. You can try increasing and decreasing the pump settings during the pumping session to find what is comfortable for you.
Use the maximum suction strength that you can handle.
Pumping should never be uncomfortable or painful although it might be a bit strange at first if you have never done it before.
Most hospitals have a pump for you to use, if not, consider renting one. It's so important because hospital pumps offer optimal stimulation most similar to the suckling of a newborn.
In these next 24 hours, you should be hand expressing at least 8 times, or every 3 hours. Combine this with pumping and stimulate your breasts for a total of 20 minutes.
IMPORTANT NOTE: You will most likely not get anything out of your breasts when pumping, it is SOLELY FOR STIMULATION. You will get more colostrum out using hand expression. Give whatever you get to your beautiful little baby.
Again, if you don't get any more than a few drops during these sessions, fret not! You are doing amazing work stimulating your body to bring breast milk in.
Day Three
I hope you're not totally exhausted at this point. You most likely are, so just remember to try to rest whenever you can.
Today the work really begins.
On day three it's time to increase your breast stimulation sessions. It's up to you whether you keep both hand expressing and pumping, depending on how much colostrum you get out. Some moms can start solely pumping, but others prefer to keep hand expressing as well.
In the next 24 hours, you have to pump or hand express (or both) 10 times. That's basically every 2 hours.
I realize that sounds like a lot of pumping, and it is. But if you keep with the program you will see results!
After the first 3 days, you should ideally keep pumping 10 times in a 24 hour period, but make sure to squeeze (no pun intended!) one 4 hour rest somewhere in those 24 hours.
Professional Pumping Program
Day 1: Hand express 6 times in 24 hours, which is every 4 hours around the clock.
Day 2: Hand express and start pumping during each stimulation session. Do this 8 times in 24 hours, or every 3 hours around the clock. You will mostly be hand expressing until you can get the milk out easily with the pump.
Day 3: Pump 10 times in 24 hours or every 2 hours (roughly). Continue until your baby has latched and is feeding well at the breast.
Once you've established your supply you want to maintain it. Below are a few pointers that will help you do exactly that.
Sleep and rest.
I cannot emphasize how important this is. Whenever you can, lie down and get a nap in. Even though you've never been a napper, now is the time to start. Sleep will help maintain your breast milk supply.
Hydration
Drink as much water as you possibly can. Your body needs water to make milk. It's that simple. If you don't like water, find a healthy drink to substitute water. I like carbonated water! Your body will also tell you that you need more fluids by making you feel thirsty as soon as you start pumping or feeding your baby. Listen to your body's cues.
Eat Healthy Meals
Get people to cook for you. Or order in. Whatever you do, make sure you are getting enough calories and eating nutritious foods to keep your supply.
Hold or Touch your Baby
This will stimulate your body to make even more milk! If you are able, do lots of skin-to-skin with your baby. Research has shown that women that pump or hand express right after doing skin-to-skin with their baby get more milk out.
Ideally, if your baby is in the NICU, pump in your baby's room, or close to them. Close contact with your baby will increase your response to the pump.
Keep Pumping!
Aim for at least 8-10 times in 24 hours for 15-20 mins at a time. Ideally, get in 10 pumping sessions every day. Even once your baby starts latching, you will need to keep pumping after every feed to maintain your supply. Once your baby is feeding effectively at the breast you can start decreasing the pumping sessions. Don't fret! There is light at the end of the tunnel and you most likely reach a time when you won't have to pump again, unless your plan is to exclusively pump then just keep it up, mama!
See a Lactation Consultant
This point comes at the very end of the post, but really, you should be doing this program while consulting a lactation expert. They will be able to help you through all the trials and tribulations of breastfeeding and pumping. Most obstetrical and NICU units have lactation consultants available for you, definitely seek and use their advice from the start.
Hanna is passionate nurse and mama of four babies. Parenthood can be hard, but you don't have to do it alone. Hanna is here for you from pregnancy, to birth and beyond!
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