Today I wanted to answer a question about exclusively pumping with a brand new baby – will milk supply increase over time on its own? And if not, what should I do if I’m only pumping a few ounces? Here’s everything you need to know about how milk “comes in,” and what to do if you’re not pumping enough.
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Here’s the question:
I am six days postpartum and have made the choice to exclusively pump. The doctors were worried about her loss in weight since she had lost 10% in 48 hours, and they were worried about her jaundice levels.
So far I’m only able to pump 1 oz (sometimes 2 oz) each time I pump. I know there are a lot of methods to increase milk supply, but is it normal for it to gradually come in? Or will my milk supply increase over time?
I keep hearing everyone talk about how they are able to produce 4 oz or more in one pumping session, and I am not even close to that. I’ve been trying to stay hydrated, eating oatmeal, taking fenugreek, etc., but doesn’t seem like it’s helping quite yet.
First, congratulations on your brand new baby! It sounds like you are doing all of the right things and doing a great job.
To answer your question about your milk supply increasing over time, let’s look first at how milk “comes in.”
How milk comes in
Your milk “coming in” is hormonally-driven. While there are many hormones that play a role in lactation, there are two that are particularly important:
- Prolactin – Prolactin is produced by the pituitary gland, and is the hormone that drives milk production.
- Progesterone – Progesterone is produced in the ovaries and plays an important role in the maintenance of pregnancy.
So let’s look at how these influence your milk coming in.
During pregnancy and immediately after birth
During pregnancy and right after baby is born, both prolactin and progesterone levels are high. Your body is producing milk, but the high levels of progesterone keep the production low.
The milk that your body produces at this stage is called colostrum.
About two to three days after birth
After your baby is born and the placenta is delivered, your progesterone levels will drop sharply.
This drop, combined with continuing high levels of prolactin, result in your milk “coming in” about two to three days after birth.
After your milk comes in, supply is driven by demand – but it’s also helped along by the high prolactin levels.
Over the first 6-12 weeks postpartum, these high prolactin levels level out to a lower baseline level. This is called supply being “established” or “regulated.”
Can milk come in gradually? Will milk supply increase over time?
Now that we understand how milk comes in, let’s actually answer the question about whether your milk supply will increase over time.
After you notice your milk coming in initially, your supply will mostly be based off of demand. (Plus a bit of a boost in your prolactin levels for those first 6-12 weeks.)
But normally, after your milk does come in, there’s no additional boost that would make it automatically continue to increase.
However, there are two important caveats to this:
1. If you “demand” more milk, you may make more milk
Your baby’s milk intake will likely increase during the first month.
For nursing parents, this means that because your baby will likely be at the breast more and removing more milk, “demand” will likely increase. Your supply may then also increase in response to this without you having to do anything.
If you’re exclusively pumping, though, you may need to pump more in order for your body to get the same message. Power pumping can be a good option to try in this situation.
2. What if your progesterone levels never went down?
One thing that can cause issues with milk production in the early days and weeks is retained placental fragments, which can interfere with that big drop in progesterone and thus your milk coming in.
If you think this might be an issue, contact your health care provider as soon as possible.
So what should you do if you’re only pumping 1-2 ounces?
The first thing you want to do is make sure you don’t have an issue with milk removal. Your pump (or baby) not being effective at getting milk out can easily be as much of an issue as there not being enough milk in your breasts in the first place.
Here are a few things to troubleshoot:
- Are your breast shields the right size? Having the wrong size can not only hurt, but affect the amount that you pump.
- Have you tried incorporating hand expression into your pumping routine at all? Some people find it helps them get another letdown, or empty more fully.
- Are you doing breast compressions while you pump?
- Are you pumping 7-10 times per day, for a total of 120 minutes per day? (Note: This applies only to exclusive pumpers, not nursing parents.)
- Have you tried using a manual pump (like the Medela Harmony) or a silicone pump (like the Haakaa)? Some people see a lot more success with these than electric pumps, and if these are more effective, you can incorporate it into your pumping routine.
Once you know you don’t have a milk removal problem, you can move on to milk supply (if it’s still an issue). This is where you can try things like hydration, oatmeal, etc. More on these strategies here.
Have you struggled with not having enough milk after your milk came in? Tell us your experience in the comments!
Stressed about establishing or increasing your milk supply while exclusively pumping? Always worried there is something else you should be trying? Check out my milk supply guide here (use code SUPPLY for 10% off)!References
- Bonyata, Kelly, BS, IBCLC. “How does milk production work?” Kellymom. https://kellymom.com/hot-topics/milkproduction/
- Bonyata, Kelly, BS, IBCLC. “My breasts feel empty! Has my milk supply decreased?” Kellymom. https://kellymom.com/ages/older-infant/breast-fullness/
- Goldberg, Joanna. “Prolactin Level Test.” Healthline. https://www.healthline.com/health/prolactin
- Gotter, Anna. “Low Progesterone: Complications, Causes, and More.” Healthline. https://www.healthline.com/health/womens-health/low-progesterone
- Nall, Rachel, MSN, CRNA. “Labor and Delivery: Retained Placenta.” Healthline. https://www.healthline.com/health/pregnancy/complications-retained-placenta