Every boobie is different so it makes for a puzzling situation for families when they intend to breastfeed and have been dedicated to doing “all the things” and their milk supply doesn’t seem to be hitting the mark. First, due to a common mis-perception of low milk supply, we should clear up one thing. A “good" milk supply is defined by your baby gaining weight on their growth curve, if they are satisfied after feeding, are properly hydrated and are showing age appropriate signs of output (pee/poop). If you have doubts, contact an IBCLC or breastfeeding medicine doctor. But here is some information that might help you wrap your mind around causes or things to ask your doctor about testing for or tweaking in a scenario when milk supply is not hitting the mark.
There are generally 3 reasons for low milk supply which can be separated into two categories:
Primary Low Milk Supply
- Caused by not enough glandular tissue or hormone receptor sites
- Caused if the hormones are present but are not signaling properly/landing
- Caused if not enough intact nerve pathways and milk ducts
Secondary Low Milk Supply
- Caused by not enough demand/stimulation. Some general reasons for this could be:
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- Oral dysfunction
- Tongue tie
- Lack of stimulation to breasts
- Separation of mother and baby
- Sleep training/schedule etc
Other Factors To Consider
- Early skin to skin contact is key to milk supply initiation, and pumping or hand expression is helpful in the case of unforeseen separation of the mother and baby
- A diet of 1500-1800 kcal/day with special attention to protein, calcium, omega 3 fatty acids and fiber can improve supply. Consider supplements of b12, iron, zinc and iodine if the milk supply is low.
- Hand Expression and frequent and complete nursing (or emptying breasts) are the best ways to initiate and maintain milk supply as well as close, ongoing contact with your baby if possible.
- When supply is low, consider hormone levels 1) prolactin 2) oxytocin 3) cortisol 4) thyroid stimulating hormone 5) insulin
- Finally, insure there are no lactogenic inhibitors (sudafed, cigarettes, placental capsules etc.)
Keep In Mind
Each breast makes milk independently and will have different output. Generally newborns figure this out and naturally will not be bothered if one breast has more milk available than the other.
