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Breastfeeding low supply


Low Milk Supply | WIC Breastfeeding Support

Many moms worry about low milk supply, but most of the time your body makes exactly what your baby needs, even if you don't realize it. There are also ways to tell if your baby is getting enough milk. If you aren't making enough, there are ways you can build your supply. And your WIC breastfeeding staff is always there to help!

Am I Making Enough Milk?

First, look for these signs that your baby is getting enough milk. For example, pay attention to the number of wet and dirty diapers and your baby's weight gain.

Things you should NOT worry about:

  • How your breasts feel. Your breasts will feel softer and less full as your milk supply adjusts to your baby's needs. This does not mean you have low supply.
  • If your baby nurses for shorter periods of time, such as only 5 minutes on each breast.
  • If your baby's feeds are bunched together. This is called cluster feeding and happens when your baby starts nursing more often and for longer. This can happen in the evenings or because of growth spurts.
  • Not getting much milk when you express. Your baby is much more effective than a pump or hand expression at getting out milk. Find tips to help you pump.

If you are still concerned, talk to your baby's doctor about their growth.

Causes of Low Milk Supply

While most moms make plenty of milk, some do have low milk supply. This might happen if you:

  • Limit your baby's breastfeeding sessions. Remember, the more you feed on demand, the more milk you make.
  • Give your baby infant formula instead of breastfeeding.
  • Introduce solid foods before baby is 4-6 months old.
  • Take certain birth control pills or other medicine.
  • Don't get enough sleep.
  • Drink alcohol or smoke.
  • Have had breast surgery.

Talk to your doctor if you have hepatitis B or C, herpes, or diabetes. These conditions may also affect milk supply.

Increasing Your Milk Supply

Breastfeeding frequently—especially in the first hours, days, and weeks—is the main way to increase your milk supply. Your body will make milk to meet your baby's demand.

Try these tips to help you make more milk:

  • Breastfeed every time your baby is hungry. In the early weeks, your baby will eat 8-12 times every 24 hours. It's best not to put your baby on a strict feeding schedule. Follow your baby's cues, and let your baby tell you when it's time to eat.
  • Make sure your baby is latching well.
  • Offer both breasts at each feeding. Let your baby finish the first side, then offer the other side.
  • Empty your breasts at each feeding. Hand express or pump after a feeding to draw out all the milk and signal your body to make more.
  • Avoid bottles and pacifiers in the early weeks. Feed your baby from your breast whenever you can.
  • Get plenty of sleep, and eat a healthy diet.
  • Pump or express your milk. Pumping or expressing milk frequently between nursing sessions, and consistently when you're away from your baby, can help build your milk supply.
  • Relax and massage. Relax, hold your baby skin-to-skin, and massage your breasts before feeding to encourage your milk to let down.
  • Take care of yourself. Get plenty of rest, eat well, drink enough fluids, and let others help you.

Consider Charting Your Progress

Record how often your baby is breastfeeding, for how long, and on which sides. If you are supplementing with infant formula, record how much your baby is getting and decrease the infant formula as your milk supply increases. WIC breastfeeding staff can help you determine how much infant formula your baby needs.

Still Have Questions?

Contact your WIC breastfeeding expert. They can talk to you about supply concerns and give you tips to increase your supply to meet your baby's needs.

Making Milk Expression Work for You

Expressing milk is an important tool in your breastfeeding journey. Ask your WIC breastfeeding staff about practical tips to help you with pumping and hand expression.  WIC staff may also suggest pumping to help you address common issues. These include relieving or preventing engorgement and building your milk supply. Pumping also lets you provide breast milk for your baby when you are apart.

Read more about how you can make pumping work for you when facing challenges, plus other helpful tips.

Relieving or Preventing Engorgement

Emptying milk from your breasts regularly will help keep your breasts from becoming engorged. If they do get engorged, pumping or expressing milk can help by removing some of your breast milk. Here's how you can use pumping to help:

  • Hand express or pump a little milk to soften the breast, areola, and nipple before breastfeeding. This may make it easier for baby to latch.
  • If your baby is not nursing well, express your milk often to maintain milk supply and prevent engorgement.
  • If your breasts are uncomfortably full at the end of a feeding or between feedings, express your milk until it's more comfortable. This will help keep your breasts from becoming too full.

Increasing Milk Supply

Each time you breastfeed or pump, you're telling your body to make more milk. If you are struggling with low milk supply, pumping may help you make more milk.

Try pumping between feedings. Aim to remove more milk from your breasts and/or increase the number of times you empty your breasts.

Supplying Milk When You're Away From Your Baby

Being away from your baby—whether you're returning to work or school, need to run errands, or want a night out with friends—requires planning. Pumping or expressing milk is a great way to make sure your baby gets the benefits of breast milk while you are apart.

  • Pump or express breast milk while your baby is napping or when you have help from others to watch your baby. Or try to pump for a few minutes after every feeding. You can store your milk for later.
  • If you're back at work or school, try to pump or express milk as often as you would feed your baby. Talk to your employer about scheduling breaks to pump.
  • An electric breast pump may be the best way to remove milk quickly when you are away from your baby for several hours.

Other Helpful Tips

Getting Started

  • Start early. Many moms mention that their breasts feel fuller in the morning. This may be a good time to express milk.
  • Relax. Don't worry if you don't get much milk at first. This is normal. Most moms are able to express more over time.

Staying on Track

  • Keep all of your pumping sessions. Skipping sessions may cause your breasts to make less milk. Keeping your sessions will also help prevent engorgement and plugged ducts.
  • Check your pump. Talk to your WIC breastfeeding staff  if you are not sure if your pump is the right fit or if you think it's not working right.
  • Take care of yourself. Get plenty of rest, eat well, drink enough fluid, and let others help you.
  • Help your baby adjust to taking breast milk from a bottle. Your baby may be more likely to accept breast milk in a bottle from someone else at first, since baby is used to nursing from your breast.

Saving Time

  • Ask for help. Let your partner or family members clean your pump and parts and pack it for your next work or school day.
  • Keep extra, clean parts on hand.

Signs of lack of milk | Improving lactation

Many mothers are concerned about insufficient milk production, but it is not always easy to find out if milk is really low. Read our article to understand if this is true and what can be done about it.

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“Do I have enough milk?” - a question that is often asked by young mothers. If your baby is healthy and growing well, there is no reason to worry. However, if you are still worried about milk production, it is best to consult a specialist as soon as possible. If everything is in order, he will be able to calm you down. In addition, you will not needlessly feed the baby formula, because of which milk production can really decrease.

Causes of insufficient milk supply

Some mothers do not produce enough breast milk for medical reasons, which include: approximately three days after birth). 1

  • Polycystic ovary syndrome, diabetes, thyroid dysfunction or other hormonal disorders. In some cases, such diseases lead to low milk production. 2
  • A rare medical condition called "mammary hypoplasia" in which there is not enough glandular tissue in the breast to produce milk. 3
  • Breast surgery or injury. However, many mothers who have had breast surgery successfully breastfeed in the future. 4

    • If you have any of the conditions listed, contact your lactation consultant or healthcare provider.

    How milk is produced

    With the advent of milk, the breast begins to work on the principle of supply and demand. Each time after it is emptied, whether it is feeding the baby or pumping, even more milk will be produced.

    This is why milk production may be reduced if you give formula to your baby - your body will not get the signal to produce more milk because it will remain.

    The way your baby eats also affects milk production. The more often and better he sucks the breast, the bigger it will be. If your baby eats only a small portion at one feeding, it is necessary to express milk regularly to maintain the level of its production. Read more about this below.

    Signs that the baby is not getting enough milk

    Although low milk production is rare, the baby may have difficulty feeding in the first few weeks, but for other reasons. You may not be feeding him often enough or for enough time, especially if you're trying to stick to a specific schedule. The baby may not latch on properly, or it may have features that make it difficult to take in milk.

    The following signs indicate that the baby is not getting enough milk:

    • Poor weight gain. In the first few days of life, newborns normally lose 5 to 7%, and sometimes even up to 10%, of their birth weight. However, after that, they should gain at least 20–30 g per day and regain their birth weight by 10–14 days. 5,6,7 If your baby has lost 10% or more of their weight in the early days, or has not started gaining weight by 5-6 days, you should contact your doctor immediately.
    • Not enough wet and soiled diapers. A good indicator of whether a baby is getting enough milk is the number of diapers used per day. Check out our article detailing the norm for wet and soiled diapers in Breastfeeding Your Newborn: What to Expect in the First Week. Seek medical advice if something bothers you or you notice that the number of soiled diapers has begun to decrease.
    • Dehydration. If your baby has dark urine, dry mouth or jaundice (yellowing of the skin or eyes), or baby is lethargic, has lost appetite, and may be dehydrated. 6 Dehydration can be caused by fever, diarrhoea, vomiting or overheating. If you notice any of these symptoms, seek medical attention as soon as possible.

    Misconceptions about lack of milk

    Newborns usually eat very frequently, about 10-12 times a day or every two hours. This does not mean that they do not have enough milk. Keep in mind that breastfeeding is also about comfort, so it's hard to tell how much milk a baby eats at each feed as the amount can vary.

    You have enough milk even if:

    • the child wants to eat often;
    • the child does not want to be laid down;
    • the child wakes up at night;
    • feeding is fast;
    • feeding takes a long time;
    • after feeding, the child takes another bottle;
    • Your breasts are softer than in the first weeks;
    • milk does not leak or has stopped leaking;
    • You cannot express much milk;
    • You have small breasts.

    What to do about insufficient milk production

    If you suspect that your baby is not getting enough milk, contact a lactation consultant or your doctor. He will determine if you have enough milk and check how the baby is latch-on and if he is getting enough milk. He may also suggest changing the feeding position or the way the baby is attached to the breast to make it easier.

    Also try holding your baby close to you more often to increase skin-to-skin contact before and during feedings. This stimulates the production of the hormone oxytocin, which promotes milk flow. Use relaxation techniques, such as listening to your favorite soothing music, to reduce anxiety that can negatively impact milk production. 8

    With proper support, most under-lactating mothers can breastfeed their babies at least partially, and some manage to normalize production.

    If your baby is unable to get enough milk directly from the breast (perhaps because he was born prematurely or has special needs), you need to express milk to support his production. Your doctor may prescribe you special drugs that stimulate lactation.

    If you are unable to express enough milk, you will need to supplement your baby with donor milk or formula. This should also take place under the supervision of a physician. The Supplemental Nursing System (SNS)* is a great way to help your baby get all the milk he needs at the breast.

    How to increase your milk production with a breast pump

    If you need to increase your milk production in the first five days after giving birth, you can use a dual electronic breast pump with lactation start technology, such as the Medela Symphony**. Such a breast pump imitates the sucking of the breast by a child and helps to increase milk production in the future. 9

    After your milk comes in, double pumping allows you to get more milk in less time. 10 This method helps to better empty the breast, which also improves lactation.

    Although every mother is different, it is often recommended to express milk immediately or one hour after a feed. This may seem strange, since it is usually easier to express milk from a full breast. However, the pumping session should be seen as an "investment in tomorrow. "

    You will probably only be able to express a little milk at first, but don't be discouraged - if you express regularly, your milk supply will increase. Try to empty your breasts - by putting your baby to your breast or expressing milk - 8 to 12 times a day, including one nightly session, when your levels of prolactin (the hormone responsible for producing milk) are highest. The more often you empty your chest, the better. After two to three days of regular pumping, you will notice a significant increase in milk production. For tips on how to get more milk with every pump, see Tips for Using a Breast Pump.

    Pumping with massage to get more milk

    If your baby is not lating at all or you are not yet able to express enough milk for him, a technique called “massage pumping” may be helpful. It helps mothers increase the amount of milk they get in one pumping session. 11.12 The whole process takes about 25-30 minutes. Remember that the better you empty your breast, the faster milk is produced in it.

    A few simple steps are required:

    • Massage your breasts.
    • Perform a double pump while wearing a special bustier top that allows you to keep your hands free.
    • While expressing, squeeze the chest with all fingers for a few seconds. Release and repeat. Squeeze both breasts until the milk flows in a thin stream.
    • Massage the chest again.
    • Express milk manually or with a single breast pump, squeezing each breast in turn to empty them as completely as possible.

    When your baby starts to gain weight and milk production increases, you can switch to exclusive breastfeeding.

    Literature

    1 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia. 2007;12(4):211-221. - Pang, W.W., Hartmann, P.I., "Lactation initiation in the lactating mother: secretory differentiation and secretory activation." J Mammary Gland Biol Neoplasia. 2007;12(4):211-221. 9 E et al . Breastfeeding in polycystic ovary syndrome. Acta Obstet Gynecol Scand. 2008;87(5):531-535. - Wanky, I. et al., "Breastfeeding in the setting of polycystic ovaries." Akta Obstet Ginecol Scand. 2008;87(5):531-535.

    3 Neifert MR et al. Lactation failure due to insufficient glandular development of the breast. Pediatrics. 1985;76(5):823-828. - Neifert M.R. et al., "Inability to Lactate Due to Deficiency of Glandular Breast Tissue". Pediatrix (Pediatrics). 1985;76(5):823-828.

    4 Neifert M et al. The influence of breast surgery, breast appearance, and pregnancy-induced breast changes on lactation sufficiency as measured by infant weight gain. Birth. 1990;17(1):31-38. - Neifert M. et al., "Influence of breast surgery, breast appearance, and pregnancy-induced breast changes on milk supply as measured by weighing the baby. " Bers. 1990;17(1):31-38.

    5 C Tawia S, McGuire L. Early weight loss and weight gain in healthy, full-term, exclusively-breastfed infants. Breastfeed Rev . 2014;22(1):31-42. - S. Tavia S., McGuire L., "Natural Weight Loss and Gain in Healthy, Exclusively Breastfed Full-Term Infants." Brestfeed Rev (Breastfeeding Review). 2014;22(1):31-42.

    6 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession. 7th ed. Maryland Heights MO, USA: Elsevier Mosby; 2010. 1128 p . - Lawrence R.A., Lawrence R.M., "Breastfeeding: A guide for healthcare professionals." Seventh edition. Publisher Maryland Heights , Missouri, USA: Elsevier Mosby; 2010. P. 1128.

    7 World Health Organization. [Internet]. Neonatal Care . 2012;12(2):112-119 - Keith D. R. et al., "Effects of listening to music on the amount, fat content, composition and calorie content of breast milk in mothers of premature and seriously ill children." Adv Neonatal Care. 2012;12(2):112-119

    9 Meier PP et al. Breast pump suction patterns that mimic the human infant during breastfeeding: greater milk output in less time spent pumping for breast pump-dependent mothers with premature infants. J. Perinatol. 2012;32(2):103-10. - Meyer P.P. et al., "Pumping patterns that mimic breastfeeding behavior: more milk and less time for constantly pumping mothers of preterm infants." J Perinatol (Journal of Perinatology). 2012;32(2):103-10.

    10 Prime DK et al. Simultaneous breast expression in breastfeeding women is more efficacious than sequential breast expression.Breastfeed Med . 2012;7(6):442-447. - Prime D.K. and co-authors. "During the period of breastfeeding, simultaneous pumping of both breasts is more productive than sequential pumping. " Brestfeed Med (Breastfeeding Medicine). 2012;7(6):442-447.

    11 Stanford University School of Medicine [Internet]. Stanford, CA, USA: Maximizing Milk Production with Hands-On Pumping; 2017. [ Accessed 04/30/2018]. - Stanford University School of Medicine [Internet]. Stanford, CA, USA: "Increased milk production from hand expression"; 2017. [Page accessed 04/30/2018].

    12 Morton J et al. Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. J. Perinatol. 2009;29(11):757-764. - Morton J. et al., "Manual pumping combined with an electric breast pump increases breast milk production in mothers of preterm infants." J Perinatol (Journal of Perinatology). 2009;29(11):757.

    Read instructions before use. Consult a specialist about possible contraindications.

    * RU No. ФСЗ 2010/07352 of 07/19/10

    ** RU No. ФСЗ 2010/06525 of 03/17/2021

    World Breastfeeding Week |

    Breast milk is more than just food, it is also a powerful way to prevent disease. "First milk" is rich in antibodies that protect children from disease and death. Breastfeeding promotes brain development in young children, protects children from infections, and reduces the risk of obesity.

    It's not just the children who benefit - a healthy younger generation helps lower health care costs, and breastfeeding protects women from ovarian cancer. Experts estimate that encouraging breastfeeding could help prevent 823,000 deaths among children under the age of five and 20,000 deaths of women from breast cancer each year. The researchers also found that babies who receive breast milk for a long time are much less likely to gain excess weight in the future. But obesity, especially in children, leads to serious health problems.

    However, most women around the world do not have access to parental leave or special breastfeeding breaks at work. Creating a friendly and safe environment for breastfeeding women is still a challenge in today's society.

    WHO research has shown that doctors often do not encourage breastfeeding enough, and many health professionals are not properly trained. In addition, there are serious gaps in maternity protection laws in some countries, and infant formula companies are aggressively marketing their products.

    In Russia, about 80-90 percent of women start breastfeeding at the maternity hospital, but quickly stop. By six months, only 40 percent of babies are breastfed. The highest rates were recorded in Rwanda (86.9%), Burundi (82.3%) and Sri Lanka (82%). Upper middle income countries have the lowest breastfeeding rates at 23.9%.

    Photo by UNICEF/Zammit

    More than 98 percent of babies in Mongolia are breastfed.

    “The social and economic benefits of breastfeeding for mother and child are known. However, almost 60 per cent of the world's children, contrary to recommendations, do not receive breast milk during the first six months of life,” said UNICEF Executive Director Henrietta Fore.

    Nearly 60 per cent of the world's children do not receive breast milk during their first six months of life, contrary to recommendations

    “Employers around the world are depriving mothers of much-needed support. We need to set aside funds for paid parental leave and to support breastfeeding in all workplaces,” she added.

    The UN Children's Fund is calling on businesses and governments to spare no expense in supporting families, including paid parental leave, encouraging breastfeeding, child benefits and affordable early childhood education.

    Today, working women are often unable to breastfeed: only 40 percent of women with newborns receive benefits. In Africa, only 15 per cent of women receive any assistance and can breastfeed their baby.

    UNICEF believes that both parents should be entitled to at least six months of paid parental leave, and mothers should be with the baby for at least 18 weeks. But you need to strive to ensure that such a vacation is 12 months.

    Learn more