Breastfeeding and Low Milk Supply
Low milk supply is one of the top concerns for breastfeeding mothers. If a mother isn't making enough milk for her baby then that means her baby may be fussy, won't gain weight fast enough, and could develop a condition called "Failure to Thrive" (more recently simply referred to as infant malnutrition).
Understanding how to identify low milk supply, the causes of low milk supply, and how to manage low milk supply are vital to maintaining your baby's health while breastfeeding. While this can seem like a scary topic, there is good news: any breastmilk your baby receives is valuable and it is possible to increase your milk supply with the right support!
What is low milk supply?
Simply Speaking, Low Milk Supply is the insufficient production of breastmilk. Early on, newborns only need a few milliliters of breastmilk per feed. But as the first week progresses they begin drinking ounces per feed. On average, an infant will require approximately 24-30oz of breastmilk daily to maintain their appropriate growth curve.
Real low milk supply vs. Perceived low milk supply
Many women believe they have low milk supply when in reality, they're making plenty of breastmilk for their baby. Understanding the difference between real low milk supply and perceived low milk supply is important.
Real low milk supply typically shows itself in the numbers: slow/no weight gain, reduced diaper output, infrequent stooling.
Perceived Low Milk Supply will often occur when an infant shows symptoms like excessive fussiness, frequent nursing, and other behavioral conditions without the quantifiable symptoms.
Mothers will sometimes notice they don't pump as much milk as they think they should or previously could, and believe that means they have low milk supply. However, in many cases, pump output does not give a true or full picture of milk production potential.
What causes low milk supply?
Breastmilk Supply & Demand
A hormone called prolactin signals how much milk should be made. Milk removal increases prolactin, telling the body to make more milk. Full breasts or infrequent milk removal, however, tells the body to make less prolactin, therefore making less milk.
In short: The more often you remove milk, and the more milk you remove, the more milk you will make. The less often you remove milk, the less milk you will make.
Hormones & Milk Production
Hormonal conditions like PCOS, Thyroid Disorders, Insulin Resistance, and Diabetes, can all contribute to insufficient milk production in different ways. Some conditions can cause decreased/poor breast tissue development meaning there is less capacity to produce milk. Others signal the body to use energy elsewhere, making milk production the "last priority".
Often, despite popular claims that low hormone birth control options don't impact breastfeeding, women will experience that milk supply is impacted when utilizing hormonal birth control.
Other Causes of low breastmilk production can be related to birth complications such as high blood loss, retained placenta, cesarean section, and more. This does not mean that breastfeeding is doomed, but it may mean you need additional support to achieve your breastfeeding goals.
How can I fix low milk supply?
Naturally, if you are experiencing low milk supply, you're wondering what you can do to increase your milk production so that you can reduce your need for supplemental feeding. There are multiple options for increasing milk supply including increasing milk removal, consuming galactagogues, and more.
Increasing Milk Removal
As we learned about supply and demand, the more milk you remove, the more milk you make. This is why increasing milk removal is often the go-to recommendation for low milk supply
Increased Breastfeeding
If your newborn is nursing less than 10 times a day, adding feeding sessions will likely help increase your milk supply. As an IBCLC, I recommend feeding on demand and ensuring your baby breastfeeds overnight for optimal milk production. Ideally your baby should breastfeed 6-8x during the day, and 2-4x overnight minimum.
Pumping for low milk supply
Pumping is another way to increase demand on the breasts. Some babies can not effectively remove breastmilk so using a breast pump to replace or "extend" their feeds can be helpful to increase milk supply. There are different techniques and recommendations based on your specific needs. To learn how often you should be using your breast pump, consult an IBCLC.
Galactagogues for Low milk supply
Galactogogues are food products that are known to help increase milk production. Many herbs such as fennel, goats rue, moringa, and fenugreek are known for increasing milk supply.
Additionally, foods such as oats are commonly recommended to increase milk output.
Here's the important thing to know about using a dietary appraoch to increasing milk supply... The root cause of your low milk supply matters. If there is a hormonal reason you're not making enough milk, dietary approaches can be useful, but some will be more effective than others depending on the specific cause of low milk supply. Additionally, simply eating an oatmeal cookie is not likely to solve your body's issues... Instead, if you want to use diet to improve milk supply, a full dietary analysis with multiple adjustment is likely necessary to truly solve the problem.
If simply eating a cookie increases your milk output substantially, it is not likely there was an underlying hormonal concern at play.
This brings me to my next point... Fixing milk supply will ultimately depend on understanding the root cause of low milk supply. If you are struggling with milk production, consulting an IBCLC can help you identify the cause of your low milk supply, allowing your lactation consultant to create a customized breastfeeding plan for you to increase your milk supply.
Little Bear Lactation offers virtual and in-person lactation care to help identify and resolve low milk supply in breastfeeding mothers. Book your consultation now!
Jaimie Zaki is a Licensed Practical Nurse, International Board Certified Lactation Consultant (IBCLC), Birth Doula & Photographer, and mother of 5. Jaimie Zaki is the owner of Little Bear Lactation, and provides in-home lactation support in Abilene, Texas and the surrounding areas. Jaimie also provides virtual breastfeeding support (telehealth lactation care) for families across America. Jaimie specializes in helping support families dealing with painful latching and low milk supply related to oral dysfunction and tongue ties.
Keywords: breastfeeding with low supply, low breastmilk supply, how to increase breastmilk supply, increasing milk output, pumping for low milk supply, causes of low milk supply, fixing low milk supply, virtual lactation consultant low milk supply, online milk supply help, virtual ibclc
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