How to Build a Strong Supply of Breast Milk

Unfortunately, mishandling primary engorgement can lead a mother to experience unnecessary pain and disappointment. Because of the misinformation that Marta received when she became engorged, she ended up losing her milk supply. Marta required general anesthesia during the cesarean section birth of her son Julio. When she woke up, Julio was already in the newborn nursery. Once they got together, Marta and Julio had difficulty breastfeeding. Over the next few days, their breastfeeding troubles continued, and Julio was given formula supplements. By her fourth day in the hospital, Marta’s breasts filled with milk and became very firm. However, Julio was still unable to breastfeed and therefore unable to receive Marta’s milk. Throughout her hospitalization, none of the doctors or nurses recommended that Marta pump her breasts. In fact, she was told to wear a tight bra and to avoid pumping for fear of worsening her engorgement and creating more breast milk. By the time she was discharged from the hospital, nearly six days after Julio’s birth, Marta’s breasts were soft, and her milk seemed to be going away.

Marta really wanted to breastfeed, but Julio was unable to attach, and she didn’t seem to have any milk. Once she was discharged from the hospital, Marta called and requested my help because she wasn’t sure what to do next. By the time I met Marta, she had passed through her natural period of primary engorgement without ever removing any milk from her breasts. The build-up of milk coupled with the lack of regular breast stimulation caused her to lose her milk supply. Marta’s body thought that she did not intend to breastfeed.

"How Can Pumping Help with Mishandled Engorgement?" In order to preserve her milk supply and help her through the engorgement phase, hospital staff should have advised Marta to use a double electric breast pump every three hours. Not only would regular pumping serve to lessen the symptoms of painful engorgement, but Julio could have been fed his mother’s pumped breast milk instead of formula. Sadly, Marta was incorrectly counseled that pumping during the early stages of engorgement would worsen her condition. This is simply not true. Early engorgement is hormonally driven, and pumping to relieve over engorgement will not worsen a mother’s condition. In Marta’s case, pumping would in fact have protected Marta’s milk supply until Julio could learn to breastfeed. Frequent breastfeeding or pumping in the days following birth awakens receptors sensitive to the hormone prolactin, a key player in the production of mature breast milk.

Marta’s story has a happy ending. Marta told me she still wanted to breastfeed Julio and was eager to do whatever was necessary to recapture her lost milk supply. Marta began using an electric breast pump every few hours. She refused to be discouraged when at first her efforts produced not even a drop of milk. In the meantime, Julio continued to be supplemented with formula. Slowly, Marta’s body began to respond, and she made measurable amounts of milk with each successive pumping. This motivated Marta to try a prescription medication to help restimulate her supply. Julio began breastfeeding, and, to my amazement, Marta went on to develop a very strong milk supply. (Learn more about balancing breast milk and formula.)