Expert: Jennifer Herrin, RN, IBCLC - 9/9/2005

Question
I am soley pumping for my baby.  I do not breast feed her any more.  My left breast only gives about 1 1/2 ounces of milk.  How can I increase it's supply, or can I?

Answer
Hi Rachel! Thanks for writing, and you have my admiration for pumping for your baby. I know pumping isn't always easy or fun to do. :)

Even though it's very common -- even usual -- for one breast to always produce more milk than the other one, you should be able to increase your total milk supply, which is a more important thing to look at than each breast individually. (It's even possible to maintain a complete milk supply with just one breast.) I'll list some general tips below, plus, here's an excellent Web site with further detailed information on all aspects of pumping, including some links to online message boards for pumping-but-not-breastfeeding mothers: www.kellymom.com/bf/pumping/bf-links-excpumping.html

* Use the best breast pump that you can. If you can rent a hospital-grade electric pump or, if you're in the United States, get one on loan from WIC (you can find elibility requirements at www.fns.usda.gov/wic/howtoapply/default.htm), you'll get the best results. Even the high-end breast pumps such as the Medela Pump In Style don't have motors designed to maintain a complete milk supply by exclusive pumping.

* Pump both breasts at the same time. Not only is this faster, but double-pumping can increase the levels of prolactin, the milk-making hormone.

* Shorter, more frequent pumpings are more effective for building supply than longer sessions that are spaced out further. (But still "finish" each breast, pumping a few extra minutes after you stop seeing milk come out.)

* Before pumping, apply heat (heating pad or warm washcloths) to your breasts for a few minutes, then lean over from the waist and massage them, sort of like doing a breast self-exam; think about moving the milk down the ducts toward the nipple. A study showed that heat and massage can increase the amount pumped by about one-third.

* Be sure you're not taking any medications that could decrease milk supply; common culprits are pseudoephedrine (Sudafed) and estrogen-containing birth control pills. You didn't mention how old your daughter is, but if she's less than a couple of months old, it's best to avoid even the progestin-only forms of control (such as Depo Provera) until after about 8 weeks.

* Be aware that "galactogogues," which are substances that can potentially increase milk supply, are available. These include pharmaceutical medications as well as herbs. They're not the first thing to try, and they don't work for all women, but they can often give a mom's breasts a "jump start" to getting a good supply back. The three most common galactogogue categories are metoclopramide, domperidone, and herbs:
-If you're in the States, you could ask your doctor about prescribing metoclopramide (brand name Reglan) for you for a couple of weeks. Here's information about it: www.breastfeeding.org/articles/reglan.html
No side effects have been reported in babies -- in fact, it's very commonly given directly to babies in newborn ICUs -- but it has been linked with depression in some women.
-If you're in Canada, Europe, Australia, or New Zealand, you could ask about domperidone:
www.breastfeedingonline.com/domperidone.shtml
Although not available in U.S. pharmacies because it isn't FDA-approved (not because it's a bad drug; just because its makers have never applied for the approval), it *is* approved by the American Academy of Pediatrics as "generally compatible with breastfeeding" (see Table 6 at http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b108/3/776).
-Some herbs are also associated with increasing milk supply. With herbs, you don't always know which concentration you're getting, and you should make sure you don't have any allergies to them before you take them. Fenugreek is the most common one, but because it's in the same family as peanuts and doctors are now advising pregnant and lactating women to stay away from peanuts, it may be wise to stay away from fenugreek. Here's some more information about herbal galactagogues:
www.kellymom.com/herbal/milksupply/index.html

I hope this helps! Enjoy your baby!

Jennifer