Low milk supply or lactation undersupply is the most common reason mothers
give for early weaning.
Today we will review and explore solutions to this frustrating issue.
All of the above!
Lactation undersupply has many names… and basically means low milk supply.
The struggle is real and is undeniably frustrating for both mother and
baby, in fact it is the major reason why mothers decide to bottle
The above signs do not indicate undersupply. Your milk supply may not be
low at all, even though you may think that it is low. This is called
perceived lactation undersupply.
Perceived lactation undersupply is mostly due to improper
technique to breastfeed your baby.
If your little one is gaining enough weight and having enough wet
diapers then they are well fed!
Exclusively breast-fed babies who have enough breast milk generally have a
weight gain of 500-1000 grams per month (around 1-2 pounds) and wet diapers
about 6-8 times a day.
If you have any concerns, always talk to your baby's healthcare provider.
What causes lactation undersupply?
Many factors can cause, contribute, or predispose to lactation undersupply.
Factors in the baby such as prematurity/low birth
weight, birth asphyxia, illness, and defects, e.g., tongue tie, cleft
palate and congenital heart disease.
Factors in the mother such as maternal health (anemia,
postpartum hemorrhage), smoking, inadequate glandular tissue resulting from
hypoplastic breasts, breast surgery such as mastectomy, breast reduction,
nipple piercing, or cyst removal; inadequate breast drainage, pain during
breast-feeding, caused by - nipple trauma from inappropriate technique or
practices, breast pain from inappropriate technique, nipple or breast pain
from disease conditions.
Factors in the environmental and hospital practices:
separation of the baby from the mother, early introduction of bottle feeds,
use of pacifiers.
Other factors include: restriction of frequency or
duration of feeds, poor motivation or ignorance leading to discontinuation
of feeds for minor ailments, administration of infrequent strict time
scheduled feeds, Inappropriate management of local problems in the breast,
e.g., flat and sore nipples, engorgement, retracted, short, or too large
nipples, sedation (also influences the baby), over-anxiety, excessive
fatigue, and drugs, e.g., oral contraceptives
Babies usually go down from their birth weight, but regain birth weight
by two weeks (10 to 14 days of life) and then continue
to put on 5-7 oz (150-200 grams) per week.
Diagnosis of undersupply is made:
When your milk is not sufficient, your baby does not feel satisfied
after feedings, cries a lot, wants to nurse frequently, takes very
long feedings, and does not gain adequate weight (loses more than
10% of birth weight, failing to regain birth weight up to 2 weeks
of life), no urine in 24 hours, and absence of yellow stools in the
If your baby wets less than 4-6 diapers each day.
If your baby accepts both breasts at every feeding and still seems
hungry after feeding ( rooting or sucking on fingers).
If you pump within 15-20 minutes of completing a breastfeeding
session, and get less than an ounce from each breast. Or you
collect an equivalent of an ounce when you pump after 2-3 hours
TRUE! The more milk you take out, the more milk your
Breastfeed more. Try to feed at least 8-12
times per day, and empty the breasts more
fully each time by letting your baby suckle on each breast more
than once and express milk after feedings. The more times per day that milk
is effectively removed, the faster your milk supply will increase.
Focus on the number of feedings rather than the time between
feedings per day.
Here are some other basic steps to take to ensure adequate supply:
Your own nutrition is important - Make sure you are
eating three healthy meals and about three healthy
snacks per day for calorie intake. Oatmeal is
said to help with milk supply, although not evidence-based it is a very
nutritious, whole grain option for breakfast.
Drink enough water to make your urine light yellow, do
not take more than necessary.
Check and improve your baby’s latch. Make sure your baby
has a good latch on and is positioned properly. Look for signs that your
baby is swallowing. A more effective latch will help your baby
remove more milk from your breast, thereby signaling your body to
If your baby stops nursing actively or falls asleep within ten minutes at
breast, stimulating the baby to breastfeed actively for longer, you can
also reposition your baby to the other breast.
Don't skip breast-feeding sessions, pump your breasts
when you miss a breast-feeding session, this will protect your milk supply.
Use the double pump method which has been found to
increase milk supply faster. Pump both breasts at the same time for 10-15
minutes either right after feedings or after about half an hour. When you
drain your breasts effectively, milk production is increased. As much as
possible, pump for another two minutes after you see the last drop of milk,
or pump for 20-30 minutes, whichever comes first.
Decrease supplementation. If your baby is younger than
one month, consider supplementing with a feeding method other than bottles,
such as a cup, syringe, or spoon. Gradually decrease the supplementation as
your milk supply increases.
Try herbs or other medications to increase milk.
Fenugreek is an herb known to increase your supply. Fenugreek has long been
used as a galactagogue (substance that increases milk production), and the
U.S. Food and Drug Administration has given it a rating of GRAS (generally
recognized as safe). Discuss with your healthcare provider before you take
it, as it can interact with some prescription and over-the-counter
medications. Take a higher dose of three capsules (of about 500mg each)
three times daily to increase your milk supply.
If you're unable to produce enough milk, despite all the efforts, and you
would like feed your baby with breastmilk, you can find a local
milk bank, where moms with extra breast milk donate what they
have for women in need.
Seek professional help. Sometimes just talking to a
Certified Lactation Specialist puts your mind at ease, and helps you relax,
which is a key ingredient to a healthy breastfeeding relationship
Remember that this is one of the most common reasons mothers stop
breastfeeding before they intend to. Be proactive, get support so you can
reach your goal!
MaternalWell text support is here for you for any general questions! For
more specific concerns, you can book consultation with our licensed
lactation consultant or reach out to your healthcare provider.