What to Do If Your Milk Supply is Low

Let me be honest. Milk supply is a very sensitive topic for all breastfeeding mothers. There may be times in your breastfeeding journey when you feel your milk supply is low. Your baby may be fussing at your breast or your baby may be cluster feeding. Both of these situations, among others, may make you feel like your baby is not getting enough milk. You can read more about signs your baby is getting enough milk here:

How to Tell if Your Baby is Getting Enough Milk

Low milk supply can either be a perceived problem or a real problem. Unfortunately, many mothers inherently think they will not produce enough milk. I think this is due to society and the influence of family and friends. Many of their experiences get passed on to us, positive or negative. This is precisely why it is important to get a proper assessment by a lactation provider and have your baby assessed by his/her pediatrician.

If your milk supply is low, don’t fret! Stressing about it will only exacerbate the situation- you need all those hormones working for you, not against you! Ensure you get a proper assessment and pre/post-feeding weight check by a lactation provider so you can be on the road to being a milk makin’ mama again!

Low Milk Supply Indicators

If you’re worried about your milk supply, it may be because of one of the following:

• Baby has not gained enough weight
• Baby falls asleep after just a few minutes of eating
• My baby seems unsatisfied after eating
• My breasts feel “empty”
• When pumping or expressing, the output is not what I would expect

These are just a few examples of why you may think your milk supply is low. Each of them has their own unique set of circumstances, and I’ll cover a few in this post. Each mother is different though, so it’s important you and your baby are assessed to determine your root cause.

There are circumstances when a mother may not produce enough milk for her baby, but these are very rare cases. Sometimes, there may be an underlying health issue that causes inadequate milk supply. Examples of these include thyroid and other hormone issues, polycystic ovarian syndrome, history of breast surgery and trauma, or the retainment of placental fragments. Again, these cases are rare and if you suspect any of these for your case, I highly encourage you to work with a lactation specialist and your healthcare provider.

Milk Expression

If your pumping or hand expressing, the output will not be as high as your baby breastfeeding at the breast. This is a common experience for mothers and is not indicative of your milk supply. Most mothers only express a few droplets of milk at first, until your body becomes familiar with milk expression.

When you are hand expressing or using a pump, make sure you stimulate your nipples between your fingers and gently massage your breasts prior to expressing. You can also use guided imagery; think of your baby in a happy state. Think about your milk letting down and flowing to your baby. You can hand express or pump while your baby is nursing on the other side. All of these tips will encourage oxytocin release, and thus milk flow. Your milk output should gradually increase over time but don’t expect a full bottle the first time you pump. The more you practice at expressing, the better you’ll get! It takes time for your body to trust the expression technique, it’s just not the same as looking your baby in the eyes as you breastfeed.

Mama’s Routines

Sometimes your milk supply is low if there is a change in your health routines. You may notice a gradual or sudden drop in expressed milk volume. If this is the case, think about whether you’ve changed or added anything into your routine.

Some examples may include:

• New medications
• Nutritional supplements, including herbal remedies
• Decreased feedings or nursing on a clocked schedule (remember, if you don’t express or breastfeed, that tells your body to produce LESS milk)
• Changes to pumping equipment
• Menstruation
• Pregnancy

Assessment for Low Milk Supply

Before a plan can be crafted to increase milk supply, it is important to do a thorough and realistic assessment of the underlying cause and symptoms associated with your supply.

Planning for Increased Milk Supply

It’s important to have a realistic set of goals associated with increasing your milk supply, based on the assessment performed. After considering the available methods and the delivery of the additional milk, a plan can be created. Once a plan is made, it can be implemented with the help of monitoring and follow-up.

Methods to Increase a Low Milk Supply and Increase Milk Delivery to Your Baby

• Increase milk expression frequency- using a hand, pump, or collection device.
• Increase nursing sessions- if the baby is willing and able to nurse more.
• Utilize an at-breast supplementer to increase breast stimulation and thus, increase supply.
• Pump longer and more frequently. The more you remove the milk, the more your body will produce.
• Make sure you are well-rested and well-nourished. Your body needs quality whole foods and lots of water to produce milk effectively. You should drink to thirst and/or at least half your body weight in ounces of water every day. 
• Power pump: Pump for 5 minutes on both sides (double stimulation triples your prolactin levels!!), take a 5 minute break, pump again for 5 minutes on both sides; take a break; pump again for 5 minutes on both sides. The length of pumping time isn’t as critical as the breaks in between and resuming again.
• If your baby is being fed formula, replace it an ounce at a time with milk you’ve expressed or donor milk.
• Find donor breast milk to give your baby- You can locate a location near you through the Human Milk Banking Association of North America. 

If you are experiencing low milk supply issues, get a comprehensive breastfeeding assessment and pay attention to the health of your baby. Use a combination of hand expression and a pump to increase your supply and stimulate both sides to increase prolactin levels.

Work closely with your pediatric care provider and lactation specialist to monitor your baby’s weight gain daily, and use expressed or donor human milk to replace any formula being used to supplement.