FREQUENT and EFFECTIVE breastmilk removal is the key to milk supply. Plain and simple. Whether this is through nursing, pumping, or a combination of both.
Research shows us that there are a few reasons for this:
- Removing milk often (emptying your breasts) sends signals to your brain saying, “Hey! Baby is hungry and needs more milk!”
- FIL is short for “Feedback Inhibitor of Lactation”.
Let’s go over these.
Removing Milk Often and Effectively:
This means that if you’re nursing (directly latching your baby), your baby is completely emptying your breasts via a good latch and effective nursing.
If you’re pumping, this means that your pump is fully emptying your breasts via well-fitting flanges, using your settings to your advantages (highest comforatable suction, using letdown and expression modes), pump parts have been replaced and are in good shape so they are able to create the best suction possible to remove milk from your breasts, and you’re pumping to get about 2-3 letdowns per pumping session.
By removing milk effectively and often, this is sending signals to the brain that releases prolactin (the milk-making hormone). Prolactin is released in response to this “ask” from our pump/baby and in turn leads to more milk synthesis.
What does “often” mean? This means you’re either nursing and/or pumping 8-12 times in a 24 hour period.
FIL (Feedback Inhibitor of Lactation):
FIL is a polypeptide that’s in breastmilk. When breasts are full, FIL collects in your breasts and milk production slows.
When breasts are full, FIL collects/increases and milk production slows.
When breasts are empty, FIL is removed/decreases and milk production increases.
FIL is actually present helps to protect the breast from harmful effects of being too full (like clogged ducts mastitis). If breast milk is removed by pumping or nursing the inhibitor is also removed, and secretion of milk resumes
Sometimes one breast stops making milk while the other breast continues making milk, for example if a baby suckles only on one side. This is because of the local control of milk production within each breast is independent. FIL can collect in just one side if only one side is being emptied properly and often.
So this helps to explain why your baby or pump determines how much milk you will make.
Empty breasts also means increased fat content in milk. Research shows that the emptier the breasts, the higher the fat content.
I want to talk about storage capacity for a minute because this is another factor in milk production and can affect supply.
Storage capacity is how much milk your breasts can store between feedings. Whether your have a large or small storage capacity, you can still feed your baby adequately, but smaller capacity mamas may need to work harder. ⠀
For example: a woman who has a storage capacity of 3 oz vs. a woman with a storage capacity of 6 oz: the woman with the smaller storage capacity will have to nurse or pump more often (the baby will get the same amount of milk throughout the day, just with more frequent feeds).⠀
- Why is it important to empty your breasts often (especially with low storage capacity)? Shortly after birth, milk production is driven locally at the breast. (Meaning the filling and emptying drive production).
- When breasts are empty, prolactin is signaled to enter and bind to the receptors and that stimulates milk to be made. When breasts are full, that receptor is blocked and milk production stops. ⠀
- If you have a high storage capacity, your breasts fill up more slowly and you don’t need to nurse/pump as often to maintain supply. ⠀
That is why there’s a wide variation:⠀
- Some women don’t lose their supply when baby starts sleeping through the night⠀
- Some women need to nurse their baby or pump throughout the night to maintain supply. -Some women only need to pump 1-2 times while at work and others need to pump 3-4 times to maintain supply.⠀
So all this is to say, if you have a low storage capacity, that DOES NOT mean you can’t feed your baby. It means you may have to work a lot harder at it (which sucks, yes). ⠀
I think it helps to know the “why” behind what makes some breastfeeding experiences different because it’s hard not to compare to other women but a lot of the time it comes down to your anatomy and biology. ⠀
Also, studies have shown that your breast size has little to do with how much milk you’ll produce. So if you’re pregnant and worried because you’re part of the itty bitty titty club (me!) you won’t have any idea until you start breastfeeding. Again it comes down to STORAGE CAPACITY. Breast size is just the amount of fatty tissue you have. ⠀
But if I’m always removing milk, what if my baby gets hungry and there is no milk? Your breasts are ALWAYS making milk and they are never “truly” empty because of this. So as your baby is nursing, your breasts are making milk and it’s sending signals to your brain to continue making milk.
How to increase supply:
After reading all this, okay, but how do I increase my supply??
- Add in a pumping session. If baby did not totally empty your breasts, then pump right after your feed so you can totally empty your breasts.
- If baby did empty you and you’re trying to increase supply, you can pump between feeds. This is ensuring breasts are staying as empty as possible which is the ultimate goal. Even if you don’t get any milk, you are STILL sending signals to your brain to produce more and this will in turn (maybe not immediately) lead to more milk.
- Nurse more often: Don’t schedule your feeds. Feed baby when they are hungry and put them to breast more often so they are stimulating your breasts more.
- Utilize breast massage and breast compression.
- Have baby nurse on both sides BUT have them completely empty one side first then offer the other side. This is like the “dinner and dester” idea: Breast A is dinner, then you can offer desert. Then on the next feed, switch breasts, so Breast B will be dinner and A will be desert. Completly emptying that first breast will send signals to increase prolactin and FIL is decreased leading to increased milk production.
- Power pump: Add in a power pump once a day. This mimics cluster feeding and is great to drive suopply up (Put visual). You may not notice a huge increase right away but over time, if you’re consistenyl doing this once a day for a week, you should see an increase.
I hope this helps you understand how milk production works and how emptying your breasts effectively and often can increase milk production. It’s so important to understand how this all works to really understand WHY you’re doing it! You can take all of the lactation teas, supplements, eat all of the oatmeal and it won’t make any difference if you’re not emptying your breasts often and thoroughly!
- Cox DB, Owens RA, Hartmann PE. Blood and milk prolactin and the rate of milk synthesis in women. Exp Physiol. 1996 Nov;81(6):1007-20
- Cox DB, Owens RA, Hartmann PE. Studies on Human Lactation: The Development of the Computerized Breast Measurement System. June 1998. Accessed May 28, 2004.
- Hartmann PE, Prosser CG. Physiological basis of longitudinal changes in human milk yield and composition. Fed Proc. 1984 Jun; 43(9): 2448-53.
- Mohrbacher N. Breastfeeding Answers Made Simple. First Edition. Amarillo, Texas: Hale Publishing; 2010. 390-401.
- Neville MC. Anatomy and physiology of lactation. Pediatr Clin North Am. 2001 Feb; 48(1): 13-34.
- Peaker M, Wilde CJ. Feedback control of milk secretion from milk. J Mammary Gland Biol Neoplasia. 1996 Jul;1(3):307-15.