Reasons for Low Milk Supply: Common Concerns and Questions

New mothers often assume that because there baby is wanting to “suck” more after feeding at the breast or “acts hungry” must mean that they do not have enough milk. The majority of the time, mother’s have plenty of milk, the baby truly just has a desire to suck. However, the concern of not making enough milk for your baby is a common one. The important thing to determine is whether or not you truly have low milk supply. The majority of the time it isn’t that the milk supply is low at all, it is simply that breastfeeding is a learned art; and adjusting to the frequency of feedings is what can make women think there is not enough. There are many misconstrued reasons that supply is considered to be low. There are also many genuine reasons that can cause a milk supply to drop. The important thing is to first understand the difference.

If your baby is gaining weight without supplementing with any other form of milk, is having at least 6-8 wet diapers, and 3-4 dirty diapers, then you do not have a low milk supply. Thankfully most paper diapers now have an indication stripe on the diaper letting you know when the diaper is wet. However, if you are using cloth diapers a good wet diaper is about 45ml or 3 tablespoons of fluid. The urine should be pale yellow and not have a strong odor. By day 5 of life poopy diapers should be yellow and seedy, no meconium present, and be about the size of a quarter or more, around 2.5cm.

Remember a 5-7% weight loss is normal for a newborn. A breastfed infant should regain their birth weight by 10-14 days of life. Once mom’s mature milk has come in then they baby should be gaining about 6oz a week. The behavior of the baby post feed, the weight or sensation of your breasts, the frequency of feeding, the sensation of “let-down”, or how much you pump are not adequate ways of evaluating whether or not you have enough breast milk. Your baby’s weight gain and diaper output is the most valid tool to measure. If you are not sure if your baby is gaining weight because you haven’t had a weight check recently, then your best gauge would be off of the number of wet and dirty diapers. When in doubt check it out. Most breastfeeding support groups have scales where you can weigh your baby, or if need be you can schedule an appointment with your pediatrician to have a weight check.

Below are some of the most common questions and comments I get in response to low milk supply. These DO NOT mean that you have a low milk supply.

1. My baby wants to eat ALL THE TIME!!! He must still be hungry?

It is true that breastfed babies need to be fed more frequently the formula fed babies. The reason for this is because breast milk, being perfect food for the baby’s gut, digests quickly. Breast milk often digests in as quickly as 1.5 to 2 hours. So it is always best to be a baby watcher rather then a clock watcher. Your baby may need to feed more frequently. However, this being said, because the proteins in breast milk are designed for your baby, it is impossible to overfeed a breastfed  baby. You CAN however overfeed a formula fed baby. The protein in formula is different and harder for the baby to breakdown and digest. This is why they often go longer in between feeds. Their little body is taking longer to digest the artificial protein in the formula, which can make them more sleepy.

It is possible that your baby is also going through a growth spurt. Babies often go through growth spurts at 2 weeks, 6 weeks, and 9 weeks of life. When this is happening, the baby will need to feed more frequently. Go off of your baby’s cues. He/She will tell you when it is time to feed again. Growth spurts generally last a few days to a week.

When your baby is naturally increasing the length and frequency of these feedings, try not to offer supplements. Your baby is feeding more often because it is signaling to your body to make more milk. The more the baby nurses or stimulates the breast the more milk your body will make. By not allowing this to happen, and giving a bottle instead, your body will not receive the message and most likely your milk supply will drop rather than increase.

Remember, that sometimes your baby just needs to suck. There is a lot of research out there in regards to non-nutritive sucking. This is part of the baby’s calming reflex. The mother can choose whether or not to allow the baby to nurse as a source of pacifying, or to use an artificial means with a pacifier or finger.

Another very common reason your baby wants to feed more frequently, is simply because the baby is missing the close contact she once had with her mommy. Baby’s need to feel close to feel secure. This is why the importance of skin to skin contact and “wearing your baby” is so very important.

2. My baby will take 2 ounces of formula or expressed milk in a bottle after I have fed without any problems?

Babies often will take a bottle willingly after a full, satisfied, feed at the breast. The majority of the time however this is due to a swallowing reflex the baby has. When fluid is being poured into the baby’s mouth they are obligated to swallow, which elicits a sucking reflex which then fills the mouth with more fluid. The baby isn’t “gulping” or “sucking down” formula, they HAVE to swallow to be able to breath again. This of course confuses parents, making them think the fussiness or sucking cues had to be because they baby was still hungry, when most likely it was the exact opposite. This of course then leads to more bottles, causing the breasts to not be stimulated as frequently which will eventually lead to a lowered milk supply. The ideal case would be to just place the baby back on the breast rather then giving more bottles.

3. But my baby is fussy?

All babies are fussy at certain times of the day. It is part of there neurological development. Often times this happens late in the afternoon or early in the evening, which again makes mother’s feel like they have lost their “Quota” of milk for the day. In fact the majority of the time it is not related to any physical need such as being hungry, having a dirty diaper, or having gas. Often times it simply is a neurological response that the baby will outgrow.

4. I am not seeing any milk when I pump?

A baby can always empty a breast far better then a pump can. The way a baby suckles elicits a completely different hormone response then the pump. This is not an indication that you do not have milk. There are many mothers who have very healthy abundant milk supplies, but are unable to get much of it out with a pump. A lot has to do with how you are using the pump, and what type of pump you have. There are different pumps for different needs. Some are strictly for stimulation purposed where others are for expression. It depends on the situation. A trained Lactation Specialist can analyze the situation and help you make the choice that is best for your personal situation.

5. My breasts feel softer and I don’t have that tingle “Let Down” response?

The longer you breastfeed, the better adapted your breasts will be, and the more at ease the cellular tissue will be. This is a normal sign that your breasts have adapted to the amount of breast milk your baby needs. Your milk composition and the amount of milk produced will change based on your baby’s needs. Not every woman will feel the “tingling” or “rushing” sensation associated with let down. That is personal to each woman and is not associated with milk supply.

These common concerns are frequent in new mothers, but not reasons for low supply. Low supply is related to various situations such as:

  • Maternal Health conditions – Not taking care of yourself can absolutely cause a drop in milk supply. If you are not drinking enough fluids, 8-10 glasses of water a day, your body will not have enough excess to give towards the production of milk. If you are not taking in enough calories your body will not have the proper nutrition or caloric needs to produce enough. Rest is another important aspect of milk production.
  • Frequent supplementation – Your breasts work by supply and demand. If you are not emptying the breast frequently, or stimulating the breast enough it will produce less. By supplementing more often with bottles the baby will not want to feed at the breast. It is a lot easier for a baby to feed out of a bottle then a breast. They don’t have to work as hard!
  • Nipple Confusion/flow preference – The bottle has a different texture and a faster flow. If the baby doesn’t have to work at all to be fed, meaning the milk just flows, a baby would much rather have that as an option then sucking to be fed. The baby receives instant gratification. When the baby then goes to the breast, and has to suck to elicit a milk ejection response, the baby will “Shut Down” or become fussy. Thus repeating the cycle.
  • Scheduled feeding – Sometimes ending a feed because it has been a certain amount of minutes rather then watching your baby feed can also hinder the amount of milk produced. This all goes back to the supply/demand ratio. Feeding on demand allows the breast to respond better. Just how you and I feed more one day then another day, your baby does also.
  • Health/Anatomical conditions of the baby
  • Thyroid Conditions of the mother
  • Diabetes
  • Herbs and medications – See peppermint and other herbs for additional information

The most important key to remember is that breasts work by Supply and Demand! Keep that baby close, at the “brestaurant” if you will, and allow that baby to feed early and often. The more you feed the more you will make.

Copyright© 2011 Danielle Gauss – All Rights Reserved.

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