Low Milk Supply

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Do I Have Low Milk Supply?

Low milk supply is sometimes a breastfeeding problem that many mothers think they have, when they do not!

"Assumed" low supply is a common breastfeeding problem.

BUT, there are many mothers who do struggle with a supply problem. On this page we discuss the reasons why. 

Mothers sometimes use the wrong signs to judge milk supply. Here are some tips on how to determine whether you have low supply: 

  • Weight gain. If your baby is gaining well on your breast milk alone, then he/she is getting enough milk. Read more here. 

It is normal for a newborn baby to first lose weight before gaining. It is likely that your baby will regain birth weight by about two weeks.

First Read:

Sometimes when a baby starts to drink more than usual and becomes fussy at the breast, the mother might think that her milk supply has gone down. Usually it has nothing to do with her supply. There are many things that can cause fussing at the breast. 

Supply and Demand

From day nine after birth and onward, your milk supply is controlled by "supply and demand". This means that the amount of milk created is dependent of the amount of milk that is removed. In other words, the more you breastfeed your baby and/or express milk (remove milk from the breast, the more milk you are going to produce. The first few weeks of milk removal are very important and determine how much milk is capable of being produced later on. So an early, good start to breastfeeding is therefore very important. 

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This page will discuss reasons for low milk supply and things you can do whilst breastfeeding, that will increase your milk supply. But firstly, lets pinpoint some of the main reasons for low milk production...

Reasons for Low Milk Supply

Common issues

  • The most common reason is stress. Stress tips for mothers who breastfeed.
  • If your baby is not latching on properly, you will not receive enough breast stimulation, which is necessary for optimum milk production. For a more detailed explanation on this, visit the latching on page.
  • Breast and nipple shapes can also influence whether or not your baby latches successfully. Read more about breastfeeding with flat or inverted nipples.
  • Overuse of a pacifier. Read more about pacifier use.
  • Using a nipple shield. Using a nipple shield, decreases the amount of stimulation at the breast.
  • Another major reason why most women are not producing enough milk, is because they do not have their babies at the breast long enough or frequently enough. 
  • The good news is that your milk supply should increase as time goes by. If you need to get back to work you can still continue to breastfeed. Read more about working and breastfeeding here.
  • Insulin dependent diabetes. Mother who have diabetes, often struggle with a low milk supply. Read more about breastfeeding with diabetes here.
  • It is assumed that about 1% of women have physiological trouble, which is usually related to their metabolism. This prevents them from producing enough milk to feed their babies.
  • Obesity is a risk factor for the delayed onset of milk production and low milk supply.
  • When Moms receive intravenous fluid by constant drip, this can lead to edema (swelling from excessive accumulation of watery fluid in cells, tissues, or serous cavities) and this can set back the onset of milk production.
  • Breastfeeding problems that a baby might have, namely: Conditions in the mouth and sucking problems, food sensitivities or allergies, being premature (born before the development of the suck/swallow/breathe reflex).
  • Supply-reducing foods and herbs such as large amounts of mint teas and candies, parsley and sage, herbs and sour foods, may reduce milk supply.
  • Hormonal changes. Sometimes when a woman starts menstruating or falls pregnant, her supply will decrease.
  • Taking oral contraceptive pills that contain Oestrogen, can lower your milk supply. Read more about contraceptives and breastfeeding here. 
  • Smoking can lower your milk supply.

Other things that can cause low milk supply, but that are rare...

  • Inadequate breast tissue. Breastfeeding with tubular hypoplastic breasts.
  • Breast surgery: namely breast reduction, breast augmentation and breast reconstruction.
  • Anaemia (a deficiency of red blood cells) in the mother.
  • Polycystic ovarian syndrome (ovaries containing many cysts/sores/ulcers/growths) can also create low supply. Read more about PCOS and what you can do, if it is affecting your milk supply.
  • Sheehan’s Syndrome: When the pituitary gland (master gland of the endocrine system; located at the base of the brain) is temporarily starved of blood, due to haemorrhaging during birth and, as a result, no longer produces enough hormones for lactation.
  • Retained placenta: If a mother's milk has not "come in" and she continues to experience abnormal bleeding after delivery, she may still be retaining pieces of the placenta within her uterus. (This is also possible with a C-section).
  • Psychological issues: Some women are not capable of breastfeeding, due to preconceived ideas about it, or ideas placed in their minds by their parents and friends. Women who have been molested as children, might also struggle with the idea of breastfeeding. 
  • Hypothyroidism (low thyroid hormone): This can be corrected with medication and is another possible cause of low milk supply.

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How to Boost Milk Production Naturally

  • Milk thistle, Blessed thistle, Fennel seed, Goats Rue, Alfalfa and Anise seed are sometimes prescribed to increase breast milk. Safe herbs while nursing. 
  • More frequent feedings at the breast and the use of a pump in-between feedings. A nursing vacation is a great place to start.
  • Warm compresses to the breast may help increase the flow of milk.
  • Many mothers have found that relaxation and visualization techniques help. There are audios that mothers can listen to that are specially made to help them relax and visualize milk removal.
  • Oatmeal has been proven to increase a woman's milk supply. The added iron in your diet will help increase milk production.
  • Mothers Milk Tea is a drink for mothers with low milk supply. It usually contains sweet fennel seed, anise seed, coriander seed, spearmint leaf, lemongrass leaf, lemon verbena leaf, althea root, blessed thistle herb and fenugreek seed.
  • Fenugreek supplement or Fenugreek seeds: This is one of the greatest milk stimulating herbs and can start increasing your milk supply within 24 hours. (Not for you if you have any nut allergies) Read more about breastfeeding and fenugreek here.
  • Drink plenty of water and juices, as fluids are vital for your body's milk production.
  • Breastfeeding requires at least an extra 500 calories per day. Read more about breastfeeding diet guidelines.
  • To maximize milk production, you can use breast massage. This will increase breast drainage so that the signal to the breast to make more milk, is improved. An easy and efficient way to maximize removal of milk, is to massage the breasts before and during feeding or by pumping.
  • Breast compression: While the baby is drinking, compress the breast gently but firmly - not too hard; do not hurt yourself!
  • Seaweed: Koreans traditionally use seaweed soup as a remedy/tonic for new mothers, to help stimulate milk production. The seaweed wraps that are used to make Sushi are just as potent. 
  • Quinoa: This grain has been used by traditional societies during lactation and is said to boost milk production.
  • A lot of skin-to-skin contact, enjoying your baby's sweet face and the feel of his/her skin, will help your milk flow, and will help you both relax.
  • Make sure that most of the milk is removed from your breasts after each feeding. If there is milk left in the breasts, it tells the body that it does not need to make as much and, therefore, leads to low milk supply.
  • Try nipple stimulation. Nipple stimulation releases oxytocin, the hormone responsible for the milk ejection reflex, into the bloodstream.

Read more about the different Galactagogues that help with milk production

Medications that Enhance Milk Production

Domperidone and Reglan. Reglan can produce side effects such as depression, so always check with your doctor and read the package insert carefully. 

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Does Breast Size Matter? 

No! I have seen mothers with small breasts, produce large amounts of milk. Breast size mainly determines the storage capacity, not milk production.

Women with large breasts usually produce milk at slower rates, since they can store a lot of milk, while women with small breasts will produce milk at faster rates in order to meet the requirements of their babies, who will drain the breasts faster.

Why are my Breasts Soft?

During the first few weeks you would have noticed that your breasts were hard and firm, especially before a feeding. By the six week mark you should start to notice that your breasts feel less full.

Leakage will usually also subside. This happens because supply and demand have been balanced and your body now knows exactly how much milk to produce for your baby. This means that excess milk and fluids are at a minimum and that breastfeeding is most likely running smoothly.

You might also notice that milk "let downs" become less sporadic and occur mostly during feedings, not while doing your grocery shopping ;-)

So what if your breasts never felt full or hard? This is okay too, some ladies have more "packing space" in their breasts. If your baby is gaining weight, is happy and thriving, chances are you are producing enough milk. 

Pumping to Increase Milk Supply

  • Use an electric pump, instead of a hand pump. Hand pumps are helpful for occasional pumping, but a lot of mothers find it to be arduous and time-consuming, if used more than once a day. Use a hospital-grade pump; they work better. Also, buy a hands-free setup for your pump to make things easier for yourself.
  • Using hand massage and hand compression while pumping, will increase milk volume; it also drains the breast better and faster.
  • Try to pump every two hours around the clock, for a few days to boost supply.

Supplemental Feeding

Bottle feeding can be detrimental in the early days of a nursing relationship. By owning your own supplemental feeding device, you can manage how your baby is supplemented after birth.

The most common devices deliver the supplement to the baby via a small, flexible tube that is taped or placed on the mother’s nipple. The baby takes both the tube and the mother’s nipple into the mouth and receives the supplement, while nursing at the breast. Read more about this here.

Read more about combination feeding.

When is supplemental feeding necessary?

Will I Ever Have Enough Milk?

Low milk supply experts state that the time spent nursing or pumping, develops mammary gland and nerve tissue, and that this improves chances of breastfeeding the next baby.

By the time the second or third child comes along, most mothers who have had supply issues, are able to fully nurse their babies. 

Breastfeeding on demand will increase your chances of a full milk supply.

If, despite your hardest efforts you are not able to make a full milk supply, you can still breastfeed! There are many mothers who breastfeed with a partial milk supply. They supplement to make up for whatever they cannot provide. Every drop of breast milk is beneficial to your baby! That is why it is referred to as liquid gold!  

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Sometimes with all these measures taken above, you may still have a low milk supply. Depression, anger and denial are all common reactions to what may come as a blow to the new mother. A lactation specialist or postpartum counsellor may be able to help you work through your frustration and depression.

One Mother's Advice...

Other Useful Pages on breastfeeding problems in connection with Low Milk Supply:

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What Other Moms Have Said

Click below to see contributions from other visitors to this page...

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