Low Milk Supply, Beyond The Basics

There is no precise definition of low milk supply. Simply, low milk supply is diagnosed when a mom produces less than what her baby needs. If you're looking for numbers, a NICU mom should express 500mL in 24 hours by the time her baby is 2 weeks old. Term babies expect to eat 700mL+ in the 24 hours by the time they are 2 weeks old. (But every baby is different!)

Low milk supply is a medical condition for mom, though the symptoms are usually only seen in the baby. Sometimes moms feel that their breasts are soft and empty. Sometimes mom feel that their breasts are full, but they can only express a few milliliters. Symptoms of low milk supply in the baby include fussiness, bottle preference and poor weight gain.

At Woven Pediatrics, it is common for moms to be surprised by their low supply because the only symptom is the baby's poor weight gain.

Consults for low milk supply start with a test weight (weigh the baby, nurse, weigh the baby again). Then mom pumps. We add the amount that baby took at the breast to the amount mom pumped; the total volume is the amount mom produced for the feeding.

Please note, lactation consults for low supply must include both nursing AND pumping. If you only know what the baby took while nursing and not what is left over in the breast, you can't know where the supply stands.

For breastfeeding, you'll need:

* a functioning pituitary gland in your brain - this secretes the milk making hormone, prolactin.

* functioning breast tissue - this is the place the milk is made

Low milk supply can be separated into two categories: pituitary/prolactin problems and breast tissue problems. Almost all chestfeeding parents seen for low supply at Woven Pediatrics have their prolactin levels checked. If it's low, we need to find out why the pituitary is not spewing out lots of the milk-making hormone. In other cases, the prolactin is normal or high, the breast tissue is the problem. 

Low milk supply is frustrating, often catches moms off guard, and can devastate a breastfeeding journey. People ask, "how can my body make a healthy baby but not enough milk to nourish him?"

In the community, pediatricians, ObGyns and IBCLCs often make a dreaded recommendation: triple feeding. Low milk supply can feel like failing as a parent. Add on a demanding feeding schedule, and you've got a recipe for post-natal depression.  Instead, all moms with low milk supply should get a medical evaluation. A diagnosis will help answer questions and provide options so that we can set reasonable expectations and goals. Often there are supplements, herbs or prescription medications that can help increase your milk supply.