What can I do to increase my breast milk production?
If you’re only nursing every 3 hours, that is probably the problem. The average baby needs to nurse at least 10-12 times in 24 hours–and that’s *before* you want to increase your milk supply. If you’re not nursing that often, it is very likely that you will never have enough milk.
So the first thing to do is to nurse more often. If it’s been 2 hours since the *beginning* of the previous feeding, pick up the baby and nurse, even if you have to wake her/him. Try offering a *little* less formula (about 1/2 to 1 ounce less per feeding) and nursing more often like this for the next 3-4 days. If baby is still having the same number of wet and dirty diapers as previously, offer a little less again (and continue to nurse every 2 hours). Keep going this way, and you will probably be able to eliminate the formula entirely at some point (but there is no way to know just when that will happen).
At the same time, call a local La Leche League Leader. She will be able to give you ongoing help and support. All this help is *free* (although offer to make a donation to the organization if you can). See sources section below to find a Leader near you. Keep in mind that LLL Leaders are all volunteers working from their own homes while raising their own kids, so if you don’t get through, try another Leader or call back later.
You do *not* need to “drink a lot of water”. It won’t help, and one study showed that forcing liquids actually *decreased* milk production. Drink if you are thirsty.
Do *not* use “mother’s milk tea” or any other herbal blend that is intended to increase your milk supply. If you need help from a medication, you can use fenugreek or a prescription medication (see below). Herbal blends are all based on fenugreek anyway, but the extra herbs can cause various problems (side effects and/or allergies). In addition, most of them contain fennel–an herb that can increase the milk supply for some mothers, but actually decreases it for others. It is risky and could cause more problems.
Do not pump if you can nurse. No pump is as effective as a nursing baby. Before you pick up the pump, nurse; the only reason to pump is if baby refuses to nurse, in which case it’s better than nothing. But if you do pump, use the most effective pump you can. The best is a hospital-grade rental pump (preferably one that pumps both breasts simultaneously), then a battery-powered pump (even if used on wall current); manual pumps are the least effective type of all. Never use a pump made by Gerber, First Years, or Evenflo, or any pump that has a rubber bulb to operate it. They could do damage to the breast that may make end your breastfeeding career–at least for this baby.
If you want to try a “galactagogue” (something that increases milk production), the only herb with any scientific evidence of its effectiveness is fenugreek. Take 1 capsule 3 times a day for 3-4 days, then increase to 2 capsules 3 times a day for a few more days. Keep increasing this way until you are taking an effective dose *for you* (typically 2-4 capsules per dose); you will know that you are taking enough when your sweat and urine smell like maple syrup. Keep taking that amount until you have enough milk, then stop gradually (the same as starting). Fenugreek is not recommended for mothers with asthma or diabetes. And if either you or baby has an allergic reaction (very rare), stop taking it.
If you prefer a prescription galactagogue, there are 2 to choose from. Most women use metoclopramide (Reglan) because it is more readily available in the