Do I have low milk production?
As a lactation consultant, one of the biggest concerns I hear is “Am I making enough milk?”
The reality is that most new parents have the ability to make enough milk for their baby, but not all. So, how do you know if you’re making enough, and what do you do if you’re not?
Modern parents have a lot working against them. Limited or no parental leave after giving birth, confusing messages on feeding and caring for a baby, and the unrelenting images on social media creating opportunities for comparison.
Just when you think things are going well with feeding your baby, influencers will show you their freezers bursting with gallons of breastmilk, and you’ll start to wonder, “Is something wrong with me?”
Chances are, there’s nothing wrong. But when you see how much milk other parents make, it’s hard not to doubt yourself.
How do you know if you have actual or perceived low milk production? Let’s get into it.
Baby’s weight.
If your baby is growing well - meaning they are following along a curve on the growth chart - all is well.
Depending on your milk storage capacity and your baby’s feeding patterns, you may be breastfeeding more or less frequently than other parents. Typically, babies under 6 months will breastfeed 8-12 times per day. It tends to be more frequent when baby is going through a growth spurt or developmental change.
Remember that breastfeeding is about more than just calories. If your baby is nursing frequently, this does not automatically mean that you have low production.
Diapers.
What goes in must come out. Here are some guidelines for the minimum amounts based on the age of your baby:
Day 1: 1 pee, 1 poop
Day 2: 2 pees, 2 poops
Day 3: 3 pees, 3 poops
Day 4: 4 pees, 4 poops
Day 5 and up: 5-6 heavy pees, 3-4 poops at least the size of a quarter
Baby’s behavior.
When your baby is getting enough, most feeds will take 10-40 minutes and baby will look very satisfied at the end. Think post-Thanksgiving meal.
During the feed, you should hear lots of swallowing. Like a swallow for every 1-3 sucks. This is called “nutritive sucking” and it means that your baby is drinking well. You’ll also see “non-nutritive sucking” here and there. This is your baby’s way of triggering more milk releases and nursing for comfort.
Cluster feeding is normal when baby is going through a change, such as a growth spurt. More frequent feeding and fussiness in the late afternoon and evening is common and normal. This is when most people’s supply is lower, which is NORMAL.
See this post for a deeper dive on how to tell if breastfeeding is going well.
What’s not a sign of low milk production.
If you’re exclusively breastfeeding, and doing a bit of pumping, you may get 0.5 ounce or less. That’s because your milk production is in sync with your baby’s needs. This is NORMAL.
In the early days of breastfeeding, you may have noticed fuller breasts, a sensation of milk release (“let down”) and leaking. Later, when your milk supply regulates, you may not notice these signs anymore. NORMAL.
If your baby is waking at night to breastfeed, this is NORMAL. Babies need to feed often, and many babies actually take in more milk at night than during the day.
Actual low milk production.
Simply put, this is when your body is not making enough to meet your baby’s needs. Slow weight gain is the most reliable sign of this. We expect babies to follow a growth curve, which means they gain about 7 ounces per week in the first 3 months of life.
Here are some possible reasons for low production:
Hormonal imbalances like PCOS, thyroid disease, insulin resistance, low prolactin
Breast hypoplasia (insufficient glandular tissue)
History of breast surgery
Retained placenta
Anemia
Breastfeeding difficulty affecting milk transfer, resulting in decreased production
History of formula supplementation and less than ideal milk removal in the early days postpartum
Taking hormonal birth control or encapsulated placenta
Nutritional deficiencies related to history of bariatric surgery
Figuring out the reason for your own low milk production may require some detective work. Some people have multiple reasons for low production. Working with an IBCLC who is trained in working on low production will help greatly.
The IBCLC that you work with should take a thorough health history and, if indicated, will suggest lab testing that may help you find the culprit. Once you have an idea of what’s causing the issue, there may be herbs, vitamins and medications that could help support your body in making more milk.
In some areas, there are breastfeeding medicine practioners, who can thoroughly assess lactation, as well as order tests and prescribe medication. See this directory to find a breastfeeding medicine specialist near you.
Making sure baby is getting enough
If your baby is not getting enough, you will need to supplement while working on figuring out the pieces of the puzzle.
You can absolutely continue breastfeeding while giving formula or expressed milk to make up the difference. This is combo feeding which you can read more about here.
If you’re interested in supplementing with donated breast milk, there are many generous moms who are sharing their extra milk with others who need it. This is often done through local or online parenting groups. If you prefer to use milk from a human milk bank, you can look for one here.
There are different methods for giving supplementation, including:
Support is everything
Learning that you have low production can be devastating. It can feel like you’re not enough or that you’re failing.
Well-meaning friends and family may say things like “Fed is best”, which may not always feel supportive to you and your feelings.
Sadness or grief around low production is real and valid. For a great book, see Why Breastfeeding Grief and Trauma Matter by Amy Brown. There are online support groups as well. You may want to look for a therapist who specializes in perinatal issues.
Regardless of how much milk you make, you ARE enough and your baby thinks you’re the best parent ever. Find the community that will support you in processing your grief - you deserve that.
If you’re looking for a lactation consultant to guide you through this process, I would be happy to work with you. I work with people virtually and it may be covered completely by your insurance. Click below to book a consult with me!
