Low Milk Supply: Common But Easily Fixable
What is low milk supply? The most common reason moms stop breastfeeding is that they think their baby is not getting enough milk. That’s usually not the case. But if you’re supplementing with formula, or stretching out the time between feeds, especially with a newborn, your breasts won’t be stimulated to produce enough milk. Women who have medical conditions that aren’t under control, such as thyroid disease, may also have trouble producing enough milk. The best way to tell if you have an adequate milk supply is to monitor your baby’s weight. By the time they’re around 14 days old, babies should return to their birth weight and start gaining 4 to 7 ounces on average per week. If your baby isn’t gaining enough or is losing weight, that’s an indication she’s not getting enough.
There are several low milk supply causes. Several factors should be considered:
- Feeling stressed or anxious
Stress is the No. 1 killer of breastmilk supply, especially in the first few weeks after delivery. Between lack of sleep and adjusting to the baby’s schedule, rising levels of certain hormones such as cortisol can dramatically reduce your milk supply. I’ve seen women who, within 24 hours, have gone from having an ample milk supply to literally none due to stress. - Supplementing with formula
After your baby is born, the breasts operate on supply and demand. Exclusively breastfeeding drives higher demand, so the breasts create more milk. However, supplementing with formula for multiple feedings every day (such as while the baby is at daycare) or releasing breast milk only when the baby wants to nurse tells your body that it doesn’t need to produce as much milk. Consequently, your supply will begin to decrease.
You can counteract this by pumping at regular feeding intervals throughout the day. Pumping tells the body to continue producing, even if the baby isn’t eating at that moment. Breast milk keeps well in the freezer, so pump at work if you can and store it for later use. - Eating or drinking too little
It can be tempting to diet after giving birth to lose “baby weight.” Make sure to eat enough to replenish the 500 calories breastfeeding burns each day. Consider eating a healthy snack, such as an apple with nut butter, between meals to close the calorie gap.
Adequate hydration also is important for breast milk production. The amount of liquid you put into your body affects how much breast milk you can produce. I encourage women to carry a bottle of water for themselves in their diaper bags. When my children were babies, a friend told me to drink a glass of water every time I nursed. It was an easy way to remember to drink enough, and I pass that tip along to my patients. - Getting sick
Just catching a virus or bug such as the flu, a cold, or a stomach virus won’t decrease your milk supply. However, related symptoms such as fatigue, diarrhea, vomiting, or decreased appetite definitely can.
Ask for help at home when you’re sick so you can continue to make enough breast milk to nurse or pump for the baby. And be sure to get your COVID-19 vaccine – it has been proven safe and effective for pregnant and breastfeeding patients. - C-section
Some women find that C-sections delay breast milk production, or have low milk supply after C-section. But rest assured that your milk will come in eventually. In the meantime, have lots of skin-to-skin contact with your newborn, and try nursing as frequently as possible.
How to treat low milk supply: If you and your pediatrician suspect your baby isn’t getting enough milk, you should see a lactation consultant, who can watch as you breastfeed to check your baby’s latch. If that isn’t the issue, you can try to feed more often to stimulate more milk production. Make sure you’re feeding your baby at least eight times per day rather than following a strict schedule. You can also pump between feedings to stimulate more milk production.
