Breast milk is created on a supply and demand basis. The more you nurse or pump, the more breast milk your body tends to produce. However, this isn't the case for everyone. Some moms have medical conditions that require the use of a medication to help them produce more milk. If your supply isn't meeting your baby's needs, you are likely wondering, should I take medication to increase my milk supply?
Before you start looking into galactagogues – herbal or prescription substances that increase your milk supply – you should first determine whether or not you truly have an inadequate supply. According to lactation consultant Diana Cassar-Uhl of Kelly Mom, few moms actually have low supply even if they think they aren't producing enough milk. Perceived low milk production is when a mom who is actually producing enough milk for her baby believes she has low supply, because she misreads normal newborn behaviors as hunger or dissatisfaction at the breast.
The amount you pump is also not an indication of how much milk your body produces, according to Jennie Rae Lanziero, Certified Lactation Counselor for the Florida Department of Health and the Pasco Hernando Breastfeeding Task Force. In a recent interview, Lanziero tells me that a baby with a good latch is able to remove more milk than a pump can. Just because you don't pump lots of extra milk doesn't mean that your baby is staying hungry. One good way to determine if a baby is getting enough milk is to look at their diapers. A well-fed baby should have four to six wet diapers a day, according to Dr. Sears.
If you still feel as though you aren't producing enough milk, talk to a certified lactation consultant who can help you figure out if your supply issues can be alleviated by making adjustments to the way your nurse. In the meantime, Kelly Mom suggested keeping in close contact with your pediatrician to make sure your baby is being adequately nourished and doesn't have a medical condition that is causing him to struggle with breastfeeding.
If you don't notice an increase in your milk supply after working with a lactation consultant, you should talk to your doctor about checking your prolactin levels. Women with low prolactin levels may be prescribed metoclopramide (Reglan), according to Kelly Mom. Dr. Sears noted that metoclopramide is generally safe for babies, however, it can cause side effects on moms such as seizures, anxiety, diarrhea, depression, headaches, restlessness, and fatigue. Because of this, it's not a right fit for some moms. Additionally, Kelly Mom warned that metoclopramide may not work in all women with low prolactin levels and shouldn't be used by women whose levels are normal or high. Women who have a history of depression should not take metoclopramide, and should talk to their doctor about taking herbal galactagogues instead.