What Causes Low Milk Supply While Breastfeeding
Many new mothers want to give their babies the best start in life, and breastfeeding is often seen as a key part of that journey. However, some may notice their milk supply is not meeting their baby’s needs. Low or insufficient milk supply can bring stress and worry, especially for those who are not sure why it is happening or how to fix it.
Understanding the reasons behind low breast milk supply can make a big difference. A lactation consultant or pediatrician can offer important breastfeeding support, answer questions, and guide parents through feeding challenges. With the right knowledge, families can feel more confident in their breastfeeding journey and find helpful solutions to boost milk production.
Breast Gland Development Issues
Some individuals have breasts that do not form enough glandular (milk-making) tissue. This condition can cause challenges with breast milk production because there are fewer ducts to produce milk. Even so, each pregnancy often increases the amount of milk-making tissue, and breastfeeding itself can encourage more development over time.
To help increase supply, mothers can stimulate their breasts regularly and nurse or pump frequently. These actions signal the body to make more milk. Sometimes, supplementing with formula may be necessary if milk supply remains low. Talking to a healthcare provider about possible treatments, such as medication, can be helpful. Even small amounts of breast milk can offer important nutrition and immune support to a baby.
Hormone and Gland Issues
Problems with hormones or glands can affect how much milk a person makes. Conditions like polycystic ovary syndrome (PCOS), diabetes, thyroid imbalances, and even high blood pressure may lower milk output. These issues interfere with the signals breasts need to get for healthy milk production. Stress and obesity can make things harder, since stress hormones and extra weight may also impact hormone levels.
Managing the main health issue, such as getting thyroid levels balanced or treating diabetes, might help improve milk supply. Meeting with a lactation consultant or specialist can offer guidance that matches each individual’s medical needs.
Breast Surgeries
Surgeries involving the breasts, such as reductions, enhancements, or even nipple piercings, can sometimes influence breastfeeding. The effects depend on several factors, including the type of surgery, the techniques used, the amount of time since the operation, and whether there were issues like scarring or injuries to the milk ducts.
Some procedures, especially breast reductions, carry a higher risk of damaging nerves or ducts needed for milk flow. Others, like certain breast augmentations, may cause fewer problems.
Women who had breast enhancements are often able to breastfeed successfully, while those with reductions may need extra support. In some cases, breastfeeding may need to be combined with bottle feeding if milk supply is limited.
Hormonal Contraceptives
Hormonal birth control, such as pills, patches, or injections, may affect milk supply for some breastfeeding mothers. While many women do not notice changes, others may see a noticeable reduction in milk production, especially if hormonal birth control begins before their baby turns four months old. In some cases, a drop in milk might still occur even if these methods are started later.
If supply decreases, it’s important to talk to a healthcare provider. They may recommend switching or stopping the current method and can suggest ways to boost milk supply—such as herbal options, prescription medication, or more frequent pumping. Working with a doctor helps ensure the safest and most effective approach for both parent and baby.
Medicines and Herbs That Affect Milk Supply
Some cold medications and herbs like sage, parsley, or peppermint, especially in large amounts, can lower milk production. Anyone who notices a drop in supply after starting a new medicine or herbal product should speak with their healthcare provider about other options.
Increasing nursing sessions or using a breast pump to express milk may help boost production. Certain herbs called galactagogues, such as fenugreek, are sometimes used to try and increase milk supply, but their effects can vary.
Sucking and Anatomical Issues
Babies sometimes face challenges that make it hard for them to effectively remove milk from the breast. One common reason is a condition called tongue-tie, where a tight membrane under the tongue keeps the tongue from moving the right way.
This can make it tough for the baby to create a good latch and transfer milk because the tongue cannot press against the breast efficiently. Parents might notice the baby has trouble sticking their tongue out or touching it to the roof of the mouth when crying.
If tongue-tie is present, a doctor can usually fix it with a simple procedure. After the procedure, babies often show quick improvement in their feeding skills. Other anatomical issues—such as a cleft lip or palate—can also affect a baby’s ability to latch or suck. These conditions may need special care and guidance from healthcare professionals.
Signs of these difficulties include breast engorgement, poor milk removal, and a baby who still seems unsatisfied after feedings. When a baby struggles with sucking or cannot create a proper seal on the breast, milk is not transferred efficiently. Over time, this can lead to reduced milk production. Addressing these signs early can help protect milk supply and support more effective feeding.
Skipping Nighttime Feedings
Night feedings are important for mothers who are exclusively breastfeeding. When mothers skip these feedings due to sleep training or other reasons, it can impact both the baby and the mother’s milk production. Some mothers, especially those with lower milk storage capacity, may find that not feeding at night leads to a noticeable decrease in their breast milk supply.
Nighttime is when the body produces higher levels of prolactin, a hormone that helps produce milk. If mothers nurse less during these hours, prolactin levels drop and milk production decreases. Babies who go without night feeds for extended periods might not gain weight as well as expected, especially if their mother’s supply drops.
Some families may choose to reintroduce one or two night feedings if they notice these issues. Keeping at least some nighttime nursing sessions can make a difference for exclusive breastfeeding, supporting a healthier milk supply and helping babies grow as expected.
Feeding Schedules and Pacifier Use
Setting a strict feeding schedule or using a pacifier to delay feedings can affect milk supply. When a baby feeds less often because of these routines, the breasts remain full for longer periods. This makes the body slow down milk production, as it senses there is less demand.
Responsive feeding, where parents follow the baby’s hunger cues instead of a set schedule, encourages more frequent and shorter nursing sessions. This keeps the breasts emptier more often, signaling the body to make more milk. The more often a baby breastfeeds, the better the milk supply is maintained.
Being aware of how schedules and pacifiers may influence breastfeeding can help caregivers support healthy milk supply.
Delivery Medications and Jaundice
Some babies experience difficulty breastfeeding if their mothers receive certain medications during labor, such as an epidural. These medications may affect a newborn’s ability to latch and nurse well, and in some cases, the effects can continue for several weeks. This can lead to less frequent and less effective feeding, which may impact the baby’s weight gain and overall milk intake.
Jaundice, a common newborn condition, can also make babies unusually sleepy. As a result, they might not wake up as often for feeds. Parents may need to express milk and offer it to their baby in a different way to help support nutrition and maintain milk production. Once the baby recovers from jaundice or has cleared the medications from their system, feeding usually improves and babies can nurse more effectively.
Supplement Use During Feeding
Giving formula in addition to breastfeeding, also called combination feeding, may impact breast milk supply, especially in the early weeks. When a baby receives more formula, they may suckle less at the breast, leading the body to make less milk. The breasts adjust how much milk they produce based on how much is removed, so less feeding or pumping can lower overall milk production.
Tracking diaper output can help parents know if their baby is getting enough to eat. Most healthy babies have at least six wet diapers a day after the first week. If the number of wet diapers drops, it may be a sign that the baby needs more milk or that supplementation is affecting breast milk supply. If supplementation is needed, it can help to both breastfeed and pump regularly to keep milk production steady.
When to Add Formula
Sometimes, breast milk by itself doesn’t meet a baby’s needs. When families face a low milk supply, they can use some formula as a supplement to ensure the baby gets enough nutrition. Supplementing does not mean breastfeeding needs to stop, and with the right steps, families can keep both methods working together.
Combining Breastfeeding and Supplementing
- Some parents use a feeding tube at the breast. This method uses a thin tube that delivers formula while the baby breastfeeds, so the baby continues to practice nursing while also getting more food. Parents can attach the tube along the breast or hold it at the corner of the mouth as the baby feeds to keep the process smooth and familiar for the child.
- Other parents offer a bottle of formula before breastfeeding. By giving a bottle with slightly less formula than the baby might want, parents keep the child from being too hungry or upset when coming to the breast. After finishing the bottle, parents let the baby nurse to make breastfeeding a pleasant, relaxed time. The baby learns to associate breastfeeding with feeling comfortable and calm.
- When using a bottle, parents can feed the baby in a slightly upright position. Holding the bottle mostly horizontal encourages the baby to actively suck rather than having milk pour into their mouth. Allowing breaks if the baby pauses too long keeps the pace slow and steady, which can prevent a preference for bottle feeding. This technique can make the transition between bottle and breast easier for both parent and child.
- Frequent breastfeeding sessions—even if short—help. Offering the breast between or after supplement feedings encourages milk supply and helps keep the breastfeeding relationship strong. Babies may only nurse for a few moments, but these extra chances to nurse signal the body to keep making milk.
Low milk supply can be discouraging, but understanding the causes is the first step toward finding solutions. With consistent support, informed choices, and guidance from healthcare professionals, many families can overcome feeding challenges and continue their breastfeeding journey.
