Low milk supply is a common concern of many breastfeeding parents. A lot of focus is spent on what they can do to fix it instead of thinking about what has already been done. Before you start downing multiple tea bags of lactation teas and those yummy lactation cookies, let’s try to get to the bottom of what is actually causing the decrease in your milk supply. This post is about ten potential causes of low milk supply!
1. Decrease in feeding or pumping sessions
Breastfeeding is supply and demand. This is one of the main things to remember when breastfeeding/pumping. Your body needs to move the milk out to make room for more milk. If at any time you are allowing the milk to remain in the breast, you’re not allowing space for more milk to flow. When this happens, it signals to your body to stop the production. This gradually slows down your milk production and decreases your milk supply.
This also applies if you’re limiting your infant’s time nursing at the breast. A common breastfeeding myth taught to new mothers is to keep the infant at the breast for 15 minutes on each side. Not every baby nurses similarly or has the exact same oral mechanisms to support this idea. By potentially limiting the time that the infant really needs to feed, you’re signaling to your body that the infant has only removed a specific quantity of milk for a feeding. The amount removed will be the amount that your body continues to produce and make room for.
This topic can also be applied to going back to work. A lot of women notices drops in their supply after returning to work and learning to balance a new pumping or feeding schedule.
The key: 1) keep the baby at the breast for as long as baby needs to show signs of being full. Try to avoid limiting time at the breast, if possible 2) Don’t skip a feeding or pumping session if possible. Stay as consistent as you can with ensuring milk removal.
2. Consuming anti-lactogenic foods/drinks/herbs/medications
We all discuss the foods that will “boost” your milk supply but we rarely discuss the food/drinks that will decrease your milk supply. If you have a generally “clean bill of health” with no significant medical history, the foods may not cause any impact on your supply. If you have a personal or familial history of low milk supply or have a significant medical history, here are a few anti-lactogenic things:
- Decongestants (ex: pseudoephrine aka Sudafed)
- Birth Control
- Any pill or shot that contains estrogen
- Herbs such as peppermint, parsley, sage (in excess)
Key: Avoid these and any other potentially milk limiting things that may affect your supply!
3. A Medical Diagnosis/Condition
Sometimes a medical diagnosis or condition is a factor in determining your decreasing milk supply. Conditions such as diabetes, hypothyroidism, hyperthyroidism, insufficient glandular tissue, and many more have been known to affect a mother’s milk supply.
Key: If you are unsure of your medical history and noticing a change or no progress in your milk supply, this is definitely something to discuss with your primary care physician, obstetrician, and/or private practice lactation consultant.
4. Lack of Support Systems
While this factor may seem insignificant or though it is not affecting you at all, it’s very common for parents to decrease the amount of breastfeeding or pumping sessions if they feel that they are unsupported by their friends and family.
Key: surround yourself (as best as you can) with people who support and encourage your breastfeeding efforts. If you don’t have those people in life, try your best to explain to the naysayers how important this act is for you and your family. Educate your loved ones on what they can do to help aide your breastfeeding efforts.
While stress is a lot of times uncontrollable, it’s good to know that it has the potential to affect your milk supply. A lot of mothers will question every thing they’re doing in efforts to boost lactation and they miss this main factor because they’re already so stressed. While this factor still needs a lot of scientific research, some studies have shown that stress inhibits the let-down reflex, making it harder to release milk.
Key: Try to relax as much as you can before feedings/pumping sessions. Look at cute pictures and videos of your baby, listen to happy music or podcasts, take your mind off of the things that are causing you to be stressed in the moments of feedings. (Easier said than done, I know!)
6. Ineffective Milk Transfer from Baby
Sometimes, even when everything seems to be going well, the baby may have oral restrictions (lip tie, tongue tie, high palate) or underlying medical conditions (heart condition, thyroid conditions) preventing her from effectively emptying the breast.
Key: If you’re in the earlier stages of breastfeeding and experiencing a decrease in supply (or no increase) in your supply, have your baby examined by a medical professional. An IBCLC cannot diagnose any medical conditions.
7. Hormonal changes (period or pregnancy)
While there are not a ton of studies done on this particular “phenomenon”, several women have reported a low milk supply in the days surrounding and during their period.
Before and during your period, you may notice that slight dip in your supply. This is only temporary. Patricia Gima, IBCLC, suggests to take Calcium and Magnesium supplements to regulate supply. You could also look into foods high in Calcium and Magnesium and eat those before and during your period. During the early days of pregnancy, milk supply usually takes a dip. The mature milk usually takes a dip as the colostrum starts the form. This is also temporary as the colostrum starts to transform in accommodation for the upcoming baby.
Key: add these two questions to your list of things to check when concerned about low milk supply: Am I pregnant? Is my period coming?
8. Breast Surgery
I’ll go way more in depth on breast surgeries and their effects on breastfeeding in the future. For now, I’ll just leave you with a snippet of information. It’s hard to determine if your milk supply will be affected by your surgery. It depends on several factors. It is worth it to know as much information about how your procedure was performed (i.e. the incision location of your surgery, any muscle or tissue removal/replacement)
Key: if you’ve had a breast surgery and are concerned about low milk supply, rule out this factor before moving on to anything else. As stated, surgeries have the potential to impact supply but there is not a guarantee. There are several factors and each breast/person/surgery is different.
9. Alternative Feeds/Pacifiers
Occasionally I hear mother’s say that they are going to have their spouse give a bottle so they can catch up on sleep. This idea is great, in theory. Long term, it has the potential to lower your milk supply due to the fact that you’re not feeding the baby in a consistent manner. See number 1 above in regards to inconsistent feedings.
When it comes to pacifiers, I’m not saying don’t ever use them. During hospital consultations, I often discourage the use of them because the baby is usually showing hunger cues. The baby is not using you as a pacifier in the newborn stages. The baby is using the pacifier in replacement of feedings. When a newborn is actively sucking at the pacifier, they can occasionally suck themselves into an exhaustion or even into sleep.
Key: if you feel the need to skip a feeding for a well deserved break, then do it. Just don’t make a habit of it without expecting a dip in your supply. Take a night (or two) off, then get back in the game. The same strategy goes for pacifier use. I know for a fact that it just gets to the point where you and your nipples need a break. Try your best to hold out on the pacifier use in the earlier weeks of breastfeeding, if possible.
10. Pump malfunctions
Sometimes it’s as simple as your pump malfunctioning. Double check the assembly and integrity of pump parts (especially the tubing and membranes). Other questions to ask yourself: is your pump new or used? Does your pump’s motor sound slower? Have you tried another pump?
Key: If you’re determining a decrease in supply while pumping, check your breast pump!
Resources for low milk supply:
- Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Lactation. Washington (DC): National Academies Press (US); 1991. 5, Milk Volume. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235589/
- Nice, F. J., Snyder, J. L., & Kotansky, B. C. (2000). Review: Breastfeeding and Over-the-Counter Medications. Journal of Human Lactation, 16(4), 319–331. https://doi.org/10.1177/089033440001600408
- Principles for Maintaining or Increasing Breast Milk Production. Kent J.C., Prime D.K., Garbin C.P. (2012) JOGNN – Journal of Obstetric, Gynecologic, and Neonatal Nursing, 41 (1) , pp. 114-121. Available from: https://www.jognn.org/article/S0884-2175(15)31026-1/fulltext