Low milk supply: Here's why you are facing this issue
There are many reasons for low milk supply, but knowing the cause and working on it from quite early on can help you as well as your baby.
There are many reasons for low milk supply. Formula feeding, low nutrition, insufficient glandular tissue and pre-existing medical conditions are just a few of them. But there is no need to worry.
The good news is that with the right information and support, you can increase your breast milk supply. Although in some cases, new mothers might need medical assistance to increase breastmilk production or even to relactate.
In this article we will explore the reasons for low milk supply, discover the amount you should ideally produce and find ways to increase milk supply.
Your low milk supply could be the result of a combination of things you might be doing. You could be managing breastfeeding incorrectly, or perhaps your baby is not able to latch properly. Giving your baby formula, or a medical condition in the mother will also affect milk supply.
These are just few of the reasons. Let’s take a look at some of the most common issues that lead to low milk supply.
For many new mothers, breast milk may take more than three days to come in. So when milk comes in slowly or late, it is medically called a delayed onset of milk or delayed lactation.
But just because it is late, it doesn’t mean you will always have low milk supply or no milk supply at all. However, it is one of the primary reasons for low milk supply.
Most of the time when milk comes in late, it worries the new mother. This stress may reduce the flow and speed of milk let down. And the cycle continues.
With the help of a lactation expert and the inclusion of food that increases breast milk production in your diet, you can get back on track.
If you have been topping your feed with formula, chances are you are slowing down your milk supply. Every time you give your baby a supplement, your breasts reduce milk production.
In some cases, your baby might need supplements. This could happen if the baby has jaundice or if your milk comes in very late post delivery. Or your milk supply has gone down and your baby has stopped gaining weight.
In cases such as these, try hand expressing or pumping to increase your milk supply.
Sometimes, even though your little one is one your breast, it may not mean that he is actually drinking. Babies often fall asleep at mummy’s breast with the nipple still in their mouth.
The best way to figure out if he is drinking or not is by analysing his swallowing sounds. Watch his jaw for active suckling. Also make sure to monitor his poop and his weight gain.
Other reasons for baby not drinking milk could be illness, a change in the taste of your breastmilk, or a condition in baby such as tongue tie.
Be sure to try different breastfeeding postures to help your baby get a proper latch.
As mentioned in our previous article, “Check with your lactation consultant to see which nursing position allows your baby to get a deep latch. Try different positions to know which is preferable for your baby. Is it the cradle hold, or the rugby hold or if he is comfortable lying down or in a cross cradle hold.”
You could also try a sleep latch, where baby latches on while still asleep. For this purpose, you can bring him close to your full breast and let him suckle. It’s better if you initiate a let down (of milk) beforehand by hand expressing.
To understand how to get a good latch, watch this video below.
As mentioned before, one of the reasons for low milk supply may be because of your own anatomy. You could have inverted nipples, flat nipples, or very long, large and differently-shaped nipples. Or you could have a skin tag or double nipples that are hindering your baby’s latch.
If you had nipple piercing, you might have been left with scarring. Or your nipple pores might have closed. Any anatomical change that causes a mismatch between the breast and the baby’s mouth can lead to low milk supply.
Usually, mothers and babies can overcome this problem with continued help and pumping.
Another probable cause for low milk supply is insufficient glandular tissue (IGT). This happens when milk doesn’t come even after you’ve tried various lactation methods.
IGT is sometimes called primary lactation failure, hypoplastic breasts, or failed lactogenesis. This condition might be present if you have very small and widely placed breasts or you’ve had a breast reduction.
It may also be because you have tubular-shaped breasts, hormonal issues, or your breasts didn’t enlarge after puberty or during pregnancy.
Low milk supply can also happen if you’ve had a breast surgery that damaged your glandular tissue. For instance, a breast augmentation or reduction, breast implants, a biopsy or a lumpectomy (surgical removal of a lump).
It can also be due to the draining of an abscess, a history of trauma to the chest, burns or infection in the chest. In addition, any issues resulting in breast development, or surgeries that affect the pituitary gland and the brain can lead to low milk supply as well.
Any endocrine or hormonal disorders can also cause low milk supply. Also, if you needed a fertility treatment to get pregnant or you have suffered from hormonal issues, it can lead to problems in milk production.
You might want to check for the following hormonal imbalances:
- Polycystic Ovary Syndrome (PCOS). It is a metabolic condition in which women have polycystic ovaries, where the ovaries produce more than normal androgens (male) hormones. High levels of these hormones affect the development and release of eggs during ovulation and milk production.
- Luteal phase defect. In this condition, the woman produces insufficient progesterone after the ovulation phase. This is related to IGT in women.
- Thyroid issues. Another common issue that leads to low milk supply is caused by the thyroid (dysfunction of thyroid gland). It affects both oxytocin and prolactin (the breastfeeding hormones). Ideally, you should get yourself checked for thyroid issues before pregnancy.
- Gestational diabetes or diabetes. If a woman has diabetes or developed it during her pregnancy, it can affect her breastmilk supply. You should monitor your blood sugar levels as well as insulin on a regular basis – pre, during and post pregnancy.
- Overweight. Being overweight with a Body Mass Index of more than 26 can be dangerous for an expecting mum. This automatically causes many problems in the body including low milk supply after delivery.
Hormonal medications and vitamins and minerals can do more harm than good. This is especially true when you are breastfeeding.
Oral contraceptives and inserting intrauterine devices, for instance, can weaken milk supply. Some studies also suggest that postpartum tubal ligation (getting the tubes tied) can also lower milk supply. Also excess of herbs such as sage, mint or parsley can also reduce breast milk supply.
In addition, low iron levels as well as hypertension during pregnancy (that increases blood pressure) can also lower the milk supply.
There are a few other factors that can lead to low milk supply. These include the age of the mother (if she is in her late 30s or over 40), drinking too much alcohol, smoking, marijuana use, and postpartum depression.
Also, support from your family — especially your partner — is important for breastfeeding success. If you are not getting this, then you might feel discouraged to continue.
All of these factors taken individually or combined can lower your breast milk supply. So make sure to avoid what you can and concentrate on increasing your breast milk supply.
Remember that milk production often works on the demand and supply principle. When your baby demands milk, your body will produce milk to fulfill his need.
However, sometimes your body needs an extra push in order to produce enough milk to sustain your baby’s demand.
As shared in our previous article, you can increase milk supply naturally by including galactagogues (breastmilk boosters) in your diet.
These include the following:
- Fenugreek seeds (methi), available as tea, are commonly used by Indian mums to increase breastmilk supply.
- Tumeric powder and turi leaves (both can be bought at Tekka market).
- Chinese herbs including Dang Gui and dates also improve your milk supply
- Filipina mums swear by malunggay. You can find it in speciality Filipino stores in Singapore.
- Include green papaya and fish head soup as well as fish maw soup in your diet. You can also have pig trotter soup.
- Also include nuts like almonds, walnuts and dried figs as well as lactation cookies (consisting of one of these ingredients: rolled oats, brewers yeast, flaxseeds or fenugreek).
- Drink plenty of water and fluids all day.
Apart from these, you can try hormone therapy and pumping. Both of these might be recommended by your lactation consultant.
You may have to start pumping using an electric breast pump. A manual breast pump may not be up for the job. Ideally, you should pump every three hours and even during the night.
Pump for five to six minutes on a low or medium setting on the pump. Then, follow it up with a breast massage. Again, pump for five to six minutes. This entire process should take 15 minutes.
Both these methods are quite effective and work for most women. However, we suggest you discuss them with your lactation consultant to zero in on the method that will work best for you.
Just remember that there are many reasons for low milk supply. Knowing the cause and working on it from early on can help you and your baby. This will also help you psychologically as many women often grieve the loss of breastfeeding experience.
We hope this information will guide you towards the right direction and help you get back on the breastfeeding track.