I had to get medical therapy to increase my milk supply for twins. Fenugreek was prescribed and it made a huge difference. Based on what the doctor told me you can try the following if you have twins or simply need to increase your milk supply:
* Fenugreek is very helpful, 2 capsules three times a day with meals, eventually working your way up to 4 capsules per meal. The body gets used to it after a while so the doctor suggested going off it for a couple of days and restarting.
* Nurse 8-12x a day, putting each baby to breast until they empty it (do not time it) the baby is much more effective than the pump at drawing the milk out than even a hospital pump, and will help increase your supply. In effect, interrupting the feeding could be counterproductive.
* You can decrease the # of sessions if the amount pumped is more than 1000 ml/ 24 hrs (try pumping instead of nursing for one day to measure). You can also try weighing the baby to calculate intake, using a baby scale in grams (same as mls for calculating). Note this will be a rough estimate as the baby may be getting more milk than the pump and some women are unable to pump much even if they can nurse well.
* Alternate sides for the babies, as one may have a stronger suck. It's possible one side will have a lot more milk than another. How you hold the baby also affects supply if you're right handed that side will hold the baby more firmly and they may nurse longer and increase supply more on that side. All normal.
* After breastfeeding the baby, pump but only for 5 minutes or so to increase demand on your body and thus milk production. Frequency is much more important than duration. Pumping for 20 min has little effect according to the doctor (I know, "now I find out?!" that's what I said)
* If you have twins, read the book Mothering Multiples: Breastfeeding and Caring for Twins or More! (La Leche League International Book) by Karen Kerkhoff Gromada. I wish I had read this early on. It provides solid advice on breastfeeding multiples plus a whole lot more up to 2 yrs of age.
* Try to eat well and sleep at least 6 hrs. Your milk production is directly related to your health and stress levels.
* If you're able to breastfeed exclusively great but if you can't don't beat yourself up over it it's Ok to supplement (we used Enfacare as my babies were low weight, then Enfamil Premium for one and Alimentum for our other). You have a lot on your hands to worry about.
* Don't try to do all feedings alone, you'll go crazy. Have your hubby do the last feeding of the night 10 or 11 pm and the early morning one (6 or 7 am) you do the ones in between. This way, you'll each get a solid chunk of sleep. The one who's not "on shift" stays in the quiet bedroom without a monitor but with a cell phone. We had an extra bed in the nursery so it would be easier to nurse the babies if I needed help (two babies crying at the same time or you're too tired) I'd call my hubby on the cell phone, but this rarely happens if you stage feedings (always feed twin A first for example). My hubby comes in at 6 am or whenever and quietly feeds the babies before they wake up so I can sleep until 8 or so.
* I kept my energy and supply up with Ensure Plus Vanilla and oatmeal.
* Google "manual expression Stanford University", the video shows how to increase your milk supply significantly using manual expression. It works better than any other method even if it feels unusual.
* If you do supplement and trying to increase breastfeeding, don't stop bottle feeding cold turkey (you may not have enough milk supply as supplementing may lower supply). Continue to supplement and give 1 oz or so BEFORE starting to nurse. The reason for this is that bottlefed babies are used to a faster flow and ready supply, with nursing it takes longer for the milk to let down. Giving the bottle-fed baby some formula before nursing will take the edge off his hunger and keep him from "chomping away at the bit" if you will in other words it will calm him down and make the nursing experience more relaxing for mom & baby and allow baby to nurse longer.
* Try a brief warm shower or use warm compresses (try putting warm water in a diaper) before nursing to stimulate milk let down.
* Keep your eyes off the clock. Another reason to not interrupt or time breast feeding the hind milk that lets down after the baby has been nursing a while is richer and higher in fat, more satisfying for the baby. If you stop after "X" minutes you may not get the hind milk.
* Continue nursing 8-12x a day don't wait too long before feedings (4+ hrs), any sign of engorgement is letting your body know there's less demand and will reduce milk production. Nursing every 2-3 hours is better, allow a stretch of 4 hours early in your sleeping cycle to feel better rested (have your hubby feed baby late at night).
* Pump for a few minutes each time you nurse to simulate increased demand and boost milk production. Manual milk expression and fenugreek will also help and over time you'll need to supplement less as your milk production increases.
* Don't do marathon pumping. As soon as you start feeling stressed or find yourself wondering how many ounces you've pumping, etc. you're overthinking things and this will affect your milk supply. Stop for a few minutes and go do something else. Then pump a little more. You can leave it out at room temperature while you do this mark the time you started & date on tape w/ a Sharpie pen to be safe. If you wait 15-30 min or so, it counts as an additional pumping session (if you're trying to fit more in).
* Pumping is not always a good indicator of your real milk supply (some women may not be able to pump much but nurse well) a baby scale is the most accurate measurement if you really want to know (don't stress this too much, just nurse until baby seems full).
* Feed on demand and expect cluster feeding (every 1-2 hrs) at the witching hour and just before a growth spurt.
* For me at least I always had to supplement with twins because I never had enough milk for two. I did see a huge increase in my milk supply from very little to being able to nurse one baby full time for a while. Fenugreek was a HUGE help.
Lastly, this tip from a sleep doctor to handle sleep deprivation log how many hours total you slept at night (even if interrupted), find the midway point and add 12 hours. Try to take a 30-60 minute nap then, this is your natural down-time according to your inner clock and will be much better than trying to catch up on sleep on the weekends (example slept 12am -6 am, midway point is 3 am add 12 hrs try to nap @ 3 pm.) Keep a log of how long you sleep each time always try to get at least 6 hrs.
With Fenugreek, enough sleep, a good diet and the tips above, your milk supply should increase.
*** UPDATE 12/27/12 another reviewer has found that Fenugreek can trigger an allergic reaction in anyone allergic to peanuts, as they are in the same family. Please see comments section for links to study. (Thank you G. Jager for this important info). This is not commonly known and was never mentioned to me by any doctor.
My mom takes fenugreek seed daily to control her blood sugar level. It works well and she has been able to reduce her dosage of Glucophage.
The use of fenugreek for treating diabetes has been scientifically validated (you can read abstracts by doing a keyword search on www.pubmed.gov ).
My mom gets it from the Indian grocer where it is much cheaper, though loose and not encapsulated.
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Fenugreek has been so typecast as a way to facilitate lactation that most guys would never dare to think of it for themselves--much less actually try it. The fact that it contains phyto-estrogens just complicates things further if you're concerned about testosterone levels. But sometimes things that look a bit crazy seem to work out well in unexpected ways.
I started using fenugreek a year ago, discontinued it because of the testosterone concerns, and recently restarted it to help moderate anxiety symptoms from a choline-related medication I had just started. Since fenugreek's action appears analogous in many ways to oxytocin (a hormone closely related to empathy and the mitigation of fear/anxiety responses), I thought it might help to defuse these reactions. It was at least worth a shot.
It does seem to have helped with the anxiety reactions (I combined it with l-glutamine for those who are really interested). What surprised me completely was the very strong boost in libido that I experienced inside of three days. And when I went back and doublechecked the research on fenugreek, I found that a mid-2011 report by Australian researchers showed a 25 percent increase in male libido for those using fenugreek. So objective research says this effect of fenugreek is real. Subjectively, I know that this supplement is way more effective for me than things like saw palmetto that are commonly marketed for libido boosts.
And I wasn't even looking for this effect. But it works, and this is one of those side-effects that's a keeper. Beyond this, fenugreek is commonly used around the world by both sexes to help with type 2 diabetes. It appears to help with blood-sugar levels, but I can't say definitively that it works. It's inexpensive enough to be worth trying.
My hoped-for long-term use for fenugreek is actually to help with what Buddhists call metta meditation, that is, focusing on lovingkindness. Research by the Center for Affective Neuroscience at the University of Wisconsin suggests that expert meditators on lovingkindness modulate the functioning of the amygdala, a component of the brain that helps to establish empathic reactions and, once again, is closely associated with oxytocin. My experience so far is that fenugreek does in fact help with empathy. This makes eminent sense. Lactation and mother-child bonding pretty much go hand in hand.
If you're interested in the underlying neurophysiology, you can probably do a much better job than me in researching this. If you're just a guy who could use a shot in the arm for lovemaking, then this is a worthwhile supplement even if we can't figure out all the physiology involved. Even if none of the above effects interests you, fenugreek is used for and may help with many other things, such as digestion (see Wikipedia for more information on such uses).
I hope some of this proves helpful.
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My milk supply began to decrease significantly after I started back to work (my son was about six month's old at this time). I took -and still take, 3 tablets of fenugreek and blessed thistle each per day at least twice a day. If I am not able to pump, I add another round of the herbs and let my son nurse more, to keep my milk supply going strong. This is a wonderful blessing to know that my milk supply can easily be reestablished, if stress, schedule or other factors inhibit our desire to feed the old fashion way! Five stars for fenugreek (and blessed thistle, too!) As a side note, the lactation nurses have told me, that these herbs do lower your blood sugar, so they should be taken with food. I say that from experience. All in all, it more than met my expectations.
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I was taking Fenugreek along with Alfalfa and mothers milk tea for months to increase my supply and I the combo had. Then my baby became very gassy and making our lives miserable. I suspected everything from my food to the supplements. I tried cutting different foods then reintroducing them and no change. Finally I decidedvto read up in the supplements and found that in 20% of babies Fenugreek causes gas and/or fussiness.
So the next day I stopped taking it. Now 1 week has passed and not only has my baby's gassiness gone away I oddly feel that I have more milk.
I'm sure this works for some so can't say it's bad. Just be aware that this can happen.
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