If you are one of the few women who experience low milk supply, don't give up. With qualified help, you can generally boost your production—if not to 100 percent, then at least to a level that's beneficial for you and your baby. "Most women who are making some milk can be helped to make more milk," says Marasco. Depending on your circumstances, you might need to supplement with formula, she adds. But any amount of breast milk you give your baby is a tremendous benefit.
Every woman's situation is unique, and a skilled lactation consultant can work with you to develop a plan tailored to your particular needs. Typically, however, the first goal is to start expressing your milk via a breast pump, as frequent pumping helps build a woman's milk supply. (The pump can "fool" the breast into acting as if there's a hungry baby who needs more milk. What's more, a well-drained breast actually makes milk faster, while a breast that's less full makes milk more slowly.)
A lactation consultant will also come up with a personalized pumping plan for you and your baby. For example, notes Burger, "If a baby is very inefficient at feeding, it's usually better to practice nursing for brief, enjoyable periods rather than exhausting yourself with long, frustrating breastfeeding sessions. These shorter sessions allow a mom and baby to bond and learn new skills while enabling the mom to have enough time to pump."
Many lactation consultants also recommend galactagogues, herbs and prescription medications that can help increase milk production. (See "Milk Boosters" below) Before using any of these remedies, however, be sure to consult with an expert to make sure you receive a customized protocol and the proper dosage.
Of course, there's one more hurdle to overcome for women who experience low milk supply: the emotional one. It can be disappointing to give up the dream of breastfeeding exclusively if it turns out you need to supplement. But it's important to make peace with that—for you and your baby.
"You've got to change your attitude from mourning what you can't do to celebrating the amazing value of what you are able to give," says Diana West, I.B.C.L.C., a lactation consultant in private practice in Long Valley, N.J., and author of Defining Your Own Success: Breastfeeding After Breast Reduction Surgery (La Leche League International). "There's tremendous value in even just a drop of milk each day."
Milk Boosters The following herbs and medications, called galactagogues, have been found to be helpful for increasing milk production:
Blessed thistle This herb is widely considered beneficial for boosting milk supply, although some experts question its effectiveness.
Domperidone This prescription medication has an excellent reputation and is widely used in Canada and other countries. However, it's not commercially available in the United States;it can only be purchased from outside the country or from a pharmacy that will compound it.
Fennel This herb promotes milkletdown and increases supply.
Fenugreek This herbal favorite is available in tincture and tea forms. Some experts question the effectiveness of the tea form, however.
Goat's rue This herb is reputed to stimulate mammary gland growth, particularly helpful for women who've had breast surgery.
Metoclopramide This prescription medication has been linked to depression, a particular concern for women in the postpartum period. What's more, it can only be taken for three weeks; when it's discontinued, milk production returns to its previous level. For these reasons, many lactation experts hesitate to recommend it.
Shatavari This root shows a lot of potential. It has been used for centuries in India and China but only recently here.