Your milk supply is considered low when there is not enough breast milk being produced to meet your baby's growth needs.
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Many mothers worry about their milk supply, especially in the early stages of breastfeeding. In fact, women who have stopped breastfeeding will most commonly say it was because they "didn't have enough milk". But most mothers do produce enough milk for their babies.
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If the breast milk supply is genuinely low it is usually a temporary situation and can be improved with appropriate support. If you are concerned about your supply it is important to seek advice from your Maternal and Child Health Nurse, a lactation consultant, the Australian Breastfeeding Association, your GP or other health care professional.
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There are some common reasons why women may question their milk supply:
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- "My baby feeds too often"
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Babies naturally feed frequently (sometimes 10-12 times in 24 hours) in the early days, and can be very unsettled, but this does not mean that there is not enough milk. In fact, frequent feeding is necessary to establish a good breast milk supply.
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See fact sheet: Breastfeeding: Getting Started
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When your supply adjusts to your baby's needs your breasts may not feel as full (this may occur as early as three weeks and up to about 12 weeks following birth). As long as your baby continues to feed well, your breasts will produce sufficient amounts of milk.
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- "My baby has suddenly started to feed more frequently"
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Your baby may wish to feed more often during a 'growth spurt', but this increased feeding over a couple of days will have the desired effect of increasing your supply.
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- "My baby only feeds for a short time"
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This is no cause for concern as long as your baby continues to grow (see below "Signs your baby is having enough milk"). After two or three months your baby becomes more efficient at feeding and therefore will take less time at the breast.
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Possible causes of low supply
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- Your baby is not attaching well at the breast. This may also cause nipple pain and damage.
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- Your baby does not feed often enough. Babies less than eight weeks old need to feed seven to eight times in 24 hours.
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- Your baby does not feed effectively at the breast.
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- You are replacing breastfeeds with artificial formula.
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- You have a past history of breast surgery, in particular breast reduction.
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- You have a recent past history of mastitis.
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- You are taking oral contraceptive pills containing oestrogen.
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- Some medications, including over-the-counter and herbal preparations e.g. cold/flu tablets may reduce your milk supply.
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- Rarely, there may be reduced or no milk production because of a medical condition. This occurs in less than five percent of mothers.
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Signs your baby is having enough milk
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After the first week following birth, your baby should be:
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- Waking for feeds
- Settling between most feeds
- Having at least 6-8 soaked nappies (4-5 heavy disposable nappies) in 24 hours
- Passing a soft yellow stool at least once a day
- Your baby should be back to birth weight by approximately two weeks of age and gaining an average of 150grams or more per week for the first three months of life.
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How to increase your milk supply
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The key to increasing your milk supply is frequent stimulation and emptying of the breasts. This may take some time and it is important that you seek advice and support from a lactation consultant, your Maternal and Child Health Nurse or other health care professional.
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- Hold your baby "skin to skin" at the breast (baby is dressed in a nappy only, so that there is direct skin contact between you and your baby). This will help to keep your baby awake and also to increase the release of hormones involved in breast milk production
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- Breastfeed frequently, two to three hourly - a total of at least eight feeds in 24 hours. Your baby may need to be woken for some feeds, or may wake to feed even more often
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- Make sure that attachment is good and that your baby is both sucking and swallowing (you may need to seek help with this)
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- Offer each breast twice (i.e. left, right, left, right) and then express to provide further stimulation and to ensure that your breasts are well drained
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- If your baby is sleepy at the breast and not feeding well you may need to cut short the feed and use the time to express each breast twice i.e. five minutes left side, five minutes right side and then repeat
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- When breastfeeding or expressing, compress or massage your breasts to assist with drainage
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- If you need to give your baby extra fluid, give expressed breast milk separately and before any artificial formula
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To manage all of the above, feeding may need to be timed so that the whole process is completed in about one hour for most feeds. You and your baby need time to rest between feeds.
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- Prescription medications for increasing milk supply are available from your doctor but should not be the first course of action.
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Where to get further information or advice
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Royal Women's Hospital
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Breastfeeding Education and Support Services (BESS)
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Tel: (03) 9344 3651
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Other contacts
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Your local Maternal & Child Health Nurse
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Australian Breastfeeding Association
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Tel: (03) 9885 0653 (helpline - Vic)
(see website for contact details of other states)
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Web: http://www.breastfeeding.asn.au
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Maternal and Child Health Line (24 hours)
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Tel: 13 22 29
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Disclaimer
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The Royal Women’s Hospital does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided in this fact sheet or incorporated into it by reference. We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.
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Last updated Jan 2008
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