Babies need lots of food to fuel their growing bodies—but what if your breast milk production isn’t up to the task? Concerns about low milk supply are common among new moms. The good news is that if your supply is decreasing, there are plenty of ways to boost it back up. The best news? Chances are, your milk supply is actually just fine.
If you’re exclusively breastfeeding and baby is on target for healthy weight gain, your milk supply is likely A-OK—even if baby seems famished or fussy. To maintain a good milk supply, most moms just need to breastfeed whenever baby is hungry, and your body will naturally take care of the rest.
“Breast milk supply is hormonally driven in the first few days following delivery,” says Stephanie Nguyen, RN, IBCLC, a board-certified lactation consultant and founder of Modern Milk, a breastfeeding clinic and prenatal-postnatal education center in Scottsdale, Arizona. “When you breastfeed, the nerves in your breasts alert your brain to release prolactin, the hormone behind breast milk production.”
While hormones are what initially spark milk production, supply-and-demand soon kicks into gear: Basically, the more you nurse, the more milk your body produces to keep up with baby’s needs. Seems pretty straightforward, right? But as any new mom can attest, that’s not always the case.
“New parents often have no clue how much their newborn should eat and tend to think they need more than they actually do,” says Katie Page, a certified nurse-midwife in Lynchburg, Virginia. This confusion leads many moms to think they have low milk supply, when they’re actually doing just fine. Plus, unlike bottle-feeding parents, breastfeeding moms can’t see how much milk baby is really drinking, which just adds to supply stress. But the fact is, “90 percent of moms have the ability to make enough milk for their baby,” Nguyen says.
So how can you tell if your supply is actually low? Read on to learn what causes a drop in milk supply, how to spot the signs and how to increase your milk production naturally.
What causes low milk supply?
Here’s one of the most frustrating, confusing truths about breastfeeding: Your milk can be flowing freely one minute and slow to a trickle the next—and you’re left wondering what the heck is going on. But it’s a mystery you can usually solve. Here are the most common causes of low milk supply:
Not feeding enough
In the first few weeks following delivery, babies can be super sleepy and sometimes snooze right through feedings. If she’s packing on the pounds regardless, by all means, let a sleeping baby lie. But if not, wake your snoozer up to nurse. For the first few weeks, you should be breastfeeding eight to 12 times a day, which shakes out to about every two or three hours.
Supplementing with a bottle
Generally speaking, your body is built to produce as much milk as baby needs—so when baby breastfeeds often, your body understands there’s a high demand for milk and ramps up production to meet it. But when baby’s getting bottles of formula instead of nursing at your breast, your body is tricked into thinking baby needs less milk—and the supply shrinkage begins.
An ineffective latch
Sometimes, the problem isn’t with how often baby is breastfeeding but how he’s feeding at the breast. “ A poor latch can be detrimental to the entire breastfeeding process,” Nguyen says. “Baby removes less milk; therefore, mom produces less milk.” When a baby has a good latch, more milk comes out, and more milk is made.
Using a pacifier
“If baby is using a pacifier throughout the day, it can satisfy her need to nurse and she may not show hunger cues,” Nguyen says. If you’re planning on using a pacifier, wait until baby is 3 or 4 weeks old and your milk supply is well established before introducing it.
Drinking alcohol or smoking
Both of these things can decrease milk supply. Smoking can also slow your let-down reflex, making it harder for baby to nurse. If you’re having issues with low milk supply, avoid these substances.
Premie babies are sometimes too small and weak to breastfeed. “If your baby was born prematurely—or was separated from you after birth—it’s important to begin pumping right away to establish a good milk supply,” Nguyen says. If it doesn’t, milk production takes a big hit.
Health issues or medications
It’s common for a mom’s breast milk supply to take a (temporary) dip if she’s sick with a cold or the flu. But other health conditions, like polycystic ovary syndrome or thyroid issues, can have a more lasting impact on breast milk production, as can prior breast surgery. Certain medications can also muck up milk supply, like a combined contraceptive pill or a decongestant.
How to tell if you have low milk supply
How can you tell if your milk supply is decreasing? Unfortunately, baby can’t yet pipe up and say, “Mommy, I’m still hungry!” But your little one can still give you some valuable clues as to what’s going on. Keep your eyes peeled for these common signs of low milk supply:
Stalled weight gain
Babies normally lose up to 10 percent of their birth weight in the first few days, but they should regain that by the time they hit the 2-week mark. If baby struggles to put those pounds back on, low supply may be an issue. But “it’s important to know that newborn weight charts are based on standards set from formula-fed babies, who may gain weight faster than breastfed babies because the fat content in formula is higher and constant at every feeding,” Page says. “The most important thing is that babies are continuing to grow, even if slowly.” (On average, a well-fed baby gains four to seven ounces a week.)
Fewer dirty diapers
During baby’s first several days, she should wet the same number of diapers as her age. So a 2-day-old will dirty two diapers. Starting around day 5, it should increase to eight to 10 soiled diapers each day. (Take a peek inside: If the urine is light yellow or colorless and her poop is big, seedy and mustard-colored, she’s likely getting enough milk.)
Decrease in baby activity
“Babies who are not getting enough to eat are lethargic,” Page says. “They may not wake as often or be as active when they wake. They also look thin, losing that chubby baby look as their body uses the energy from their stored fat to power the brain, adrenal glands and more.” Trust your mom instincts.
How to increase your supply
A decrease in breast milk supply is not a permanent problem. There are many natural ways to stimulate your milk ducts so they produce more breast milk. Read on for the how-tos of boosting your milk supply.
See a lactation consultant
This should be you first course of action. “A lactation consultant can help you determine the cause of decreased milk supply and create a personalized plan for you to increase supply while ensuring your baby is getting enough to eat,” Nguyen says.
Up the frequency of feedings
Breastfeed baby every one to three hours. “If you go longer than four hours, hormones can signal the breast tissue to narrow gaps and lower production,” Page says.
Tweak baby’s latch
In order to get the most milk, baby needs to open her mouth nice and wide and drop her chin so that it touches your breast. Her tongue needs to be down and her lips flanged—not puckered—on the areola. This way the transfer of milk is more efficient and baby gets better feedings, which in turn helps create a robust milk supply.
It’s important to at least offer both breasts at each feeding, alternating which breast baby gets first. “This can ensure that each breast gets equal stimulation,” Nguyen says. “Moms should always start on the breast that she last finished on.” (And if baby only drank from one breast, pump the other.)
Give yourself a massage
Mimic the motions you use to do breast self-exams: With your fingers, press firmly at the top of your breast, working in a circular motion toward the areola. “Do this during feedings and pumpings to help increase supply by stimulating the milk ducts to release milk,” Nguyen says.
Use your pump
It’s important to pump (hospital-grade double pumps work best) for every missed feeding or anytime baby gets a supplemental bottle of breastmilk or formula. It’s also a good idea to express any leftover milk after each feed. And if your supply is truly low, power pump, Page says. “For an hour each day, pump 20 minutes, rest 10 minutes, pump 10, rest 10, pump 10. This can be done for a few days and works by signaling the body to make more.”
Feed your baby at night
Levels of prolactin, the breastfeeding hormone, are higher at night, so you’ll produce more milk—making it an ideal time to feed baby and ramp up your supply.
Consume breast-friendly foods
Try eating certain foods to increase lactation. Oatmeal and brewer’s yeast are packed with iron, which can help up milk supply. Flaxseeds can do the same, thanks to their omega content. To get all three at the same time, Page recommends the lactation treat Milkin’ Cookies. “You should also drink a ton of water,” she says. Try downing an eight-ounce glass each time you breastfeed, plus a couple more throughout the day. Finally, barley, fennel and hops, like in beer, may also support your supply efforts.
Try a supplement
Fenugreek, blessed thistle and alfalfa are all herbal galactagogues sometimes used to increase supply. “Fenugreek is probably the most common, which works well for many moms,” Nguyen says. “There are also supplement blends that contain multiple supplements in one pill. I prefer these because you may respond to one supplement and not another, so it’s best to try multiple supplements at once." Talk to your physician before taking any supplement. And if you’re given the go-ahead, know that once you reach a point where your supply is where you want it, you should stop taking the pills.