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Expert Q&A

	By Mary Kay Smith IBCLC, Lactation Consultant

I have a 10-week-old baby, my second. I breastfed my first baby for 13 months. With this baby, as with my first, at my last feeding of the night I don't always have enough milk, which then means the baby is still hungry and wakes up sooner than she should because she didn't get a full tummy. I pump some extra milk in the morning and tried to feed it to her after nursing, but she refuses the bottle from me or her dad or grandma. How can I get some extra milk in her on the evenings when my milk is low? And how can I get my milk supply increased? I started pumping for a couple minutes after my morning feeding, I drink plenty of water, eat well, take fenugreek capsules. I don't know how else to increase my supply. Any ideas would be certainly welcome!

It would be helpful to know how often you nurse and how long the baby is at the breast for each feeding. Are you working? How many times per day are you feeding/pumping?

Occasionally a mother interprets fussiness at the breast as lack of milk when it can actually be another problem. One is that baby is getting lots of foremilk; the first milk that the breast makes which is high in lactose and can cause symptoms of gassiness and fussiness. Occasionally a baby will desire a really long feeding at the end of the day, and that is when the fatty hindmilk makes him or her feel full and sleepy.

Fenugreek can be an effective galactagogue when taken appropriately. The recommended dose is three capsules three times a day. I would also try to pump at other times of the day rather than first thing in the morning. Rest assured that pumping after baby has been asleep for an hour or more will not ""take away"" any milk from the next feeding.

Remember that the breast is a gland and will respond to stimulation by producing more milk. I am concerned though, about the statement that this happened with a previous baby. Have you ever had breast surgery or an injury to the breasts? An assessment by a knowledgeable lactation consultant can be very helpful in this case.

Read more about increasing milk supply in How can you tell if your milk supply is low and increase it if necessary? and Will Fenugreek increase my milk supply?"

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