Low milk supply
Did you know that only around 2.5% of mothers are physically unable to make enough milk for their babies?
The most common conditions or circumstances which may impact on a mothers’ ability to produce milk include;
Polycystic Ovarian Syndrome (PCOS) - only 20% of women with this condition are likely to struggle with supply.
Insufficient glandular tissue
Previous breast trauma, surgery or radiation treatment
Sheehans syndrome
Despite such small numbers of women struggling due to a physiological reason for low milk supply, approximately ;
35% of women who stopped breast feeding before they wanted to cited low milk supply as their reason for stopping.
The most common reasons I hear mothers tell me they doubted their supply are as follows:
Baby behaviour: babies feed very frequently or can be as unsettled between feeds. This is very normal in the early days, weeks and months. Babies need to be close to their mothers and fed around the clock.
Breasts don’t feel full or have stopped leaking – after the initial engorgement that occurs when the milk comes in, the breasts begin to ‘settle down’ and as milk supply regulates the breasts feel softer more regularly. This is a normal physiological and hormonal process and has nothing to do with supply. Many mothers tend to notice this change around 6 weeks.
You don’t pump much milk – a mother’s ability to produce milk is not related to her baby’s ability to remove milk from the breast. The mechanisms are different and your baby is much more efficient at triggering the hormones involved in the milk let down and removing the milk than a pump will be.
If your baby is growing well and peeing and pooing as they should then milk supply is not an issue.
Knowing how breastfeeding works can be helpful in trusting your baby and your body and having the confidence that you can make enough milk for your baby.
Did you know that typically babies only actually take 2/3 of all the milk that is available to them?
So here is the science: After the first few days of life, breast milk is made via a supply /demand mechanism. Milk supply is driven by your baby, the more your baby feeds at the breast the more milk your breasts produce. This is why responsive breastfeeding is the most effective way of establishing and maintaining a milk supply.
Low milk supply will occur if the supply/demand mechanism is impaired. The most likely reasons for this to happen include:
1. Your baby does not remove milk effectively. Examples of this could be poor latch, tongue tie or difficulties with sucking.
2. Your baby does not remove milk frequently. For example, a jaundiced or sleepy baby who may not wake to feed.
3. Only offering one breast per feed. If you do this you half the potential milk your baby can get access to and you also half the possible breast stimulation.
4. Supplementing. By offering formula instead of the breast then feeds are missed and your breast milk supply will reduce. Formula also takes longer to digest and may encourage the baby to go longer between feedings, this will also impact supply by reducing time at the breast.
5. Spacing out feeds/feeding to a routine. This will include using a dummy to ‘stretch’ baby to go longer between feeds. This may lead to less frequent feedings and negatively impact your supply.
6. Thinking you have low milk supply when you don’t and then supplementing. (see point 4).
If your baby is growing well and peeing and pooing as they should then milk supply is not an issue.
So if you suspect your supply may be low what can you do to help?
Seek qualified breastfeeding support who can identify and treat any baby related feeding issue that is stopping frequent or effective milk removal. You may also need to pump after breast feeds to ensure your supply is maintained until the issue is resolved.
Feed responsively. If in doubt feed! If your baby cries - feed! If your baby has just fed and is still unsettled - feed again! If your baby wants to feed for three hours straight -keep feeding….
Avoid dummy use - especially whilst establishing breastfeeding.
Offer both breasts at each feed - if baby only takes one that is fine.
Avoid supplementation with formula unless advised by an appropriate professional.
Please get in touch if you would like to make an appointment for lactation or breastfeeding support.
