Infants & Toddlers | Women's Health
September 22, 2016

Low breast milk supply? We’ve got answers

by breast-mii-supply

If baby’s breast milk supply seems low, consider these points before making any attempt to increase it.

 

What do Blue Gatorade and Double Stuf Oreos have in common? According to internet lore they are both attributed to increased milk supply, although there is a lack of scientific evidence to support that claim. But before running out to the nearest store to stock up, let’s examine low milk supply, which is something many breastfeeding mothers will worry about at one time or another.

The first question that should always be asked before attempting to increase milk supply is simply “What makes you think your supply is low?”

Common answers and responses include:

  • My breasts no longer feel full/I no longer feel let down. As milk supply regulates after the first few weeks of nursing, breasts may not be engorged or feel as full as they once did and mothers may or may feel the pins-and-needles sensation of let down. This is normal and not a sign of milk supply. In fact, when breasts are full, milk production actually slows, so soft breasts mean working breasts.
  • I only pump a few ounces at a time. While the internet is full of pictures of women with stocked freezers of pumped milk, the actual expected output from pumping is about 0.5-2 ounces total from both breasts for a mother who nurses full time. Babies are much more effective than pumps at extracting milk, so pumping is also not a good way of knowing how much baby is getting at each feed.
  • I can’t keep up with how much baby is taking while I’m at work. Sometimes an issue of not being able to produce enough milk is actually an issue of how much baby is being given. Unlike formula, breast milk changes to meet a baby’s specific nutritional needs at any given age, so the total amount of what baby takes doesn’t change much between 1 and 6 months old (average is about 25 ounces per day). After 6 months, as baby starts solids, the amount of milk may decrease slightly. Calculators for estimating how much to feed baby based on weight are for formula, since more milk is the only way to increase the amount of calories per feed with formula. Most breastfed babies will not ever take more than 3-4 ounces at a time by bottle. Pace feeding is a bottle feeding technique that can help prevent overfeeding.
  • My baby wants to nurse all the time. Frequent nursing, or cluster feeding, is a common behavior. Nursing is supply and demand, so during growth spurts she may want to nurse more often as a natural way of boosting supply. Babies also nurse for reasons other than hunger — it might be for comfort or fighting off illness, or coincide with a developmental milestone like rolling over or crawling.

Before considering supplementing or trying methods to increase supply, it is also important to evaluate baby’s weight gain, the number of wet and dirty diapers each day and any medications the mother might be taking that could affect her milk supply. A visit with a lactation consultant is crucial for identifying any issues with the baby’s latch and ability to transfer milk.

Herbal supplements are often hailed as galactagogues, or substances that increase milk production, but there is limited research to support this. Herbs also are not regulated in the U.S., so what is on the label may or may not match what the product inside the bottle is supposed to be. Prescription medications are often last resorts, but are not without side effects. Research supporting their use is limited.

Concerns about milk production are quite common, but the reality is that most women produce enough milk to exclusively breastfeed their babies.

Community resources such as lactation consultants, La Leche League and other group support meetings and evidence-based Internet resources such as KellyMom.com can help provide mothers with educational and emotional help so they are able to achieve breastfeeding goals.

As milk production is largely supply and demand, the easiest way to make more milk is to nurse more frequently. Nurse on, mamas!

Bethany Sanders is a certified nurse midwife and cares for women at the West End Women’s Health Center and Cole Family Practice. While originally from the Midwest, she is thrilled to have called the South home since graduating Vanderbilt in 2006. When not attending births or measuring pregnant bellies she can be found at the local park chasing around her two young children and discussing babywearing, cloth diapers and breastfeeding.

Infants

Vanderbilt offers a Mom’s Milk Club that meets from 12-2 p.m. Thursdays at the Family Resource Center on the second floor of Monroe Carell Jr. Children’s Hospital at Vanderbilt.  The club offers breastfeeding support and answers to your breastfeeding questions. Details: 615-936-1414.

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