Dealing with a Low Breastmilk Supply

Read time: 10 minutes

What should I know about a low breastmilk supply?

• What are not signs of low milk supply?
• What are signs of low supply?
• Tips to increase supply and when to find help

Worries about milk supply are consistently the most common concerns among breastfeeding parents and is one of the top reasons for quitting altogether.^{1, 2} It’s normal to worry whether your baby is getting enough milk – breasts don’t come with measuring cups attached!

In most cases when a mom believes her breastmilk supply to be low – it’s normally just fine. Unfortunately, there are many misconceptions about what our newborn’s behavior and feeding patterns should be that may lead us to believe otherwise.^{1, 3}

When supply truly is low, this is often related to baby not being able to feed well; such as with a poor latch, high palate, or tongue tie.^{1, 3} When babies aren’t breastfeeding efficiently and emptying the breast, breastmilk supply may suffer.

Read on to learn if your breastmilk supply is low, and if it is, what to do about it.

What are not (necessarily) signs of low milk supply?

It’s true that certain signals can sometimes mean a drop in breastmilk supply. But more often than not, the following signs are false alarms:

Baby wants to feed more often or is giving hunger cues shortly after feeding

A hungry baby doesn’t necessarily mean you are low on milk. In fact, many babies “cluster feed” when they hit growth spurts.^{3, 4} During these times your little one may seem to want to feed all the time for a couple of days straight.

You can expect growth spurts around: 2 weeks, 4-6 weeks, 3 months, and 6 months²⁵

Know that younger babies can cluster feed outside of these growth spurt times too.³

What to do : Breastfeeding frequently when your baby shows signs of hunger, even if you feel like your breasts are empty, will help your supply catch up with your little one’s new and growing needs.^{3, 4, 5}

Baby seems fussy

Many infants have a “witching hour” (which may actually be more or less than an hour). During these times in the day or night you may notice your baby is fussier than usual, but it’s not necessarily related to hunger.²⁶

Depending on your baby’s personality, they may need to be soothed, they may need sleep, or perhaps they’re overstimulated.⁵ With time you’ll learn what works best for your little one.

If your baby does settle down once you offer the breast, it’s ok to feed them. This is not necessarily a sign that they are not getting enough milk. The breast offers comfort and security to your baby in addition to nutrition.⁶

Baby takes a bottle when offered

Milk comes out very easily from a bottle as compared to the work your little one must do at the breast. Because of this, babies may very well take the bottle and drink even if they are not truly hungry.³

This gives many parents a false sense of insecurity: they assume that if baby drank what’s in the bottle, then they did not get enough breastmilk. But this is often not the case.³

What to do : If you feel your little one is still hungry, continue to offer the breast; alternate breasts when baby seems to slow down on one side. While it’s important to supplement your baby with extra breastmilk or formula should your supply be low, be sure that you offer both breasts before a bottle.

Read about: What is Paced Bottle Feeding?

Baby starts nursing for shorter periods of time

As babies get the hang of nursing, they become more efficient.6 What used to take them 20 minutes or more, could take them closer to 10 minutes a few months in. This change doesn’t mean you have less milk, rather, it means your baby’s eating skills are developing – a normal and positive sign.^{4, 6}

What to do : Follow your baby’s lead, they know when they are hungry and when they are full. As long as your baby seems satisfied, is making enough diapers, and is gaining weight well, eating for shorter periods may just be their new feeding pattern.

Your breasts feel different

As your baby gets older, you may find that your breasts become softer or leak less often (or not at all). When baby is first born, it’s normal to overproduce milk.²⁷ Around 4 to 6 weeks, your body figures out how much is needed to feed baby and regulates to meet that exact amount.⁴

This change is good news as it means your supply has adjusted to your baby’s needs.²

What to do : Continue to feed on demand, or whenever your baby asks, to help keep your supply meeting your little one’s needs.

You or baby have an illness

If you are sick or have a health complication, your milk supply may dip until you are back in good health. Many mothers can breastfeed straight through an illness to maintain their supply and be back on track when the dust settles.²

Babies may nurse more or less often when they are sick as well. Sometimes the illness can be “hidden”, as in the case of an ear infection. Baby suddenly having trouble at the breast could be the only sign.⁶

What to do : Continue to feed as often as baby would like. If baby misses any normal feedings when they are sick, go ahead and pump at those sessions to make sure your supply stays adequate.²⁸ If you feel your supply has dipped after being sick, you can pump after feedings for a few days to help boost it back up.

You’re not pumping a lot

Pumping is not always the best indicator of milk supply. In fact, most babies are much more efficient at getting milk out of the breast than a pump.

A lot of factors go in to how much milk you can pump, including pump type, timing of your pumping session, frequency of pumping, flange size, and stress.²

Signs your baby is getting enough breastmilk:

• Baby is gaining weight appropriately. Weight gain recommendations are around ½ oz to 1 oz per day for younger babies (up to around 4 months), although this is an average and some babies do gain their weight in spurts.^{6, 8}
• Baby is having regular dirty diapers. For newborns who are exclusively breastfeeding, look for at least 3 bowel movements larger than the size of a quarter by day 3 of life.^{9, 10}
• Baby is having at least 5 full wet diapers per day by day 5 of life. Less than this could mean that baby is dehydrated, and you should contact their doctor as soon as possible.^{6, 11}
• Baby is meeting milestones and developing on schedule.⁶
• Baby is able to stay awake to feed vigorously.⁶

Is your breastmilk supply low?

If you are still uncertain if your baby is getting enough breastmilk, the below will help you dig deeper and figure out if your supply low. Remember that working with your healthcare provide and a lactation consultant will be your best bet should you be concerned.

Signs that you may want to get assessed for low milk supply:

• Baby is losing weight or gaining too slowly.
• Your newborn is exclusively breastfeeding and is having less than 3 bowel movements per day.
• Your baby has difficulty staying awake at the breast or overall is very sleepy.^{2, 6, 11}

And in addition to any of the above:

• You have conditions such as PCOS, diabetes, thyroid disease, anemia, infertility, etc.
• You have started a new medication that may cause low supply (some examples include estrogen-based birth control or a decongestant).
• You experienced little to no changes to the size of your breasts during pregnancy or the postpartum period.
• You have a history of breast surgeries, injuries, or infections.
• You had a traumatic birth, especially if you and baby were separated for a period of time afterward.
• Baby is having trouble at the breast and/or you don’t see signs of good sucking/swallowing.^{2, 6, 12, 13, 14, 15}

If you do in fact have a low milk supply, the remedy begins with finding the source of the problem.

For example, perhaps your baby needs more practice with a proper latch, baby has tongue tie, or another physical problem preventing them from latching well such as inverted or flat nipples. It could also be that you’re taking a medication which is impacting your supply.

Should you notice any of these signs in your supply or your baby, contact your health care provider and a lactation consultant immediately.

Our team of experts can help you investigate potential milk supply issues and help you find a lactation consultant in your area. They’re registered dietitian nutritionists and lactation specialists and are here to help on our free to live chat from Monday – Friday 8am-6pm (ET). Chat Now !

Tips for helping increase your breastmilk supply

First: make sure you are doing everything you can to support a good milk supply

This will include:

• Making sure baby is latching well and transferring milk efficiently⁶
• Breastfeeding frequently and on demand^{18, 19}
• Reducing stress and relaxing while feeding or pumping^{16, 17, 29}
• Eating and drinking well^{2, 22, 23}

To learn more about building and maintaining your breastmilk supply, read this article: Breastfeeding: How to Support a Good Milk Supply

Make sure baby is getting enough nutrition

If your supply is low and your baby is not gaining weight well or making enough diapers, supplementing with either breastmilk or formula will be very important for their growth and development.³¹

Some professionals recommend first putting baby to breast so that they are hungry and more likely to empty your breast, which stimulates milk supply.³⁰ Offer both breasts then provide supplemental breastmilk or formula in a bottle once your breasts are drained.

You can also try supplementing a small amount of breastmilk or formula first and then put baby to breast for the rest of the feed. Try both methods to see which one works best to help encourage your baby to empty the breast.

Pump anytime you supplement with a bottle feeding

Should you be offering supplemental formula or breastmilk, try to pump anytime baby takes a bottle.³⁰ This will help stimulate the body to produce more milk.

Pump after each time baby breastfeeds

While not all women need to do this, you may decide to pump after each breastfeeding session.³²

Over time, this often helps to encourage milk production. Pumping after breastfeeding is particularly important if your little one is not emptying the breast well or needs to be supplemented.³¹

If you’re able to pump some milk during these sessions, this excess milk can then be used for supplemental breastmilk feeds when needed.

Try power pumping

Should your supply truly be low, power pumping may be another way to help boost your breastmilk production.^{33, 36} This method of pumping imitates cluster feeding, which is what babies do during growth spurts to help increase supply.³⁵

The primary goal is not to get a lot of milk during the sessions, but rather to stimulate your body to increase breastmilk production over time.³³ So don’t worry if you aren’t pumping much milk. With that said, anything you do pump can be stored for later use.

Some women opt for one power pumping session per day, while others set aside a whole day and do it multiple times. Some working moms may do it on the weekends. Whatever you choose, it can take as little as a day or a much longer time for your body to respond.

A typical power pumping routine is pump, pause, pump, pause, pump. You can do this by pumping for 10 to 20 minutes, pausing for 10 minutes, pumping for 10 minutes, and repeating this 10-minutes-off and 10-minutes-on for up to an hour.^{33, 36}

Power pumping tips:

• Use a double electric pump for best results.³³
• No need to refrigerate the breastmilk during the ‘pause’ periods as freshly pumped breastmilk is safe for up to 4 hours at room temperature.³⁴ Though it’s best to refrigerate as soon as you’re able.
• Stay relaxed by reading a book, resting, or enjoying a snack during the power pumping session.

While breastfeeding and pumping, try breast compressions

Compressions can be particularly effective during nursing and while pumping if your breast shape and pump flange allow it. This helps to increase the flow of milk which can keep baby on the breast for longer and give your pumping output a boost.

When you notice baby has stopped breastfeeding or their drinking/swallowing has slowed down, give your breast a squeeze (but not so strong that it hurts). You should see baby’s suckling start to pick up or the milk to start flowing again with the pump.

Keep the squeeze until baby slows down their suckling again. You can repeat this as often as you would like.²¹

Schedule a nursing vacation

Some professionals recommend taking some time for just you and your baby to relax and breastfeed. Cuddle up in bed with your baby and do nothing but rest and nurse – and, of course, feed yourself as well.

This will give your baby the opportunity to nurse as often as they would like and help you get some R&R – both of which may help boost your supply.

Increasing breastmilk supply will take time

We are living in fast-paced time when we expect things to happen quickly. Unfortunately, increasing your milk supply often takes time, patience, and consistency. Some women may notice their supply increasing after a few days, while for others it may take a few weeks.

Be kind to yourself, feed your baby to meet their needs – including with supplementation if necessary, and know that any amount of breastmilk is beneficial.

You’re doing a great job!

Contact a healthcare professional

If you are worried about your supply, reach out to a local lactation consultant for an in-depth and individualized assessment. Our team of experts can help you figure out what’s going on and help you find local breastfeeding help as well.

If you’re concerned about your supply and baby is lethargic, has not had a bowel movement, or does not seem well, contact your baby’s healthcare provider ASAP.

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