Switch Nursing: A Simple Practice to Support Milk Production

In between the google vortex of "is my baby getting enough milk?" and "why do I have low supply?" I want to provide you with one of the simplest things you can do to support breastfeeding right now. Enter: switch nursing.

One of the most effective methods to support and increase milk production is switch nursing. This technique encourages more frequent stimulation of the breasts, which increases the hormone prolactin, which is the "messenger" of milk-making. For many people, when prolactin is increased then supply is increased, or the higher level of what your body can produce is sustained. This post explores what switch nursing is, how it works, and practical tips to use it effectively during lactation.

A mother breastfeeds her baby in a softly lit room.

What Is Switch Nursing?

Switch nursing means offering both breasts to your baby during a single feeding session in accordance with baby's cues, and switching from one breast to the other multiple times. Instead of feeding from just one breast until the baby finishes or timing each side, the the feed alternates to opposite breast in response to infant behaviors: when suckling slows, the infant becomes more drowsy, or the infant turns away/becomes distracted.

How Switch Nursing Supports Milk Production

Milk production isn't just supply and demand, but we hear about supply and demand so often because the feedback loop of external action on prolactin is incredibly important to lactation. When the breasts are emptied and nipples stimulated, prolactin raises. Prolactin sends signals to your milk-making factories to speed up milk production, and this "faster" milk production results in higher milk yield for many people. Switch nursing helps in several ways:

• Increases stimulation: Frequent switching keeps the milk flowing and stimulates those increased prolactin signals which speed up milk production.

• More milk transferred: Especially with low supply, a baby may become fatigued or frustrated at the breast when nursing on one side is too long, and switching throughout a feed helps promote more milk transferred during active feeding.

• Encourages more engaged feeding: Switching at the first instance of suckling slowing or becoming drowsy is particularly helpful in increasing engagement in the feed and the physical body realignment helps to refocus your infant.

  
  

When to Use Switch Nursing

Switch nursing is especially helpful in these situations:

• Low milk supply: If milk production is low, switch nursing can help increase prolactin and efficient milk transfer.

• Cluster feeding: When babies feed frequently in short bursts, switch nursing can make feeding more efficient.

• Premature or sleepy babies: Babies who tire easily may benefit from switching breasts to encourage more sucking.

  
  

How to Practice Switch Nursing Effectively

Here are practical steps to follow when using switch nursing:

1. Start feeding on one breast: Let your baby nurse actively until the sucking slows down, which could be as soon as 3-5 minutes.

2. Switch to the other breast: Offer the second breast imediately.

3. Repeat the process: Continue switching back and forth several times during the feeding session as soon as suckling slows, your infant becomes drowsy or distracted.

4. Watch for hunger cues: This will depend on your individual milk supply, but remember that more than hunger cues- satiety cues are really informative. Hungry babies have clenched fists and babies that are satiated have relaxed limbs and their fists settle to open palms.

5. Avoid forcing: If your baby resists switching, try gently burping or soothing before offering the other breast. As with all nursing, a no-pressure approach works best and if you find switch nursing challenging, please reach out for help.

   
   

Tips to Maximize the Benefits of Switch Nursing

• Create comfort: Find a comfortable spot and grab a yummy drink or snack. Opt for more reclined positioning and explore football and cross cradle holds.

• Use breast compression: Gently(!) compress your breast during feeding to help milk flow and encourage sucking.

• Feed on demand: Respond to your baby’s hunger cues rather than sticking to a strict schedule.

• Consider hand-expression to help guide you: With low supply, it can be difficult to ascertain exactly when the breasts might be empty. It can be helpful for some to attempt to hand-express milk when the question of "are we done?" arises. When the breasts are sufficiently emptied, hand expression will either yield no milk or will yield 1-2 single, short sprays followed by small milk beading at the surface of the nipple.

  
  

Common Concerns and How to Address Them

• Baby refuses to switch: Most babies will happily switch nurse, but this practice ca be more difficult with infants who have significant body tension (including torticollis) or reflux.

• Breast discomfort: If switching causes soreness, it's worth exploring latch and oral function with a specialist (me!).

• More effort: Switch nursing can feel more involved with the hot-potato nature of the practice, but it ultimately speeds up the feeding process in how it promotes more engaged and effective milk transfer.

• Foremilk/hundmilk imbalance: Unless a person is making more milk than their baby requires (oversupply), there is no concern of foremilk/hindmilk (aka lactose overload). So long as both breasts are adequately being emptied, milk composition is perfectly suited to your infant.