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Signs and Causes Of Low Milk Supply

Signs and Causes Of Low Milk Supply

Apr 23, 2020

It’s very common to experience concern with your milk supply, every breastfeeding mother is going to wonder if her baby can thrive on her milk alone. While nature’s design is so beautiful, there’s a lot of negativity and fear around “being enough” for our little ones. Thankfully, the vast majority of the time, your worries are simply that and nothing more. A true case of low milk supply is very rare.

Our culture has a huge influence on whether or not we have enough milk. In a study conducted in Sri Lanka, 78% of mothers thought they had adequate milk. For the rest, what were the sources of being fearful of not having enough? Either someone telling them that they didn’t and, to a lesser extent, if the baby was born with complications or by cesarean section. This shows us just how influential other’s opinions are when we know those opinions are unfounded. Perhaps this can reassure you that you know your baby best and to remember that well-meaning family can often cause unneeded stress. You know your baby best!

What is Defined as a Low Milk Supply?

While more than 80% of women start breastfeeding in the US, only 25% are exclusively breastfeeding by 6 months, which does not meet the recommendations by the American Pregnancy Association or the World Health Organization. What causes this decline? Most often, it’s a fear of low milk supply or a perceived drop in supply. Though there is a known method that can be used to more accurately determine milk supply over a 24 hour period, it is virtually never used. A large part of the problem of defining a low milk supply is it’s almost always determined by a mother’s perception. Most mothers actually produce 30% more milk than their baby’s drink, making it almost impossible to “run out of milk.”

What are Signs of a Low Milk Supply?

When there is truly not enough breastmilk, your baby will show clear signs:

  • In order for there to be a low milk supply, your baby will not be gaining a sufficient amount of weight or could be losing weight beyond what’s normal.
  • Your baby may become lethargic and listless and will not have enough wet diapers. (If you are concerned, always seek medical support)
  • If there are not enough wet diapers. This can lead to serious dehydration and should be addressed by a health care practitioner immediately. 
  • Fussing at the breast can be another sign of low supply but this would need to be paired with at least one or more of the indicators above. It’s very normal for new babies to fuss and take several times to latch.


Oftentimes, rather than truly having low milk production, there is an issue with the frequency of feeding and/or issues with the baby’s latch. A proper latch and feeding on demand are two factors that should be addressed first before assuming there is not enough breastmilk.

The Top 5 Reasons for Low Supply

A mother’s body will respond to their baby’s suckling by producing more milk. Oftentimes, mothers have issues with an abundance of milk at first while their bodies are adjusting to how much milk their baby needs. Milk production will regulate after 8-12 weeks. This is often a time of concern about a decrease in supply because breasts will feel less full. This is simply the body regulating the amount of milk and could also be aligned with a growth spurt. The feeling of fullness in no way indicates the quantity of milk available to your baby. All that said, these are the most common reasons for low milk production:

1. Not breastfeeding soon enough after birth

The “golden hour” after birth is the term that’s been given to this time immediately after delivery. Skin to skin contact is the most important, with the breast available. Babies do not need to eat immediately but respond to the smell, warmth, and touch of the mother in very positive ways. Of course, there are many circumstances where you may not be able to have skin to skin time immediately and if you were unable to, it’s not too late to practice it! Strip baby down to their diaper and keep your shirt off. Use a blanket over you both if necessary.

2. Not feeding frequently enough

The idea of schedules and only feeding your baby every 3 hours should not be applicable to babies who are less than several months old. Not feeding on demand can impact the breastfeeding relationship, particularly in the first weeks. It is normal for babies to need to feed frequently, sometimes they will be on the breast for an hour or more and then after 10 minutes may need to go back and eat again! New baby’s stomachs are extremely small and cluster feeding is another normal occurrence where the baby can be hungry minutes after finishing a nursing session. Remember that breastfeeding provides more than just nourishment and in those early weeks, your baby and your body are working together to create and sustain a supply of breastmilk tailored exactly to your baby’s needs.

3. Latch and/or tongue & lip tie issues

If the baby cannot create a good latch they may be suckling at the breast for ages but so inefficiently that they are not getting enough milk. Tongue and lip ties are easily correctable and often a source of a poor latch. Remember that breastfeeding is a learned skill -one that both you and baby need to learn over time. Using a lactation consultant or other qualified professional to ensure you have a good latch can save you a lot of trouble. Latching issues are also the underlying problem of sore or cracked nipples.

4. Using a pacifier too early

The use of a pacifier has been linked to lower breastfeeding success. New babies are wired to suck often and for long periods of time. It is important that this is done at the breast instead of with a pacifier so that it can signal the mother’s body to produce milk. This is especially crucial in the hours/days after birth and some recommend waiting until 5 weeks to use a pacifier. It is not recommended to use a pacifier to stretch the time between feedings or to try and replace a feeding.

5. Not offering both breasts & skipping breastfeeding sessions

At first, always offer both breasts in a feeding session, even if your baby doesn’t drink for long or isn’t really interested in the second side. Too long between feedings on one side can cause decreased milk production. If you are able to pump and someone else feeds the baby, pump again when the baby would normally eat to keep up your supply. Again, your body responds to the frequency of feedings in order to make an appropriate amount of milk.

How much milk should you expect to produce?

Just like adults with different appetites, babies will vary on their intake and feeding schedules. With on-demand breastfeeding, your body will produce the perfect amount of milk for your baby and respond to their needs as they happen. Mothers often think they are not producing enough when their baby goes through a growth spurt (the first is commonly around 6 weeks) but your baby nursing more frequently will cue your body to produce more to help them grow. Pumping to get an idea of how much milk you are making is not an accurate way to assess milk production. A baby at the breast will always be able to get more milk than by pumping. If you pump regularly, you can notice an increased milk supply, but don’t use pumping as a reliable way of seeing how much your baby is eating. This requires a lot of trust that your body and baby are working together for exactly what your baby needs.

Common Misconceptions about Milk Supply

1. Babies need to eat immediately after birth.

Questions about milk supply can begin immediately after birth, when will your milk come in? Colostrum is all that baby needs for the first 2-5 days of life and sometime in that period, milk will begin to be produced. In most mothers, milk will appear 2-3 days after delivery but in 25% of cases, it can take up to 5 days for the milk supply to start. You do not need to supplement if your milk is not yet in and you can speed up the process by lots of skin to skin and time at the breast. Remember that your baby’s stomach is tiny so a couple of teaspoons of colostrum is all they need at first.

2. Once your milk supply dips, you can’t increase milk supply

False! Your body will adjust to the demands of your baby, and there are many known lactogenic herbs and foods that can boost milk supply. Our Majka Mama’s can attest to seeing an increase in supply with our Lactation Booster & Protein Blend.

3. Your breastfeeding experience will be the same as with your previous child

You will have a different experience breastfeeding each of your children so if you are anxious because of the first time around, be sure to get extra support and know that previous experiences will not dictate your breastfeeding relationship with your new baby.

4. If your breasts feel “deflated/empty” you’re not making enough milk

Around 8-12 weeks, you’ll likely notice a change in how your breasts feel. This is not an indication of supply, but rather your body has learned how to make just enough milk for your baby’s needs and not more. In those first weeks, your body is still learning how to manage supply and it becomes more efficient over time. Also, if your baby is going through a growth spurt it’s normal to feel like you don’t have enough when they’re eating all the time. Again, the extra feeding will encourage your body to make more milk to meet the demands of a growth spurt.

Do I Need to Supplement with formula?

If your baby is happy, alert, has enough wet diapers and is gaining weight there is no need to supplement. For your particular situation and baby, this question is best left to a professional. Supplementing with donated milk or formula is a decision that can be made for a variety of reasons and is important in the cases where milk supply is truly low. That being said, most people do not need to supplement.

When Should I Contact A Lactation Consultant?

Breastfeeding may be something that you and your baby pick up quickly or it may be something that takes some time to learn. Always trust your instincts and reach out for support if you want it. You cannot have too much support while breastfeeding, but you can easily have too little. A knowledgable practitioner can spot potential breastfeeding issues and correct them making it a much more enjoyable process for you both. If you are in any way concerned about your baby’s weight or latch, reach out!

It can feel overwhelming to be your baby’s only source of nourishment and know that those feelings are very normal and very common! Plugging into a community of mothers, like the one we have at Majka, can be a great way to see what’s normal, what’s not and to support you on this journey. Breastfeeding your baby is no small task, it takes commitment and time, but those precious moments and work pay off when you take a moment to notice your beautiful babe! As with anything as a new mom, reach out for support even if you’re not sure you need it. You got this, mama! 

If you want to learn more about motherhood and breastfeeding, check out these free resources and posts to help you feel confident and prepared as a new mom!

References:

CDC 2018 Breastfeeding Report Card. Accessed Online. August 20, 2018.

Gatti L. Maternal perceptions of insufficient milk supply in breastfeeding. J Nurs Scholarsh. 2008;40(4):355–363. doi:10.1111/j.1547-5069.2008.00234.x

Kelly Mom: When Will My Milk Come In?
March 1, 2018.

LaFleur, E. Low milk supply: What causes it?
Mayo Clinic Online. November 17 2018.

Rodrigo R, Rodrigo A, et all. Maternal Perception of Adequacy of Mother's Milk Among Mothers Giving Birth at a Teaching Hospital in Sri Lanka. J Hum Lact. 2019 Feb;35(1):171-180. May 22 2018.

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