Breast Milk - Production

Production

Under the influence of the hormones prolactin and oxytocin, women produce milk after childbirth to feed the baby. The initial milk produced is referred to as colostrum, which is high in the immunoglobulin IgA, which coats the gastrointestinal tract. This helps to protect the newborn until its own immune system is functioning properly, and creates a mild laxative effect, expelling meconium and helping to prevent the build-up of bilirubin (a contributory factor in jaundice).

Actual inability to produce enough milk is rare, with studies showing that mothers from developing countries experiencing nutritional hardship still produce amounts of milk of similar quality to that of mothers in developed countries. There are many reasons a mother may not produce enough breast milk. Some of the most common are an improper latch (i.e., the baby does not connect efficiently with the nipple), not nursing or pumping enough to meet supply, certain medications (including estrogen-containing hormonal contraceptives), illness, and dehydration. A rarer reason is Sheehan's syndrome, also known as postpartum hypopituitarism, which is associated with prolactin deficiency: This syndrome may require hormone replacement.

The amount of milk produced depends on how often the mother is nursing and/or pumping; the more the mother nurses her baby, or pumps, the more milk is produced. It is very helpful to nurse on demand - to nurse when the baby wants to nurse rather than on a schedule. If pumping, it is helpful to have an electric high-grade pump so that all of the milk ducts are stimulated. Some mothers try to increase their milk supply in other ways - by taking the herb fenugreek, used for hundreds of years to increase supply ("Mother's Milk" teas contain fenugreek as well as other supply-increasing herbs); there are also prescription medications that can be used, such as Domperidone (off-label use) and Reglan, however the American Academy of Pediatrics considers Reglan a “drug whose effect on nursing infants is unknown but may be of concern." There are concerns over the use of Domperidone as well.