Breastfeeding: How to Establish a Good Milk Supply

Am I going to make enough milk for my baby? That’s a common worry of many new moms who’ve just returned home from the hospital. Here Marie Gerecke, CNM, offers 13 tips for establishing a good supply in your baby’s first weeks.

1. Feed your baby. For the first 2-4 weeks, focus solely on nursing your baby. Avoid pumping unless recommended for medical reasons. Did you know: There’s no pump as good as your baby. Your baby is a 10-star “pump,” while the best breast pump is only a 5-star.
2. Aim for feedings at least every 3 hours. Watch for feeding cues (smacking lips, sucking on hands or searching for your breast). Breastfeeding provides comfort as well as nutrition. Did you know? Newborns breastfeed often. The average is 8-12 feedings per day. Breastfeeding “on demand” is most natural. The more you breastfeed, the more milk you’ll make!
3. Practice skin-to-skin. For the first few weeks, your chest is the best place for your baby to adjust to the outside world. Skin-to-skin not only helps babies breastfeed better ― it enhances brain development. Did you know? Compared with babies who are swaddled or kept in a crib, skin-to-skin babies stay warmer and calmer, cry less and have better blood sugars.
4. Check for proper latch. Make sure your baby’s mouth is opened wide (like a yawn) before they latch on to your breast. Did you know? Your baby needs to be able to open their mouth wide, swallow and breathe. Begin with your nipple to their nose. Pull baby close when they open wide. Make sure their head is tipped back (hold them by the shoulders ― it’s hard to swallow with the chin on the chest!)
5. It shouldn’t hurt! It’s a very pervasive myth that pain while nursing is normal in the beginning ― or the entire time. Did you know? Pain while breastfeeding or damage to your nipples is a sign of poor latch. It increases your risk for clogged ducts and infections. If you’re noticing pain, see a lactation specialist.
6. Alternate breasts. It’s OK if your baby doesn’t feed at both breasts during each feeding. Start on the other breast at the next feeding. Did you know? Keep on the first side for as long as your baby is vigorous and swallowing. You may need to tickle and do compressions to keep baby drinking in the early days. If your baby is still hungry, offer the second side. Then start with that side for the next feeding.
7. Try hand expressing. Early removal of milk by hand boosts your supply. For the first couple of days, hand express after your baby nurses. You can spoon-feed this added nutrition to your baby. Did you know? It might sound daunting, but hand-expression isn’t hard. A lactation consultant can teach you this easy-to-learn technique.
8. Do compressions. Keep your baby busy at the breast by compressing your breast (applying gentle pressure with your hand) to keep the milk flowing. Did you know? Compressions aren’t necessary if breastfeeding is going well. But it’s a helpful technique for babies who are sleepy, have jaundice or are struggling to gain weight.
9. Keep ‘em awake. In the early weeks, you may need to wake your newborn if they fall asleep at the breast to ensure getting enough feedings in. Try tickling, changing diapers or undressing your baby. Did you know? If you baby has returned to birthweight and is having lots of wet diapers and seedy yellow stools, you can let them sleep for a long stretch ― if they will!
10. Avoid supplementing. Avoid pacifiers and bottles for the first 3-4 weeks. They might decrease your milk supply. You need to frequently empty your breasts to establish your supply. Plus babies suckle differently on artificial nipples. Did you know? During the first weeks, your milk gradually changes from colostrum (a thick, rich fluid) to mature milk (a thinner, whitish fluid). Your milk provides all the food and fluid your baby needs.
11. Don’t be your own worst enemy. Sure, online you’ll find moms bragging about having hundreds of ounces frozen before returning to work. Don’t compare yourself or fall prey to obsessive behavior. Did you know? Working moms only need a little stash (a few days’ worth) of milk on hand. As the time nears, pump once a day. Try, for instance, if you’re still somewhat full after a feeding.
12. Don’t do it alone. There are no points awarded for struggling in solitude. Ask for help from an experienced mom friend, a lactation consultant or join a moms’ group. Did you know? While it might feel odd at first to join a breastfeeding support group, many moms end up becoming fast friends. Some even blossom into play date groups for their kids!
13. Follow your instincts. Trust your heart and watch your baby. Don’t be so focused on the numbers ― whether ounces or minutes. Tune in to your intuitive side. Did you know? Once you and your baby learn how to breastfeed, breastfeeding will be a good time to relax and enjoy each other.