Hormones that Regulate Breast Milk
Prolactin is the essential hormone in lactation, and attempts to increase breast milk supply are largely centered on increasing the hormone prolactin. Prolactin stimulates milk production. The production and release of prolactin is dependent on slowing the release of prolactin inhibitor factor (PIF) from the hypothalamus. Dopamine (a neurotransmitter) stimulates the release of PIF.

Galactogogues are medications that are used to induce, augment, or maintain lactation. These pharmaceuticals (Metoclopramide, Domperidone, Sulpiride, Chlorpromazine) work to decrease the release of dopamine or block dopamine receptors. This action decreases prolactin inhibitor factor (PIF) secretion from the hypothalamus, allowing the production and release of prolactin to increase. All of these pharmaceuticals have side effects.[1]

Ways to Increase Breast Milk Production
Many herbs are reported to aid in lactation. Fenugreek and blessed thistle are mentioned more frequently than others which include milk thistle, fennel, alfalfa, oats, and marshmallow root.  How they work to stimulate milk production is not clear.  Although no published studies exist on the effectiveness of herbals, there are anecdotal reports of increased milk production with the use of fenugreek.[2] I used Herb Pharm's Mother's Lactation Tonic Compound while breastfeeding my three children, and found it consistently increased my milk supply.

Another way to increase the production and release of prolactin is nipple stimulation. Local factors within the mammary gland regulate the day-to-day milk volume, and these factors depend on milk removal. So, suckling (frequent nursing) and adequately emptying the breast of milk are vital to effective breast feeding. Using a supplemental feeding device worn at the breast that delivers formula (or stored breast milk) allows the baby to stay at the breast for all feedings, and increases the release of prolactin through nipple stimulation. Two popular devices are the SNS by Medela and the Lact-Aid Nursing Training System.

Some hormones (glucocorticoids, insulin, growth, and thyroid) indirectly influence breast milk production. Therefore, a mother with low milk supply should be checked for conditions with a hormonal etiology (e.g., hypothyroidism, diabetes, and/or obesity). Be aware of side-effects of the medications you consume. Some maternal medications (i.e., pseudoephedrine, progestin-only and/or estrogen containing birth control methods) can decrease your milk supply.[3]

Remember to take care of yourself as a mother. Eat REAL food and stay well hydrated by drinking plenty of filtered water.  Rest and find ways to relax (yeah, right!) - as stress can decrease your milk supply. Successful lactation is dependent on a supportive, nurturing external environment.
 

I recommend exclusive breast feeding for the first 6 months of life.  After 6 months, I recommend continued breast feeding (until at least 12 months) while introducing solid foods. Holding off on solid food introduction until at least 6 months of age allows the baby’s intestines to continue to grow and mature without the added burden of digesting solid food.

Formula Supplementation Options
If you are faced with making a choice between formulas for your baby, I recommend choosing an organic brand formula, free of genetically-modified ingredients, herbicides, pesticides, hormones and antibiotics. I often recommend Earth's Best Organic. Due to the isoflavins in soy that can disrupt hormones such as thyroid, I recommend dairy formula over soy formula. Not all infants will tolerate dairy formulas, and in such cases organic soy formula is an alternate solution. Goat’s milk formula is not available in the United States.

Breast feeding an infant is an amazing opportunity for a mother.  Sometimes it comes easy, and other times it can be quite challenging. Be sure to ask others for support. There are professional lactation consultants available to answer your questions and support your amazing effort. You can also contact La Leche League, an international organization to help mothers through mother-to-mother support, encouragement, information, and education about breast feeding. 
 

---

Susan McCreadie, MD is a Holistic Pediatrician and co-founder of nourishMD. She shows parents how to find REAL health for their child, so they can stop treating their child's symptoms and instead find solutions that help their child heal from the inside out.

Sources:

1. Bryant, C. Nursing the Adopted Infant. J Am Board Fam Med. 2006;19(4):374-9.
2. Taylor, C. (2010, February). Mother's Milk, How to Increase Your Supply. Dr. Jay Gordon. Retrieved January 3, 2012 from http://drjaygordon.com/breastfeeding/increasing-milk-supply.html
3. Hurst, N. Recognizing and Treating Delayed or Failed Lactogenesis II: Summary. Journal of Midwifery & Women's Health. 2007;52(6):588-594.