I am so excited to delve into this topic because there are so many MYTHS and misinformation out there about breastmilk supply. We are going to cover the following topics:
Do you actually have a low milk supply?
In my years working with new moms, I have found that many moms think they have a low milk supply when they actually do not. Here's a quotation from one of my favorite resources, Kellymom, about this:
"It’s important to note that the feel of the breast, the behavior of your baby, the frequency of nursing, the sensation of let-down, or the amount you pump are not valid ways to determine if you have enough milk for your baby."
Your breasts, your milk, and your baby will go through many changes in the first two months. This can be alarming, especially if you don't know what to expect.
Do you want to breastfeed and you're tired of all of the confusing information? Take our online & on-demand class: Breastfeeding Made Simple. Join us as we partner with an IBCLC to teach you all about how to breastfeed with confidence.
Breastmilk Production Basics:
After your baby is about a day old, your body will begin to produce milk based on supply and demand. Here's a graphic to understand this process:
Here's what is normal:
Right after birth: Your breasts will likely feel soft. You may wonder, "is my baby getting any milk at all?" The answer is YES! Your breasts are producing a special kind of milk called colostrum. Colostrum is thick and comes out in small quantities, which is perfect for your newborn's small stomach size. Colostrum has all the nutrients your newborn needs. Colostrum is made regardless if you nurse or not (it's signaled by hormones, not by supply and demand). Continue to nurse on demand.
2-7 days after birth: Your milk will "come in." What this really means is that your colostrum will transition into what most of us know as breastmilk. Your breasts will likely feel engorged. You may leak milk. You may be thinking - HOORAY! I'm a milk-making machine! But at this point, your body switches over to the supply-demand cycle for determining how much breastmilk your baby needs.
So, if you supplement or are unable to nurse on demand the first week, you may not feel engorged or have as much milk. This is why it's important that you nurse as much as possible.
6+ Weeks after birth: Your breasts may begin to feel softer. This is normal and doesn't mean that you're running out of milk. This simply means that your body knows how much milk your baby needs, and is producing the right amount without causing you to feel engorged.
Here's what may happen that DOES NOT mean that you have a low milk supply:
Your baby wants to nurse all the time. This is very normal newborn behavior, and it has a name: CLUSTER FEEDING. Read this blog to learn more about this. Breastmilk is digested quicker than formula, so most babies will want to nurse every 1.5-2 hours. It's also normal for your baby to suddenly want to nurse more. Babies go through growth spurts and developmental leaps that cause them to need to nurse more, and has nothing to do with your milk supply.
Your baby is fussy. Babies can be fussy before, during, and after breastfeeding. Fussiness alone is not an indicator that you don't have enough milk. There are many reasons for fussiness - read this article to learn more.
You're not producing much milk while you're pumping. Pumping is not a good indicator of how much milk you're making, because pumps just aren't as good as babies at removing milk!
How do you know if your baby is getting enough milk?
Here's a graphic to show you the signs:
The two most important items from that list are baby gaining weight and having enough wet/dirty diapers. If your baby is doing both of those, then you're on the right track!
If you do have an actual low milk supply, there are some reasons why this may be the case:
Your baby has a latching issue. This can be caused by a tongue or lip tie, and needs to be diagnosed by a professional. But if your baby has a tie, they may nurse frequently but be unable to get enough milk. If you suspect this is the case, call a lactation consultant near you to be assessed!
You're supplementing. Any amount of formula given in place of breastmilk will reduce your baby's demand for milk, which will in turn, eventually, lower your supply.
You're using a pacifier instead of nursing. I know this one won't be a popular one, but it's true. When you ignore your baby's hunger cues with a pacifier and space out your feedings, your milk supply will eventually lower. I'm not saying that you should never use a pacifier! But before you use one, make sure your baby has had a full feeding at the breast. Also make sure, especially in those first weeks, to feed your baby every 2-3 hours (or as much as your baby wants).
Your baby prefers the bottle. Sometimes bottle & breastfed babies get frustrated while nursing because your breastmilk doesn't come out as quickly. This causes your baby to be fussy at the breast, which often causes couples to give a bottle in exasperation (which only perpetuates the cycle).
You're not feeding on demand. Scheduling newborns or limiting the amount of time they can eat can result in a low supply. This is why we do not recommend implementing a sleep/eating schedule with newborns (before 3-4 months postpartum).
You have anatomical, hormonal, or other issues. Low supply is a legitimate thing and effects up to 10-15% of moms. If you are doing all the things I mentioned above and are still having issues, please reach out to a lactation consultant and your pediatrician.
That's not a complete list, but those are the most common reasons why moms have a low milk supply. If you're like "YES. THIS IS ME. I NEED HELP!" then keep reading...
Do foods increase milk supply?
I'm gonna be straight with you - there have been no scientific studies that have linked certain foods to a significant increase in milk supply.
So yep, all those lactation cookies and foods don't hurt, but they're not likely to have a direct effect on your supply.
What about galactagogues?
Galactagogues are substances that cause an increase in milk supply. Some common ones are: fenugreek, blessed thistle, and alfalfa. There are also prescription medications you can take to increase your milk supply.
In general, the evidence on all of these is still mixed, but many moms report seeing an increase in milk supply 48-72 hours after using one. To get dosing recommendations, please contact your local lactation consultant.
What about all those moms who swear that drinking Body Armor, eating oatmeal cookies, drinking beer (etc.) increased their supply?
I'm not calling them liars! What's difficult is that often when a mom eats or drinks a new food, there are multiple factors at play.
For example - maybe she was dehydrated before drinking Body Armor, which was causing her low supply. Was it the Body Armor specifically that increased her milk supply, or was it just increasing her fluid intake in general?
That's why we need more high-quality studies that can isolate these factors and give us good data on what, if any, factors actually cause an increase in milk supply.
Bottom line: if eating cookies or drinking a tasty beverage works for you - go for it! Most of these will do no harm. But eat/drink these along with the evidence-based methods I will outline below...
What are the evidence-based ways to increase milk supply?
Make sure your baby doesn't have a tongue or lip tie and is latching correctly. It is very important that you have your baby assessed by an experienced lactation consultant (LC). Depending on your hospital, the LC you see may or may not be trained in how to do this.
How do you find a good LC? I find that many private lactation consultants are more specialized and can either diagnose a tie or will know who can help in your area. You may also ask around in local Facebook mom groups. They're a wealth of information.
Nurse frequently and as often and as long as your baby wants to nurse. Here are the most common baby hunger cues:
Notice how subtle some of these are! I think many moms wait until their baby is crying or is obviously agitated before latching. You'll be surprised how often your baby wants to nurse. Take some time to notice your baby's cues. I know this may be hard to do, but if you want to increase your milk supply, it's the best way to go about it.
3. Try breast compression as you nurse. Watch this video for a demonstration on how to do this. Remember - no need to go hard!
4. Try switch nursing. This is a great way to encourage a sleepy baby to keep nursing. Basically, you switch sides every time your baby's sucking starts to slow, they fall asleep, or they get distracted. This will signal your body to make more milk.
5. Try pumping after you breastfeed, or adding in a few pumping sessions throughout the day in addition to nursing on demand. You may worry that this will rob your baby of milk, but that's not the case. Your body will simply make more milk!
If your baby is struggling to gain weight and you really don't want to introduce formula/want to breastfeed, you may try Triple Feeding. Basically you nurse, you pump, and then you feed your baby a bottle of your expressed milk. This does two things at once: helps your baby get more milk and gain weight while also increasing your supply.
You may notice that all of these have one thing in common - increasing the demand for breastmilk - which will result in an increase in supply! Typically moms will see an increase within 48 hours. Remember: do not look at how much you're pumping as an accurate gauge. Watch to see if your baby is swallowing, is obviously satisfied after eating and their diaper output increases.
Nothing is helping! What to do.
Here at Balanced Families, we love one thing: BALANCE. You will never hear us shame you into breastfeeding or because you cannot breastfeed, no matter the reason.
If you try all of the above and nothing is working, first of all please, please, please make sure you've seen a lactation consultant. There is no replacement for a real person, who assesses your specific situation and helps you achieve your goals. No blog post, social media post, or Youtube video can give you that kind of help.
If you've done it all, there are some amazing resources out there for moms with low supply. Many moms choose to combo feed, which means breastfeeding some, pumping some, and using formula as well. We include lots of information about this in our Newborn Class for Couples.
It's also perfectly fine if you decide to switch to all formula feeding, no matter the reason. I know many moms want to try all the things so they can feel like they did all they could to breastfeed. I also know that breastfeeding can cause many moms mental health stress as they try to nurse and keep up with the demands of our modern society. In fact, I (Jessica Lagrone), switched to formula-feeding our third daughter at 4 months old, due to some extenuating life circumstances. I don't regret that decision one bit!
I hope this blog empowered you to learn about your breastmilk supply and make decisions that are right for your family. Breastfeeding doesn't have to be complicated, but it does require work. There's no way around that! But for most moms, putting in the work in the first couple of months will yield a long & satisfying breastfeeding journey for you and your baby.