Is your milk supply really low?New mothers who are learning to breastfeed often worry that they might not be making enough milk for their baby. Their breasts might stop feeling full and their baby might sometimes be unsettled, or not want to be put down between feeds. There are many reasons for babies to be unsettled and breasts usually get softer after the first few weeks – these are not proof of low milk supply. If your baby is growing as expected (at least 20-30g a day, on average, during the first three months) just on your milk, then your milk supply is fine. If your baby does not grow well on your milk alone, then you may be making less milk than your baby needs. Show The most common reason for genuine low milk supply is a slow start with breastfeeding, when not enough milk was removed from your breasts in the early days after birth. It may be possible to turn this around, with prompt action. Some other causes of low milk supply, such as previous breast surgery and some hormonal conditions, may mean that there is a limit to how much milk you can produce. Many nursing parents can make more milk than they are making, and you never know what you can do until you try! Increasing low milk supply is hard work. It takes time, energy and commitment. It is important to be realistic from the start about your goal and how much time and energy you are able to invest. It works best when you have lots of practical and emotional support, so you can concentrate on your baby and your milk supply. Remember that this won’t be forever – it is a short-term investment for long-term gain. Set yourself short-term goals, e.g. 48-72 hours, then review your progress. If you are not able to increase your milk supply as much as you would like, or decide that it is not realistic to try, you can still have a close, happy feeding relationship with your baby. While you are working on your milk supply:
How milk production worksMilk production starts in the middle trimester of pregnancy. After birth, milk continues to be made in the breasts in response to milk being removed. The most common reason for low milk production is a slow start with breastfeeding – not enough milk being removed from the breasts in the early days after birth. Milk supply usually reaches its peak around four weeks after birth, with most of the increase happening in the first two weeks. If not enough milk is removed during this time, your breasts may end up making less milk than your baby needs. It may be possible to increase milk production, by removing more milk from your breasts. The earlier you start this, and the more energy you put into it, the higher your chances of making more milk. Even if more time has passed, it may still be possible to increase your milk production to some extent, but unfortunately there is no guarantee of being able to make a full milk supply. Any amount of milk you are able to produce is valuable to your baby. Breastfeeding is about much more than just milk and you can enjoy nurturing your baby at the breast, however much milk you are making. For more detailed information about how milk production works see How Milk Production Works. Risk factors for low milk supplyThese include:
If you have any risk factors for low milk supply, you may be referred to an infant feeding specialist. Some of these conditions are treatable. Even if you have underlying factors that can’t be treated, you may still be able to make more milk than you are currently making. Effective attachmentA baby who isn’t deeply attached at the breast may not be able to get enough milk, and feeding may also be uncomfortable for you. Squashed (“new lipstick”) nipples after a feed, skin damage and pain that lasts throughout feeds are all signs of shallow attachment. You can read more about positioning and attachment here. Face to face help (including via video call) is usually best when working on attachment. If feeding doesn’t become more comfortable and/or effective even with skilled help, your baby may be referred for an oral assessment (a thorough examination of their mouth) to check for tongue tie, which is a problem for a small number of babies and can be treated. You can read more about this here and here. Hold your baby skin to skinThis helps your milk-making hormones to work well, keeps your baby calm and happy, helps you and your baby feel connected and encourages interest in feeding. You can read more about holding your baby skin to skin here. How often and when to feedWhile you are working to increase your milk supply, you will want to encourage your baby to feed as often as possible. Signs of interest in feeding include your baby turning their head and opening their mouth (rooting), licking lips, mouthing hands, restlessness and making small sounds. Try to offer a feed when your baby is first interested, before they become upset. If your breasts are feeling full or you just feel like feeding your baby, you can offer your baby a feed, even if they are not asking.
Keep your baby feeding actively when they are at the breastKnowing when your baby is feeding actively at the breast, with deep sucks and swallowing after every one-two sucks, can be very helpful. While you are working to increase your milk supply, you will want to make sure that milk is removed from your breasts as effectively as possible. If your baby is mostly doing light, fluttery sucks with very little swallowing (three or more sucks per swallow), they are not removing much milk. If your goal is to increase the amount of milk removed from your breasts, you may want to end the feed and use a breast pump instead to maximise efficient milk removal. Breast compressions and switching sides can help to keep your baby actively feeding for longer. Start compressing your breast as soon as your baby stops actively feeding. You can read about how to do compressions here. When your baby is no longer actively feeding even with compressions, repeat on the other side. Offer as many breasts as your baby will take – it can be more than two! Some babies seem to want to feed all the time and protest when you take them off the breast. If they are not growing well, it may be because they are not yet breastfeeding effectively. To increase your milk supply, you may temporarily need to limit their time at the breast, to give you more time to express your milk. Increasing breast stimulation by expressing your milkIf the steps above do not result in increased milk supply, the next step is to increase stimulation of your breasts by expressing your milk:
You can find more tips on how to express milk here. Balancing breastfeeding and expressingThe priority at this stage is to increase your baby’s milk intake and your milk supply. This may mean limiting your baby’s time at the breast, for now, to free up enough time to express. Your baby has lots of time to learn to breastfeed. Your milk supply will become more difficult to increase as time goes on, so it is important to act quickly. This might feel all wrong – you want to breastfeed, not pump! Remember that it is an investment of your time now to help your baby breastfeed later. As your milk supply increases, breastfeeding will get easier and more rewarding for your baby. When breastfeeding is going well, you will be able to let your baby feed as much as they want. How to feed expressed milk to your babyThere are lots of options – an LLL Leader can help you choose some to try, including paced bottle feeding and more,
Keeping the breast a happy place for your babyIf your baby is upset, try offering some extra milk before offering the breast. This helps your baby to associate the breast with feeling full and happy, rather than hungry and frustrated.
DomperidoneThis is a prescription medication that can help to increase milk supply in some women, whilst they are taking the tablets. It is not suitable for everyone, e.g. it is not safe for those with certain heart conditions. Because of this, doctors are currently discouraged from prescribing domperidone to anyone. However, the NHS states that domperidone may be appropriate in some cases, so if you would like to try it, it’s worth discussing with your GP, and taking along some information for them to read. The most important thing to do to increase milk supply is to remove more milk from your breasts, so don’t worry if you can’t or prefer not to take domperidone. Formula milkSome babies need extra milk for a short time or longer term if their mother is not making a full milk supply. If donated human milk is not available, the only safe alternative is infant formula milk. You can find LLLGB’s information on milk sharing here. It is never safe to suddenly stop or reduce supplements of formula or donor breastmilk. This needs to be done gradually, to allow your own milk supply time to increase. and it is very important that your baby is weighed regularly, to make sure that they continue to get enough milk. It would usually be appropriate to weigh your baby every 1-2 weeks while working on reducing supplements. You can read about how to use donor milk or formula to support breastfeeding here. Whether or not you are producing all the milk your baby needs, you can still have a great feeding relationship with your baby. The breast can still work beautifully to calm, comfort and soothe your baby, even if your milk supply remains low. Any amount of your milk that your baby gets will be beneficial to them. Some of the immune components of milk become concentrated so that babies get the same amount, no matter how much of your milk they get each day. Whatever feeding looks like for you and your baby, we are here to support you. SummaryStage 1 – make sure your baby is feeding as effectively as possible
Stage 2 – if milk supply has not increased enough
Further readingGetting breastfeeding back on track after a difficult start Books Written by Jayne Joyce and Emily Tammam, LLL Oxfordshire, February 2021 How can I produce more breast milk at 2 months?Try these tips to help you make more milk:. Breastfeed every time your baby is hungry. ... . Make sure your baby is latching well.. Offer both breasts at each feeding. ... . Empty your breasts at each feeding. ... . Avoid bottles and pacifiers in the early weeks. ... . Get plenty of sleep, and eat a healthy diet.. Pump or express your milk.. Can you establish milk supply after 2 months?Some women will be able to bring in a full supply within weeks. Some will take a bit longer, and some will never quite be able to bring back a full milk supply. Every ounce of breast milk counts, though, and making peace with what you have is vital when you're working on relactating.
Why is my milk supply low at 2 months?Various factors can cause a low milk supply during breast-feeding, such as waiting too long to start breast-feeding, not breast-feeding often enough, supplementing breastfeeding, an ineffective latch and use of certain medications. Sometimes previous breast surgery affects milk production.
Is 3 months too late to increase milk supply?Increasing Milk Production After 3 Months
Women who want to increase their breast milk supply after the third month should continue to nurse frequently. Feed on demand and add in one additional pumping session a day to keep milk supply strong.
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