Transitioning to life with a newborn can be overwhelming enough as it is, without adding feeding issues and worries about low milk supply into the mix. IBCLC Holistic Lactation Consultant, Joelleen Winduss Paye explains what low milk supply is and shares nine tips to help increase it.
Nine Tips to Increase Your Milk Supply
What is low milk supply?
Low milk supply, also known as insufficient milk supply, refers to a situation in which a breastfeeding parent believes they are not producing enough breast milk to meet their baby's nutritional needs. This is different to Delayed Milk Supply, which is where milk can take up to 10 days to fully come in. It's important to emphasize that true cases of low milk supply are relatively uncommon. Many parents worry about their milk supply at some point, but most concerns can be addressed with proper support and information.
Signs of low supply
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Low Weight Gain: If a baby isn't gaining weight as expected, parents might worry. However, many elements impact weight gain, and overall health matters.
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Non-stop feeding or cluster feeds for hours on end may indicate your baby’s attempts to drive up demand for milk.
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Falling asleep quickly at the breast, and shorter feeding sessions may concern parents, particularly in the early days and weeks.
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Consistent fussing at the breast or not being able to sleep unless it's a contact nap. Keep in mind, babies will also be fussy for reasons like gas, discomfort, or developmental changes.
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Low volumes when expressing breastmilk. Pumping doesn't always reflect actual milk production, and there are many variables when it comes to choosing the right breast pump.
A note about normal newborn weight gain
- In the first week of life, it is normal for newborns to lose some weight, typically due to fluid loss. A weight loss of up to 7% to 10% of the birth weight is generally considered within the normal range. This will be assessed around 48 hours of age.
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Most newborns regain their birth weight by about two weeks of age. After regaining birth weight, infants usually gain weight at an average rate of about 150-250 grams per week during the first month.
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At around 12 weeks breastfed babies tend to gain weight at a slightly slower pace than the first month. On average, a healthy, breastfed baby might gain around 110-200 grams per week during these months. Breastfed babies and formula-fed babies can have slightly different weight gain patterns. Formula-fed babies might have a more consistent weight gain pattern.
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Keep in mind that there is a wide range of normal weight gain for newborns. Some babies may gain more or less weight than the average, and as long as they are meeting developmental milestones and have a consistent growth pattern over time, it's usually not a cause for concern.
Conditions that may predispose low supply in the mother/breastfeeding parent
Insufficient Glandular Tissue (IGT), Gestational Diabetes Mellitus (GDM), Diabetes T1 & T2, Hypothyroidism (low thyroid function), Polycystic Ovarian Syndrome (PCOS), fertility challenges/ hormonal imbalances, obesity, breast surgery and maternal age can all factor into delayed (longer than 5 days postpartum) or low milk supply.
Other possible causes of low supply can include tongue tie, suck challenges, sub-optimal latch, separation at birth, early introduction of infant formula, bottle preference and preterm birth. Reach out to your Lead Maternity Carer for support.
Tips for an optimal milk supply
Before your baby arrives:
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Learn about hand expression from 36 weeks
One of the most practical ways to support milk supply is to learn the technique of hand expressing while you are still pregnant. This is the process of manually squeezing and collecting any colostrum (early milk) in the breast. Not everyone manages to collect colostrum and that is ok, learning the technique ahead of time is the main goal. You will need to wait until 36 weeks of pregnancy and seek approval from your healthcare provider.
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Learn about the golden hour and the benefits of skin to skin
The golden hour/hours represent the first 1-3 hours post birth that are very impactful on the long-term breastfeeding journey. Learn about the breast crawl, which is where the baby finds their way to the nipple and latches on themselves! Studies have shown that babies who self-initiate their first feed have better feeding outcomes. Discuss prioritising the golden hours in your birth plan with your care providers.
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Touch base with a Lactation Consultant and know what services are available
It is great to know what support is available ahead of time. Find out what specialist health services are available in your local area, your local hospital may have a breastfeeding outpatient support. If you have the means to enlist some private support, seek out a local International Board Certified Lactation Consultant (IBCLC) and see if they have some availability around your due date. Doing a bit of research before your baby arrives helps to take the stress out of finding support if needed when your baby is here and you may be experiencing challenges. Delegating this research to a close support person can also be a good thing to do.
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Naturopath, nutritionist and/or integrative doctor support for hormonal conditions
If you have any (above) conditions that may predispose you to low milk supply it is great not only for your breastfeeding journey, but your overall health to get support with these before your baby’s arrival. There is so much a naturopath, nutritionist and/or integrative GP can do to support your health and optimise your milk supply, and having a solid treatment plan can help to guide the way.
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Postpartum planning: meal planning and delegating household chores
Planning will allow you and your partner to focus on establishing feeding in those early days and weeks. Good nutrition is really important to support healing, sleep and milk supply. The less you have to worry about running the house and the more you can utilise your village of friends, family and professionals, the more mental and physical energy you can dedicate to feeding and bonding with your newborn.
After Your Baby Arrives
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Unlimited breastfeeding Deep latch
When your baby arrives, frequent and unlimited breastfeeding will allow your baby and body to communicate, and this drives supply and demand. The more your baby demands (feeds) breastmilk, the more your body will respond by increasing the supply. It is normal for feeding to be all over the place in the early days, particularly before your milk volume increases, which is typically seen around 72 hours and beyond.
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Hydration and nourishment
A well-nourished mother is better able to nourish her baby. Eating an extra 300-500 calories per day is required to support breastmilk production and volume. Getting adequate protein levels is also really important, aiming for around 20-30 grams per meal will support hormonal health and provide the building blocks for breastmilk production. Around 3 litres of water is required, as 80% of breastmilk volume is water.
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Pumping and bottle feeding technique
If expressing breastmilk is needed to support milk supply and enhance supply and demand, making sure you have a hospital-grade pump that fits well is essential. Efficiency is key. A lot of parents find pumping and washing pumping equipment very time-consuming. Feeding any expressed milk with a bottle must be done with the paced bottle feeding technique, this means your baby will be less likely to develop a flow preference for a fast and easy bottle and reduce their fussing at the breast.
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Supplements and galactogogues
Most stop taking their prenatal once pregnancy is done, however, taking a good quality prenatal throughout breastfeeding will support the body’s need for micronutrients. Certain foods are thought to have milk-increasing effects, although high-quality research tends to be lacking around these, and knowledge is more anecdotal. Some galactagogues (milk-increasing foods and herbs) to try are oats, brewers yeast, fennel, fenugreek, goat's rue, raspberry leaf, linseed, ginger, garlic and barley to name a few. Consulting with a nutritionist, herbalist, naturopath and/or IBCLC is a great way to go, particularly when exploring herbs. Always use guidance when using complementary medicines such as herbs and essential oils.
Seek support
If you are concerned that your baby is not getting enough breastmilk and you are needing support with breastfeeding then seeking some professional support is key! Book in with a local IBCLC or GP + IBCLC for guidance around your individual needs. Perceived or genuine low supply can be stressful, so speaking with a psychologist, or enlisting the support of a postpartum doula can also help you to feel emotionally supported. Stress can have an impact on your hormones and milk supply, so taking a holistic approach means you are covering all bases.
With thanks to Joelleen Winduss Paye, IBCLC Holistic Lactation Consultant, Endorsed Midwife, Naturopath & Educator. Joelleen is a holistic lactation consultant with over 13 years of experience supporting breastfeeding families. She combines her knowledge of midwifery, naturopathy and IBCLC lactation consulting to help parents feel guided and confident in their breastfeeding journey.
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