Low Milk Supply: The Truth and What to Do About It
Breastfeeding is a complex system, and many factors must be accounted for when concerns of milk supply arise. Although the prevalence of low milk supply is unknown, low supply or the perception of low supply, influences approximately 25-73% of mothers to cease breastfeeding early. Low milk supply is defined as producing an amount of breast milk less than the volume required to sustain healthy infant growth by exclusive breastfeeding (Sultana, 2013). Let’s take a closer look at signs of low supply and how to seek assistance if you are experiencing one of these signs.
Causes of Low Milk Supply
Low milk supply can be divided into two categories: primary and secondary. Primary causes are related to any medical issues or anatomical factors existing within the mother. Secondary causes are related to issues with milk transfer and breast drainage. Primary and secondary causes can stand alone or also co-exist. Also, keep in mind having one of these does not mean low supply will occur.
Primary Indicators of Low Milk Supply
- Maternal history of PCOS
- Previous breast surgery
- Postpartum hemorrhage
- Maternal history of diabetes/insulin resistance and/or thyroid/pituitary gland dysfunction
- Insufficient glandular tissue
- Retained placenta
- Medications affecting supply
- Delayed initiation of breastfeeding
- Infrequent or inefficient breast emptying
- Ineffective latch/weak suck from infant and/or oral restrictions
- Premature birth
How to Help Your Milk Supply
It is important to know the root cause of low milk supply. MOSAIC highly recommends working with a lactation consultant and primary care doctor when PRIMARY indicators of low supply are present. Now, let’s explore options to increase secondary low milk supply issues.
- Monitor infant’s weight gain with help of lactation consultant and primary care physician
- Consume adequate calories and hydrate, and note that increasing water consumption does not increase your supply
- Check infant’s latch to ensure optimal breast drainage with support of lactation consultant
- Know infant feeding cues and limit pacifier use to ensure feeding cues are noticed
- Feed on demand by observing infant feeding cues/incorporating more feeding sessions (10-12x/day for a newborn)
- Switch nursing – Alternate breasts multiple times during a feeding
- Hand express intermittently throughout the day in between feeds and/or hand massage breast while nursing to increase transfer
- Check flange size and that pump parts are working appropriately
- Power pump 1-2x/day
- Firstly – Let down mode x3 minutes, pump x20 minutes, break for 10 minutes
- Secondly – Repeat starting with let down mode x2-3 minutes, pump x10-15 minutes, break for 10 minutes
- Finally – Let down x2-3 minutes, pump x10-15 minutes – complete
- Parallel pumping – Use a breast pump to pump one breast while simultaneously breastfeeding baby on the other
- Triple feed – Trial only with help from lactation consultant as this can be a strain on a new mom
- Feed on demand; supplement with expressed breast milk or formula if baby is still hungry; pump 15 minutes after feed
Overall, be patient and consistent when implementing these options to increase supply. Initial results can take up to 7 days to be noticed. Always balance what approaches are attainable with your mental health, especially in the newborn stages. Balancing these is important as sometimes all the effort put into using these approaches will not increase milk production because it’s just our biology. Seek assistance from a lactation consultant and primary care physician. If you are wanting to hear parent stories or further resources, visit the Low Milk Supply Foundation.
- Low Milk Supply Foundation. (2022). Low Milk Supply Foundation. https://www.lowmilksupplyfoundation.org/
- Cadwell, K., & Turner-Maffei, C. (2016). Pocket Guide for Lactation Management (3rd ed.). Jones & Bartlett Learning.