Potential causes of low milk supply
At various stages of your breastfeeding experience, you may find that your milk supply drops a little, which can be quite common, and it is good to know the reliable signs that tell you that your baby is getting enough milk.
If, after looking at that information, you find that there is evidence that supply has indeed dropped, the info here seeks to help you to identify the cause and take you through steps that you can to rectify this.
When your baby feeds at the breast, with every swallow of milk, your body makes more milk on that particular side.
There is a factory scenario going on here! Where there is lots of swallowing happening, your body will produce more milk.
Sometimes your baby may put in less ‘demand,’ and therefore, less swallowing is happening.
In this situation, there will be less emptying of the breast, and your body will make less milk on that particular side. It’s good to know how breastfeeding works!
If you offer formula in place of a breastfeed, commonly called combination feeding, there will be less stimulation at the breast, so in effect, your baby is putting in less demand. Therefore there is less emptying happening, and your body will, therefore, make less milk.
However, it’s worth knowing that there are times when formula supplements are essential, and in those situations, so look at the information on this topic, and ways to boost supply.
If you are using formula, you are likely to be using a bottle, and as you can imagine, babies can often take milk from a bottle with minimal effort.
It is a very different sucking mechanism from feeding at the breast. Babies faced with a bottle can often drink milk very rapidly.
Consequently, some babies appear to get ‘confused’ or frustrated at the breast, mainly because the flow is generally slower at the breast, and there is less volume at the end of each letdown of milk.
Using breast compressions when your baby is feeding at the breast can be helpful if you are also offering formula supplements for any length of time.
Breast compressions will help to push extra milk to your baby when your baby is attached at the breast, thus helping to maintain your supply.
Another common reason why your supply can potentially drop is if you offer feeds in a more regimented way, which can mean either cutting the feed short or adhering to strict timing of feeds. It’s fully understandable why a lot of mothers want to do this. There are lots of parenting books on the market which put breastfeeding on a schedule. These regimented regimes, however, are not based on evidence, and it’s a sure way of reducing your milk supply.
It is far better to watch your baby’s feeding cues and let him come to the breast as often and for as long as he wants.
Consider the use of breast compressions if your baby is falling asleep at the breast, hanging out at the breast a lot with little swallowing heard, or coming off the breast frequently after really short feeds.
Another potential reason that can cause your supply to drop is the overuse of dummies.
Some babies are so passive that they will suck on a dummy instead of the breast, even when they are hungry.
Some babies will allow themselves to be pacified that way without stimulating your supply, so this can cause a drop in milk production.
Dummies may also interfere with latching – most likely to occur in the first month when you and your baby are learning how to breastfeed.
It can be beneficial to avoid their use entirely during this time, if possible.
Another common reason why your milk supply can drop, and sometimes even in the first few weeks of breastfeeding, is if your baby is unusually sleepy.
Sleepy babies, particularly sleepy newborns, do need to be proactively woken to stimulate milk supply.
Sometimes breastfeeding women say that they have been encouraged to offer only one breast per feed, which is, in fact, a sure way of reducing your milk supply.
Offer both breasts per feed to give your body a chance to establish your milk supply.
However, if you have an oversupply, you may find that offering one breast per feed works well.
If your supply has dropped, then allow your baby to feed on one side for as long as he will feed actively, and then offer the other side, which can boost supply.
Look at weight gain and wet and dirty nappies as the most important and reliable signs that help you to assess your milk supply.
All of the above points are common issues that can happen when you are breastfeeding and can be easily rectified.
However, sometimes the reason for low supply can be due to other causes.
For instance, it may be that your baby is not stimulating your supply adequately enough because of a tongue tie.
If this is the case, your baby may not have the tongue movements necessary to be able to drain the breast adequately.
Medical conditions that you have can potentially impact your milk supply, e.g., anemia, hypothyroidism, or polycystic ovary syndrome.
Any of those medical conditions could affect your milk supply.
If you have had a retained placenta after the birth of your baby, this, too, can affect the hormones involved in milk production and can potentially cause a problem with milk supply.
A significant blood loss during delivery of 1000ml or more, where you may have had to have a blood transfusion, can sometimes impact on reaching a full milk supply too.
Sometimes a low milk supply can be caused by what is known as hypoplastic breasts, which is a condition where you may not have enough milk-making glandular tissue within the breast itself.
With this condition, breasts may appear somewhat conical in shape and lacking in glandular tissue.
Even in this situation, however, it can still be possible to make milk, and some women even make a full supply. It is very variable from woman to woman.
Please bear in mind that any breast or chest surgery that you may have had in the past could potentially impact on reaching a full supply, e.g., breast reduction surgery or augmentation surgery (breast implants).
Some medications can potentially reduce your supply. You may be taking these without realizing the potential effects.
Seek out reliable sources to discover whether a particular drug could be impacting supply.
The critical thing to consider, if you are concerned about your supply, is to rule all of these things out FIRST.
Even if you identify a particular cause of your low milk supply, you need to know that it is still possible to bring about an increase in your milk production.
Everybody is different. You all have a different interplay of hormones.
Many mothers who have several potential factors against them have still been able to move forward with breastfeeding.
Review dates, references & further resources
Version 1.1 published in March 2019. Next review date: Jan 2022
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