There are many reasons parents might experience a bump in their planned breastfeeding road and have to supplement with donor milk or formula. Before eliminating formula or donor milk, you need to increase your milk supply to provide the appropriate amount of milk to your baby while reducing or stopping supplement feedings. You have lots of options for increasing milk production. You may find one strategy works better than another or a combination of strategies to be effective

Exclusive breastfeeding is recommended for the first 6 months of a baby's life and continued breastfeeding for two years, adding complementary foods after 6 months. The World Health Organization and the American of Pediatrics further say breastfeeding should continue beyond two years and as long as mutually desired. (1) 

Identify what contributed to the need to introduce formula or donor milk. The answer will often help you plan the best way to increase your milk supply. Milk supply can decrease because of issues on the mom’s, baby’s, or both sides.

If your baby had latching difficulties and could not remove milk well, causing a decrease in your supply, get in touch with an International Board Certified Lactation Consultant (IBCLC) who can help your baby improve their feeding skills. As you increase your supply, if your baby cannot effectively remove milk because of unresolved latch and feeding challenges, milk production may decrease again despite your hard work.

Hormones drive the milk supply after your baby is born. In the first few weeks postpartum, every time your baby nurses, it gives information to the body about how much milk needs to continue to be made for your little one. Milk supply is regulated based on that feedback, and milk production follows the rules of demand dictating supply.

• Nurse more - offering to nurse more often will keep prolactin levels higher because each time your baby removes milk, it tells the body to make more milk. You will still need to continue supplementing until your supply increases and you can safely start to reduce the amount of formula being given and replace it with nursing sessions. Using a tool like a supplemental nursing system ensures your baby will get the amount of food they need, but every feeding is at the breast, which means more stimulation for increasing milk production.
• Skin-to-skin - being skin-to-skin with your baby positively contributes to boosting your supply. Oxytocin is known as the love and bonding hormone and is responsible for milk release. Oxytocin is released during skin-to-skin contact, warmth, and as soon as your baby begins to suck while breastfeeding. In fact, even just thinking about your baby or smelling your baby's scent on their blanket can release oxytocin and trigger the milk ejection reflex. (2) When oxytocin is released, it causes the myoepithelial cells in the breast to contract and squeeze milk from the alveoli into the ducts and toward the nipple. (3)
• Wear your baby - Wearing your baby in a sling facilitates bonding with your baby, and babies who are worn cry less and regulate easier when they are held close to your body. It is shown that babywearing increases the amount of time a baby nurses, which can help improve and maintain milk supply and lead to longer total breastfeeding durations. (4)
• Nursing holiday - Take a “vacation” with your baby. Spend the entire day or a weekend in bed, primarily skin-to-skin, relaxing and nursing your baby. Nurse, rest, and nourish your body with nutrient-dense food, and repeat. 
• Middle of the night - It is biologically normal for babies to nurse during the night. 

The hormone prolactin, responsible for making breast milk, is naturally highest during the night between 2-5 am. 

When you sleep with your baby in contact with you, you and your baby may wake more to feed, naturally responding to each other. (5) Safe co-sleeping parents and babies wake up more often during the night but get more quality sleep. (6) Babies get about 20% of their calories from milk during the night. 

• Flange size and pump parts - The right tools to get the most milk are important. The correct flange size will make pumping more comfortable and remove more milk. Follow the recommendations for replacing pump parts to ensure they are all in their best working order.
• Massage your breasts and chest area before you begin to pump - Prepare your breasts by gently stroking or massaging. Moving the tissue around gets milk moving and ready to flow more easily. Touch should be gentle and as soft as you would stroke your baby’s face. Oxytocin is released during touch, so you may start to leak a little milk as your supply increases. Breast massage can help manage any stuck milk and help increase your overall supply. (7)
• Heat - Using a heat pack, like the Breast-Ease from Legendairy Milk, encourages milk output and the milk ejection reflex or let down. (8) Apply heat before and during your pumping session. Breast-Ease makes it easy because it fits comfortably around your breast and will not interfere with where the pump is placed. It can fit inside your bra to be held there for the entire pumping session.
• Breast compressions - using your hands during pumping to compress your breast tissue can help move milk through the ducts. You will get more milk out with this hands-on technique. 
• Hand express at the end of each pump session - Ending with hand expression removes more milk and can boost your production. Many people respond better to hand expression than pumping alone, and it is a valuable skill for all lactating parents to know.
• Power pump - Replace or add one hour of simulating “cluster feeding” with your pump. Power pumping is a method of alternating pumping and resting for a total of one hour. You can experiment to find intervals of time that work best for you or follow a pattern of pumping for 10 minutes, rest for 10 minutes, and repeat until you have reached a total time of one hour. By resting in between and then beginning to pump, you stimulate your milk ejection reflex more often and signal prolactin. Some people notice results from power pumping in just a couple of days, while others do not see results for closer to a week. 
• Increase the total number of pumping sessions - Add another pumping session to your day or overnight. Most people need a minimum of 8-10 milk removals every 24 hours to maintain their milk supply. If you are trying to increase your supply, pumping more frequently and during the middle of the night sends the message that your baby is taking more milk, and the demand for more milk will trigger more milk production.
• Middle of the night - Going too long between milk being removed will slow down milk production. Prolactin’s circadian rhythm follows a pattern of being highest during the night and early morning hours and lower later in the day. Going too long at night between milk removals signals to slow down production and affects your next day's supply. Find ways that you can pump your milk during the night and still get your rest. Setting up a nighttime pump station with everything you need beside you will make those sessions less disruptive.

• Galactagogues - There are many foods and herbs that support lactation and milk supply. Include a variety of whole foods in your diet, and avoid processed foods. Some foods that help boost nutrition and increase milk supply include leafy green vegetables, oats, raw nuts and seeds, seaweed, chia seeds, beans, and lentils. 
• Avoid pacifiers - Instead of using a pacifier, let your baby nurse every time they want to suck, including for comfort. Every time your baby removes milk, it signals more milk to fill the cells. Using pacifiers interferes with the number of times a baby breastfeeds. It is normal for babies to nurse for some shorter periods during the day and other times for a longer, full feeding. Breastfeeding meets the need for calories, but it is about much more than just calories, including comfort, helping a baby to fall asleep and secure attachment, so it makes sense that they may ask to nurse many times day and night.
• Lactation supplements - herbs and herb blends are a great way to help increase your milk supply as you address underlying issues and make dietary changes that support overall health. Choosing the supplement you use will depend on your unique health history. 
• Find a local or online support group to connect with others. It always feels good to share experiences with others in the same situation, talk about what is working and what is not, and know you are not alone in this journey.

Some herbs like fennel and anise can help improve digestive health. Your gut health can impact the regulation of hormones and your milk supply.

Find Anise and Fennel in:

• Lechita
• Liquid Gold

Moringa and nettles are nutritional powerhouses and can improve vitamin and mineral status, enrich your milk, and aid recovery from birth.

Find Moringa and Nettles in:

• Milkapalooza
• Cash Cow

Black cumin seed can increase insulin sensitivity and breast milk refill rate. It may be helpful for people who have thyroid imbalance or a history of PCOS.

Find Black Seed in:

• Pump Princess

Remember, moms, take a deep breath and remember you're doing an incredible job! Increasing your milk supply is possible with the right strategies and support. Reach out to a lactation consultant for guidance if your baby has latching difficulties, and remember that nursing more frequently and practicing skin-to-skin contact can work wonders. Remember to take care of yourself, too. Tools like wearing your baby, enjoying a nursing holiday, and prioritizing rest can assist you in achieving your milk-increasing goals. Consider using lactation supplements like Legendairy Milk's various herb blends to support your milk production further. You're not alone in this journey, so connect with local or online support groups for encouragement and advice. Trust your instincts and believe in your ability to nourish and love your little one.

1. https://www.bfmed.org/assets/DOCUMENTS/abm-position-breastfeeding.pdf
2. https://www.ncbi.nlm.nih.gov/books/NBK148970/#:~:text=The%20oxytocin%20reflex%20is%20also,to%20get%20the%20milk%20easily.
3. https://www.infantjournal.co.uk/pdf/inf_054_ers.pdf
4. https://pubmed.ncbi.nlm.nih.gov/22734604/
5. https://cosleeping.nd.edu/assets/135560/emph_2014_mckenna_nightwaking_copy.pdf
6. https://www.ingentaconnect.com/content/springer/clac/2011/00000002/00000002/art00007
7. https://pubmed.ncbi.nlm.nih.gov/31135656/
8. https://www.researchgate.net/publication/221712891_Does_Warming_the_Breasts_Affect_the_Amount_of_Breastmilk_Production

https://www.legendairymilk.com/blogs/news/power-pumping?_pos=1&_sid=aff74b0e4&_ss=r

https://www.legendairymilk.com/blogs/news/feher-pumping-challenge?_pos=2&_sid=aff74b0e4&_ss=r

https://www.legendairymilk.com/blogs/news/how-to-use-breast-ease-for-heat-cold-therapy?_pos=2&_sid=767977ab2&_ss=r