Low Breast Milk Supply? What Causes It and How to Increase It
Producing enough breast milk is a big concern among many new mothers. While about 75 percent of new mothers in the U.S. now start out breastfeeding, the rates of breastfeeding at 6 and 12 months as well as rates of exclusive breastfeeding at 3 and 6 months remain far lower, according to the Centers for Disease Control (CDC). One of the most common concerns among these parents is anxiety about an inadequate breast milk supply.
For many women, the body produces plenty of milk (even if you don’t realize it), and there are ways to tell if your baby is getting enough to eat. Sometimes, however, this isn’t the case. Low breast milk supply can be caused by a number of factors, but fortunately, there are effective several ways to increase production.
How to Know if Your Baby Is Getting Enough to Eat
There are two ways to tell whether you have a potential problem with your milk supply.
- Track wet and dirty diapers. Newborns should produce two wet diapers over 24 hours by the second day after birth, and six or more wet diapers after Day 5. If you’re seeing fewer, contact your pediatrician or a local La Leche League Leader.
- Monitor weight gain. Most babies lose a little weight immediately after birth but typically regain it a couple of weeks later, averaging about 5 to 7 ounces per week. Keep all well-check appointments with your pediatrician to track your baby’s progress.
Potential Causes of Low Breast Milk Supply
Although many women worry about low milk supply, insufficient breast milk production is rare. In fact, most women make one-third more breast milk than their babies typically drink. There are a number of reasons that may contribute to a decrease in milk production.
Supplementing
Many parents begin to supplement with formula because they are concerned that they’re not making enough breast milk to rely exclusively on nursing. La Leche League (LLL) recommends parents who want to continue breastfeeding be aware of and avoid the supplementing cycle. If you want to exclusively nurse, LLL advises parents to pump or hand express to replace any missed nursing sessions.
Rigid routines
While predictable schedules are helpful for many things in life, they aren’t always the best at accommodating the needs of a nursing baby. LLL advises parents to watch for their infant’s hunger cues and feed their baby on demand – “watch the baby, not the clock.” This allows breastfeeding to become well-established from the onset. While parents with ample milk may nurse on a schedule without any issues, those who are struggling with a low milk supply may see a further decrease in production when attempting to follow a strict schedule.
A sleepy baby
You’ve probably heard you should never wake up sleeping baby. It’s mostly good advice – except when it comes to breastfeeding. Some newborns sleep for long stretches at a time (more than 3 or 4 hours), skipping much-need nursing sessions. Breast milk production works on a supply-and-demand basis. Going for long time periods without nursing will cause your body to decrease milk production. Until your baby has regained their birth weight and nursing has been well-established, wake them up to eat.
Block feeding
Once your milk supply is well-established, it’s fine to offer only one breast per feeding session. This is called block feeding. However, if you’re concerned about your baby’s weight gain or you’re trying to improve your supply, feed your baby from both breasts during each nursing session.
Medical issues with the baby
Certain health or anatomical issues with your infant, such as tongue or lip ties, low muscle tone, or uncoordinated sucking, may cause them to nurse inefficiently, thus creating a decreased milk supply.
Medical issues with the nursing parent
There are a number of other issues that can impact milk production, including:
- premature birth
- pregnancy-induced hypertension
- maternal obesity
- poorly controlled insulin-dependent diabetes
- use of certain medications, including hormonal birth control and pseudoephedrine
- retained placenta
- postpartum hemorrhage
- anemia
- hypothyroidism
- breast reduction or augmentation surgery
- breast injury
- hormonal conditions, including PCOS
- hypoplasia and insufficient glandular tissue (IGT)
Medela Nipple Shields can be an effective tool for professionals and moms to manage infants with latch-on problems, for moms with overactive let-downs or for flat, inverted and sore nipples. Medela Nipple Shields enable continued breastfeeding without interruption until these problems are resolved.
How to Increase Low Breast Milk Supply
Again, breast milk production works on a supply-and-demand basis. If you need to increase your milk supply and speed up production, the key is to remove more milk from the breast more frequently.
Ensure your baby is nursing efficiently
If all of the milk is not consistently removed from the breast at each breastfeeding session, the milk supply will decrease. An incorrect latch, a tired baby, certain anatomical issues, and even using nipple shields can all interfere with a baby’s ability to efficiently remove the milk. Make sure your baby is latched on and positioned well. Look for signs that your baby is swallowing.
Nurse often
Breastfeed your baby for as long as they want to actively suck. Keep in mind, in order to increase production, the goal is to remove more milk more frequently. For the first few weeks, breastfeed at least eight to 12 times a day or about every two to three hours.
Offer both sides at each feeding
Let your baby finish one side first, then offer the second side. This technique also helps wake a sleepy nurser. For the next breastfeeding session, begin on the opposite breast.
Consider pumping
Adding pumping sessions after or between nursing sessions can be very helpful, especially if your little one isn’t nursing efficiently or often enough. Again, when trying to increase your milk supply, the goal with pumping is to remove more milk from the breasts more frequently. To ensure that the pump removes the most amount of milk possible from each breast, continue pumping for 2 to 5 minutes after the last drops of milk.
Don't bypass nursing sessions
Pump your breasts each time you miss a nursing session to help protect your milk supply.
Take care of yourself
Eating healthful foods and drinking plenty of water are extremely important to breast milk production. Rest. Sleep when the baby sleeps. Relax.
The Medela Swing Breast Pump is an occasional use breast pump for lactating women to express and collect milk from their breasts to complement breastfeeding and is a single-user product. Perfect for quick, efficient expression whenever you need it. Ideal for breastfeeding mums who want to share feeding with a partner, get out for an appointment, or simply take a break.
The Takeaway on Low Breast Milk Supply
Maintaining your milk supply while nursing is important for your baby's health and development. If you're worried about your milk supply or your baby's feedings, talk to your healthcare provider, your pediatrician, or a lactation consultant. It may be possible to resolve low milk production issues with a few alterations to your routine or nursing technique or by changing the medication you take. While a decreased milk supply can be upsetting, try to remember that “fed is best.” As long as your little one is getting the sustenance they need to grow and develop, both breast milk and formula are okay.