Tips shared by "everyday experts" and resources of insights by specialists on low breast milk supply. Use what speaks to you. Please consult a doctor for medical conditions and treatments.
1. For the most part, “low milk supply” is a symptom, not a diagnosis. We know of plenty of situations that can cause low milk supply, like IGT (insufficient glandular tissue), or infrequent or insufficient milk removal, or oral or muscular issues in the baby, or thyroid problems in the nursing parent, or previous breast reduction or other surgeries, or retained placental fragments… the list goes on.
Rachel Obrien – International Board Certified Lactation Consultant (IBCLC) and Registered Lactation Consultant- USA
2a. The only reliable signs of milk supply are proper weight gain in baby, diaper output, and a weighed feed. That’s a baseline for full milk supply. Most women can product a total of 24oz to 30oz in a 24 hour period. You can go by pump output only if you are exclusively pumping or not pumping enough. At some point our milk supply is supposed to regulate so that we don’t feel full anymore . Many Moms interpret that as their supply is going away, but that’s usually not the case.
2b. Increase milk supply, in order of effectiveness: a) Pump after a feed (emptying the breast signals the brain to make more milk) and power pump (pump 10 mins rest for 10, and do it 3 times) b) Herbs like Goat’s Rue, fenugreek, etc or mixes like More Milk and More Milk Plus; c) Oatmeal and other lactogenic foods. Furthermore to increase supply, start using the hands on pumping technique as many times if the pump by itself doesn’t fully empty the breasts.
2c. Difficulty in baby latching is not optimalfor sucking out all the milk. A curled lip would indicate a lip tie. Lip ties can absolutely cause pain while breastfeeding and the best course of action is usually to visit a Pediatric ENT or Pediatric Dentist who specializes in treating lip and tongue ties. Read more here Tongue tie vs lip tie and The difference between the two.
2d. Some of these are helpful ways to figure out what may be affecting your milk supply. Do check for any hormonal imbalances – thyroid for hypothyroidism and PCOS or Type 2 diabetes? You may not produce a full milk supply due to a hormone issue or possibly even a condition called IGT (insufficient glandular tissue). Did your breasts grow during pregnancy and did you experience engorgement a few days after birth? Are your breasts tubular shaped or are your nipples puffy? Here are some useful pictures. A lactation consultant in person would be able to help so much more.
2e. If you have had a breast reduction and have low supply it really depends on how much glandular tissue was removed and if the milk ducts were severed during the surgery. SNS full time can be an option to provide feedings at the breast. That’s the route many Moms who need to supplement long term go. The Lact-aid SNS is the easiest to use. Domperidone may be the best option for you to increase and maximize your production.
2f. Anemia can cause milk production issues. Floradix or iron infusions are safe for breastfeeding.
Ashley, peer support Admin: USA
3. If baby is not successfully latching, consult a lactation consultant/pediatrician to rule out tongue tie or flat nipples which would make it hard for baby to latch. “The Nursing Mother’s Companion” which gives multiple ways to increase supply. Try expressing some milk on your nipples to help entice baby to latch.
4. Soak 1 tsp fenugreek seeds (easily found in Indian groceries) overnight in a cup with little water – drink only the water first thing in the morning. I took it only a few times a week initially and after that stopped as there was an over supply (if you are diabetic, have thyroid disease or asthmatic, avoid fenugreek). A slight dip would be noticed when I didn’t get a morning nap after a rough night, did not drink enough or had insufficient calorie intake (healthy diet, healthy fats- almonds, walnuts, soaked chia seeds, flax seed oil). Yes, eatingcalorie dense foods meant making ample milk and also that meant being heavier. If you are having trouble to open baby’s mouth wide enough, while holding your breast, use your middle finger to thrust jaw down, place your breast further inside baby’s mouth and tilt head back. It’s common for one breast to make more milk than the other.
Sangitha P Lorenz: USA
5. I pumped in desperation, ate many suggested foods and herbs (fenugreek, oatmeal cookies, almonds….) and I still did not make enough so I had to supplement with formula. I saw lactation consultants, nursed, pumped, and formula fed for almost 8 months. Half way through the nursing experience I realized that I was anemic right after delivery and that it can affect milk supply. However I know a mom who was anemic but her supply was fine. If I would have known of the effect of anemia earlier (in the first 3 months when the supply normally gets established) I would have taken some iron supplementation and eaten loads of lentils, maybe it would have made things easier. My main resource on lactation was www.kellymom.com.
Tatiana Sonnenberg: USA
6. When I developed HELLP Syndrome, the doctors never told me that it would affect my milk supply, I tried every remedy known to man, worked with lactation consultants, and it still wasn’t enough, I was heartbroken. The only thing that seemed to do a little good for me was a supplement called Motherlove More Milk Plus. For women who develop HELLP/pre-eclampsia, if you receive a blood transfusion it can delay your milk from coming in for several days (the doctors never told me this and the nurses just looked at me in pity as I pumped and pumped and pumped to try to get anything). Your body also is trying to heal your internal organs (HELLP causes some organ failure), and it may not have enough resources to do that and breastfeed. Some women who develop HELLP Syndrome never struggle with breastfeeding or with time they are able to breastfeed with no problems (a mother who had a baby in the NICU at the same time as me had HELLP and was actually overproducing). But many are never able to produce enough milk and have to supplement. Give yourself grace to know it is ok either way, your body has been through a lot and your child will be just fine if you do have to use formula or someone else’s milk.
Rachel Smith: USA
7. For small supply boosts, just eating oatmeal can help as it is a galactagogue (food that promotes lactation).
Rachel Fox Roberts: USA
8. Being on schedule with pumping worked great with the supply for me (the consistency in emptying the breast at a session which tells your body to make more milk).
Anitha Fiest: USA/India
9. Do not wear jasmine flowers (commonly worn in India) during your nursing phase. Maybe it is a good idea to avoid smelling the scent too. Jasmine flowers are stuffed in the bra to dry up the milk glands. Foods rich in iron is essential so lots of greens are important for a new mother to consume during this stage.
Padmini Purushotam- India
10. I found simply nursing often and longer always helped. I think the term was a “nursing weekend” where mom and baby are just in bed nursing on cue when the baby needs. The more you nurse, the more milk is produced (the supply increases with the demand), so I would avoid any supplementation because that could hamper the milk supply. Certain foods helped too–like leafy green vegetables (kale, collards, etc) helped to increase my supply. I also avoided pumping because the baby’s suckling was more efficient at drawing out milk and hence increasing supply than a pump.
Prita Lal: USA
11. Foods such as cilantro, chia, flaxseed, brewers yeast, rootbeer, gatorade, avocado, almonds, spinach, cinnamon can increase supply. Baby may latch better after pumping because the pump pulls out the nipple for the baby so he/she doesn’t have to work so hard especially when engorged. Bowen therapy done by a chiropractor is helpful for tongue ties.
12. I was doing great in the beginning then my supply dropped and I did not enough to pump because of going back to work soon so started doing EVERYTHING to boost my supply! Flax seed oil capsules 3 times a day, I put ground flax seed in almost everything, oatmeal in the morning, at my 3 am feeding ate the lactation cookies and trail mix with almonds for snack. I switched out my white bread for oatmeal bread. And for my meals I just made sure I was eating a good amount of calories and drank tons of liquids (water and Gatorade). What you eat and drink really does help… I also started pumping every two hours. Took me a week but my supply is up again. Nursing time tea helped me too. I nurse 24/7 plus pump about 24-30 oz a day.
13. Try breast compresses. Change positions of the pump every once in a while to test which is most effective. And I have heard that warm wash clothes can help. Also, try pumping either near your baby, item of clothing that smells like baby, a picture of baby, or both!
14. Lipase is an enzyme that breaks down the fats in your milk to help baby digest it. When lipase occurs in excess, this process happens much more rapidly and can make the milk taste off or sour after a period of time. Milk with excess lipase is safe to drink, but some babies dislike the taste and refuse it. If the milk that you are freezing or saving in the fridge tastes odd you might be producing lipase in excess.
15. There are 6 golden rules to weight loss and maintaining milk supply: 1) wait until at least 8 weeks postpartum to start with weight loss; 2) maintain at least 1500 to 1800 calories per day and taking care to replace calories burned while exercising to keep a consistent supply. MyFitnessPal app works great for this; 3) drop calories slowly and not cold turkey; 4) stick to a healthy diet and exercise and avoid weight loss supplements, MLM products, and fad diets; 5) don’t lose more than 1.5lbs per week; 6) breastfeed on demand and without any restrictions.
16. For those with PCOS, Type 2 diabetes and hypothyroidism– (please consult doctor for any medications)
I started domperidone at 4 weeks PP and continued to take it until 12 months. I was able to achieve a full milk supply after a few weeks with nursing 8-12 times a day and pumping after every feed. A full milk supply is 24oz to 30oz per day. Once supply came up, I stopped the extra pumping and just nursed on demand. If it will take you time to get your domperidone, you can take a short term course of Reglan while waiting as it is readily available at most pharmacies. Reglan can only be taken for 2-3 weeks at a time and has some common side effects like anxiety and depression. Domperidone can be taken long term and the most common side effect is weight gain because the drug is primarily used to speed up gastric emptying so users eat more. If you stick to a portion controlled healthy diet you can avoid this.
You may also want to find a really good Endocrinologist and work with them to improve your insulin issues and PCOS symptoms. It was a total game changer for me. Also, consider avoiding hormonal birth control that is normally recommended for women who are breastfeeding. There are studies that show a dramatic increase in Type 2 diabetes diagnosis in women with PCOS who take the mini pill and other progesterone only birth control methods. After 5 years of pre-Type 2 diabetes diagnosis, I now have a normal A1C and BMI. I do continue to take Metformin daily and treat my thyroid condition with breastfeeding safe medication.
Myoinsitol is a great option and works in a similar way to Metformin. I also suggest eating a low carb, low glycemic diet! The Whole 30 nutritional plan seems to work well for PCOS, too. In reality, I was only able to achieve a full milk supply using domperidone but the other suggestions did help. I also suggest getting your thyroid levels tested because there is a higher frequency of postpartum thyroid disease with PCOS Moms. It can also impact milk production. Make sure your TSH is at or below 2.5.
None of this will be a quick fix. Even domperidone takes a few weeks for a full effect. But it is possible. My son went from 100% formula fed to 100% breastfed by 5-6 weeks old. Part of this was because we weaned of formula supplements very slowly to make sure he was getting enough while my supply was increasing. We dropped 1/4oz per supplement bottle every 3 days until we got to zero.
I had low milk supply due to PCOS, insulin resistance caused by pre-Type 2 diabetes, and hypothyroidism. The first few weeks I was getting between 4mL and 10mL at a time when pumping while my son was hospitalized for a UTI and dehydration. My suggestion would be to order domperidone and start consistently pumping after every feed for 15-20 minutes. Metformin is beneficial too. The driving force behind milk production issues with PCOS is insulin resistance and hormones so getting hormones regulated well can improve milk supply
You can also ask your OB or Midwife for a 2 week prescription for Reglan or Domperidone to help kickstart milk production.
Postpartum thyroid disease is a very common and treatable cause of milk supply problems.
17. Keep in mind that while breastfeeding you may not get an accurate reading of your thyroid.
18. Something that I have come across that has worked for me is not eating after 5pm. The prolactin surge occurs between 12-2am. Ingestion of carbohydrates within 4 hrs of going to bed causes suppression of the prolactin surge. This phenomenon is well known in the bodybuilding community but I have not seen any applications towards lactation. My personal theory is that women who tend to experience more insulin resistance will experience this effect more profoundly. I know my own personal biology tends towards insulin resistance more readily during times of stress. I had plenty of milk for the first 10 weeks and then experienced a substantial drop. This one simple change of cutting off my eating at 5pm has single handedly brought my supply back. This phenomenon might explain why women have enough milk to start and then experience a drop. The relationship between prolactin insulin and leptin really needs to be explored in depth. I hope this helps someone!
18. Nursing is very hard to figure out at first, as it takes time to get to know one´s body and also to know how the baby wants to nurse. So stay relaxed as the baby can sense when the mother is stressed.
My general tips –Slowly introduce pumping for backup supply as one tends to produce much more than one needs. This can cause an over supply and one can become engorged easily. Nipple shields are a lifesaver during the first two weeks of nursing. It’s like a bullet proof vest-It can hurt but will not kill you. Get some comfortable (doesn’t have to be costly) nursing bras as boob comfort is key. Its good to learn how to nurse under a loose shirt easily without having to take a nursing cover or extra blanket everywhere (simplicity is the key in coping as a mom).
Tickling under the baby’s chin before one unlocks them from nursing is a good idea. It has worked great to keep them happy if you need to cut short the session for whatever reason. Breast milk is called liquid gold and it is the cure for everything. One does not need all the creams – just a little milk and let air dry and this heals all sorts of cuts (side note my husband nailed a huge nail through his finger and I talked him into putting breast milk in the wound and it healed the next day-). Once I nursed while soaking in a tub with water up to my hips. It was so natural.
Gwen Hutton -USA
You can add more tips to this topic here
Support – Facebook Closed Groups:
Breastfeeding Resources and Support –
IGT (Insufficient Glandular Tissue)
App for Android & Apple
Breastfeeding Solutions App (reviewed by Kelly.com) – Nancy Mohrbacher, IBCLC, FILCA
Opportunities to share and receive human milk:
1. HM4HB – Human Milk 4 Human Babies – Global Network
2. Milk Banking – Association Of North America
LLLI – Le Lecha League International – Lactation consultants around the globe
LLLI – Emotional Healing When Breastfeeding Does Not Work
It is Not About Weight – Dr. Jack Newman
Problem Solving Lactation Consultant – Dr. Bobby Ghaheri
How Much Milk Should Your Expect To Pump – Nancy Mohrbacher
Proper Breastfeeding latch and Sucking – Dr. Sears
Informal Milk Sharing – Study
Proven Traditional Herbal Remedies – Realnatural.org
Breastfeeding Success and Labor Medications – Healthy Children Project, Inc.
Proven Traditional Herbal Remedies – Realnatural.org
Make Life Easier as a Nursing Mom – Cafe Mom
Lack Of Medical Support for Breastfeeding Women – The Huffinton Post
Aluminum antiperspirants potential hazard – Mommymeds.com
Milk sharing in India – Hindustan Times
Watch what really good drinking looks like – Breastfeeding Inc.
Why Human Milk Is A Medical Marvel – Newyorker.com
The Healing Powers Of Breast Milk (Mom’s photo of breast milk went viral)- Scarymommy.com
(Not sponsored) (Products available in USA and possibly other countries)
1. Breast pumps – Check with your insurance companies as they often cover breast pumps. If using the pump frequently, replace the membranes so it works efficiently- every few weeks to a month.
If you are using a Medela PISA, you may want to try a Spectra S2 or even a Medela Harmony manual pump as women with low milk supply seem to respond better to those pumps (just an observation).
Ashley, peer support Admin: USA
2. Pump anywhere with clothes on
3. Nipple balm – Organic and for quick healing
4. Softshells – For sore nipples and worn with clothes
5. Flanges – Eliminates constriction of milk ducts caused by traditional flanges. If your nipple does NOT touch the edges of shield when pumping then its the right size
6. Versatile nursing covers -great coverage