Many moms report that their breasts no longer feel full, stop leaking, and do not seem to produce as much milk by the end of the “4th trimester.” Some of these changes are normal and to be expected, but if milk supply has truly decreased there are a few reasons why and more importantly, ways to increase milk supply.
In the early days, many moms will notice that their breasts become full or engorged with milk between feedings or pumping sessions. As time goes on, you may no longer experience breast fullness thanks to supply regulation and our body’s ability to make milk “just in time.” This does not necessarily mean that you have lost your supply or are experiencing a decrease in milk production. Similarly, as our bodies adapt to our usual feeding and pumping routine, leaking subsides.
These two naturally occurring changes are normal. A better indication of milk supply is how well your baby is gaining weight and how much milk you’re able to pump. Read on to learn more about influencers on milk supply and what you can do to increase supply while breastfeeding or pumping.
IN THIS ARTICLE
Why is my milk supply changing?
What to expect at 3 - 4 months
What to do when breastfeeding
What to do when pumping
How to start combo feeding
What to expect when weaning
FAQ about milk supply at 3 months
Why is my milk supply changing?
Immediately after birth, hormones play a huge role in how much milk we produce. During the newborn period, levels of the milk-producing hormone prolactin are usually quite high, helping to ensure a full milk supply. By 3 months postpartum hormone levels have leveled out making frequent breast stimulation and milk removal even more important.
It is also true that our bodies are more efficient at producing milk and no longer need to store large amounts of breast milk between feedings or pumping sessions. Instead, your body has learned your usual routine and will ramp up and slow down milk production as needed.
What to expect at 3 - 4 months
Aside from the normal regulation of milk supply due to hormones and our body’s ability to make milk “just in time,” there are often some changes to lifestyle that occur around 3 - 4 months postpartum.
Going back to work
12 weeks of maternity leave is quite common for many new mothers. As mothers return to work it can take some time for their milk supply to adjust to the new routine and schedule. When going back to work it is important to keep up with pumping to prevent a decrease in milk supply. As a general rule: moms should pump at least every 3 hours at work. Skipping pumping sessions or pumping for less than 15-20 minutes can result in a low milk supply.
Beginning birth control
To prevent unintended pregnancy mothers are encouraged to begin progesterone-only birth control 3 months postpartum. While progesterone-only birth control (the “mini-pill”) and intrauterine devices (IUDs) do not cause a decrease in milk supply for many mothers, some report a decrease in milk supply after beginning birth control.
Dropping feedings/pumping sessions
Another common reason milk supply changes at 3 months is a decrease in the number of feedings or pumping sessions. By 3 months babies who initially nursed 10-12 times per day (or more) may be feeding fewer than 8 times per day. Exclusively pumping moms may have also scaled back on the number of pumping sessions per day. If the decrease in feedings or pumping sessions results in long stretches without milk removal our bodies respond by slowing milk production. It is generally best to avoid stretches longer than 5-6 hours without breastfeeding or pumping for at least the first 4-6 months.
What to do when breastfeeding
If you are breastfeeding and are looking to increase milk production there are a few things you can do.
Breastfeed more frequently
Since milk supply is directly related to how frequently and fully the breasts are emptied, the first step to increasing milk supply is to feed more often. Bringing your baby to the breast frequently (even if just for a few minutes) signals your body to produce more milk. If your baby is sleeping long stretches overnight, cluster feeding before bed, adding in a dream feeding just before you go to bed, or waking up overnight to nurse or pump can help.
Use breast compressions
While nursing you can help your baby take in more milk by massaging and compressing your breasts. Breast compressions are performed by positioning your hand in a “C shape” towards the back of your breasts and gently squeezing the breast tissue down towards the nipple. By draining the breasts more fully your body will begin to replenish milk more quickly, resulting in increased milk production.
Increase water intake
Whether you are back at work or doing your best to keep up with an increasingly busy baby, it can be easy to forget to drink enough water. Since breast milk is made up of about 90% water it goes without saying that a scarcity of water decreases milk production. To ensure proper hydration, aim to drink at least 100oz of water each day.
What to do when pumping
If you’re no longer pumping as much milk as you used to there are a few ways to increase milk supply.
Power pump
One of the most effective ways to increase milk supply is by adding a power pumping session to your regular pumping routine. Power pumping is when you pump in intervals -- simulating what it’s like when your baby is going through a growth spurt and cluster feeding. To begin, pump for 20 minutes (both breasts simultaneously). Then, take a 10 minute break. After the break, pump again for 10 minutes. Turn off the pump and wait 10 minutes. To finish out the power pumping session, pump again for 10 minutes. Do your best to power pump once per day, around the same time every day, for 5-7 days in a row. You should begin to see an increase in milk supply after 3 days.
Pump maintenance
If you have been pumping several times per day for months, now is a good time to replace the membranes or duckbill valves your pump uses to create suction. Membranes and duckbill valves should be replaced every 3 months.
Hands-on pumping
When pumping it is very helpful to use your hands to massage your breasts and move milk towards the nipple. While wearing a hands-free pumping bra, position one hand between your breasts and one hand on the outside of the breast you will be massaging. Gently “roll” and compress the breast between your hands. This technique helps ensure you thoroughly drain the breast and can increase milk output by 25% or more.
How to start combo feeding
If you have been exclusively breastfeeding or pumping and are considering introducing formula you may have questions about what to expect and how to ease into combo feeding.
Discuss with your pediatrician
Before introducing infant formula it is important to talk to your baby’s pediatrician. Your pediatrician can help you determine which formula is best for your baby and let you know how much your baby needs.
Start slowly
When possible, it is best to introduce formula slowly to give your baby’s digestive system time to adapt. Rather than mixing breast milk with formula, consider keeping the two separate and alternating formula feedings with breast milk feedings. This gives your baby’s tummy more time to process any formula and can limit issues with gas and constipation.
What to expect when weaning
If you’re planning to wean from breastfeeding or pumping, be sure to give your body time to adjust.
Listen to your body
When weaning from breastfeeding or pumping it is important to keep an eye out for clogged ducts. If your body is used to nursing or pumping frequently, a sudden change to your usual routine could lead to painful clogged ducts or mastitis. To reduce your risks for developing clogged ducts, gradually increase the length between feedings/pumping sessions.
Set realistic expectations
It can take several weeks for milk supply to completely cease after beginning the weaning process. To speed up the process it can be helpful to apply cold cabbage leaves and peppermint essential oil to the breasts.
FAQ about milk supply at 3 months
Q: Do certain types of birth control have a greater impact on milk supply?
A:
Combination birth control pills containing both estrogen and progesterone decrease milk production and should be avoided while breastfeeding.
Q: Do lactation supplements really increase milk supply?
A:
Herbs and supplements claiming to increase milk production can be helpful when combined with increased breast stimulation and milk removal. Simply consuming lactation supplements [without changing your nursing or pumping routine] will not make a significant impact on milk supply. Milk supply is primarily driven by “demand” or milk removal.
Q: If I skip a pumping session at work, will it hurt my milk supply?
A:
When nursing or pumping sessions are missed our bodies send signals to our brain to decrease milk production. While occasionally skipping a pumping session may not do too much harm, frequently neglecting to pump at work will result in decreased milk production. It is best to pump at least every 3 hours at work.
Q: How will pumping sessions impact my milk supply if I breastfeed?
A:
To protect milk supply it is recommended that moms pump anytime their baby receives a bottle. Pumping in place of missed breastfeeding sessions helps to maintain milk production. Pumping even when breastfeeding sessions are not missed will result in an increase in milk production.