One of the most common concerns new parents face when breastfeeding is whether they are making enough milk for their baby. While true low milk supply (also known as hypogalactia) is less common than many believe, it can be distressing when it does occur. If you’re struggling with milk production, it’s important to understand the potential causes and, more importantly, the solutions.
What Causes Low Milk Supply?
Several factors can contribute to low milk supply. Below are some of the most common reasons:
1. Infrequent or Ineffective Breast Stimulation
Breastfeeding is a supply-and-demand process. The more often and effectively the breasts are emptied, the more milk they produce. If a baby is not latching well, has a weak suck, or if feedings are too infrequent, the body receives signals to produce less milk.
Solution:
- Ensure a deep, effective latch. Working with a lactation consultant can help optimize positioning and latch.
- Feed on demand, ideally at least 8–12 times in 24 hours, including overnight.
- If nursing isn’t effective, consider pumping after feedings to increase stimulation. Ensure to use an effective pump with well-fitting flanges and appropriate pump settings to avoid trauma to the breast and nipples.
2. Supplementing Too Early or Too Often
Introducing formula or bottles before breastfeeding is well established can lead to decreased breast stimulation, ultimately lowering milk production. In addition, babies can get used to or prefer a faster flow from the bottle making it harder for them to stay focused and patient at the breast.
Solution:
- If supplementation is necessary, consider using methods like syringe feeding or a supplemental nursing system (SNS) to encourage breastfeeding while providing additional milk.
- Work with a lactation professional to develop a plan to protect and boost milk supply while supplementing.
- Offer the breast frequently and prioritize direct nursing when possible.
3. Maternal Health Conditions
Certain maternal health conditions can impact milk production, including:
- Hormonal imbalances (e.g., polycystic ovary syndrome [PCOS], thyroid dysfunction, insulin resistance or diabetes)
- Insufficient glandular tissue (IGT) (a rare condition where the breast tissue needed for milk production is underdeveloped)
Solution:
- If you suspect a medical condition is affecting your supply, work with a healthcare provider specializing in lactation medicine to address underlying issues.
- Some conditions can improve with targeted interventions, such as medications and herbal supplements, or specific breastfeeding techniques.
4. Birth-Related Factors
Complications during labor and delivery can delay or impact milk production, including:
- Excessive blood loss (postpartum hemorrhage)
- Retained placenta fragments (fragments left in the uterus after birth can delay milk production)
- Severe swelling from IV fluids (which can delay the onset of milk production)
Solution:
- If milk production is delayed, frequent breastfeeding or pumping can help stimulate supply.
- Seek medical evaluation if you suspect retained placenta or have prolonged bleeding after birth.
5. Medications and Birth Control
Certain medications, including some decongestants (like pseudoephedrine) and hormonal birth control methods (especially those containing estrogen), can reduce milk supply.
Solution:
- If you’re considering birth control, discuss options with your lactation-friendly provider, such as progestin-only methods.
- Review all medications with a healthcare provider to determine their impact on milk supply.
6. Stress and Fatigue
New parenthood is exhausting, and stress, anxiety, and sleep deprivation can negatively impact milk production. High cortisol levels (stress hormones) may interfere with the hormones (oxytocin and prolactin) responsible for lactation.
Solution:
- Prioritize rest when possible and accept help from family and friends.
- Hydration, nutrition, and relaxation techniques (such as deep breathing or skin-to-skin contact with your baby) can support milk production.
When to Seek Help
If you are concerned about low milk supply, you don’t have to navigate it alone. Seek help from a lactation specialist or healthcare provider if:
- Your baby is not gaining weight appropriately.
- You notice a drop in the number of wet and dirty diapers (fewer than 6 wet diapers per day after the first week of life).
- Your baby seems constantly hungry or unsatisfied after most feedings.
- You experience pain during feedings, signs of poor latch, or engorgement that doesn’t resolve with nursing.
- You suspect an underlying medical condition is affecting your milk production.
At Village Lactation Medicine, we specialize in identifying and addressing the root causes of low milk supply. Whether you need help with latch, pumping strategies, or medical concerns, we’re here to support you on your breastfeeding journey.
Final Thoughts
Many breastfeeding challenges can be overcome with the right support. If you’re experiencing low milk supply, early intervention can make a significant difference. Don’t hesitate to reach out for professional guidance—your breastfeeding journey matters, and help is available!