There are times during breastfeeding you may question your milk supply. Some people experience a dip or drop in supply early while for others, it happens later in their breastfeeding journey and can come on quickly. Sometimes, the decrease in supply happens more slowly and may not be noticeable for a couple weeks. Take a step back to look at the big picture, play detective to point in the right direction for why it happened to get back on the path to making more milk.
Every mother wants to know they are making enough milk for their baby. Exclusive breastfeeding is recommended for the first six months of the baby’s life, introducing complementary foods after the first 6 months as your baby shows signs of readiness, and to continue breastfeeding up to two years of age or longer if mutually desired.(1)
As your milk transitions in the early days from colostrum to a more copious milk supply, your breasts will feel full, perhaps heavy and then less full after your baby nurses or after pumping. During this time, your milk supply is primarily driven by hormones.(2) Prolactin, responsible for making milk, is highest right after delivery while estrogen and progesterone drop and milk begins to flow.
Over the next few weeks, as your baby feeds and removes milk, hormones signal the body just how much milk needs to continue to be made to sustain your baby. It is like an information gathering hub. Prolactin begins to taper down, but is still released anytime milk is removed. As your baby removes milk, the signal is sent to refill, make more milk. Your milk supply begins to rely more on demand than hormones alone. Your breasts may feel less full than before. You may not feel your let-down as intensely as before or perhaps not at all. Your supply has regulated.
Reasons your milk supply can become low
- Stress can really make your milk supply take a hit
- You or your baby were sick and your supply took a dip
- Your period returned
- Feeding your baby on a schedule may be spacing feeds out too much
- Your baby slept longer at night
- Unresolved oral restrictions
- No milk removal overnight
- Giving a bottle to your baby without pumping or hand expressing during that time
- Need a different flange size or to replace your pump parts
- Taking medications or hormonal birth control that lower your supply
- Eating foods that are anti-lactogenic
- Your baby was on a nursing strike
- Drinking alcohol
- Smoking
- Using a pacifier
- Long periods of time with no milk removal
- You are pregnant
How to boost your milk supply quickly:
Take a nursing holiday! Spend the day skin-to-skin with your baby. When you are skin-to-skin, your baby has an all access pass to your breasts and will likely nurse more. Removing milk more often will leave space for milk to refill. For older babies or if you don’t want to be in bed all day, wear your baby in a sling that you can nurse in. Taking a bath together can help reduce your stress and relax your baby especially if they have any resistance around nursing.
When the alveoli cells are full of milk, prolactin is not allowed in, there’s no more room is the message and milk-making slows down. With more frequent removal, the milk production system refills more often, boosting your milk supply. Your baby doesn’t need to take a full feeding each time to signal more milk to be made. Just coming to the breast for a snack empties some of the cells and so more is made to fill that space.(3)
Power pumping is a strategy to trigger several let-downs in a one hour period of time. Each let-down helps to empty more milk from the breasts and increase your supply. Power pumping can look many different ways. The goal is to pump, rest, pump and rest. Some people pump for 15 minutes and break for 15 minutes repeating the cycle for one hour. Others choose to pump for 20 minutes, rest for 10, pump for 10 and repeat the 10 minute intervals until you reach one hour. You can experiment and see what pattern triggers the most let-downs for your body.
Hands-on techniques before (and during) nursing and pumping can help milk flow more easily and more quickly. Use heat on your chest to open up the ducts for milk to be able to release more easily. Heat is also shown to help lower stress which can delay milk let-downs and reduce the amount of milk you are able to express.(4)
Lightly tapping or massaging your breasts can add gentle stimulation and increase milk flow. Very gentle touch releases oxytocin, the feel good hormone. As oxytocin is released, the body relaxes and the milk ejection reflex is triggered, milk flows and as it is removed from the breast, prolactin increases telling the body to make more milk. Massage your chest/breast tissue, tapping on all areas of the breast including your armpit where there are many lymph nodes and blood vessels.
Middle of the night milk removal impacts overall milk supply. Going long stretches of time without milk removal disrupts the information feedback system signaling the body to keep up the pace of milk making. The lack of milk removal by breastfeeding or pumping during the night sends the message to slow down production and make less milk.
Keeping your baby close to you during the night causes less disruption to your sleep while still being able to respond to your baby’s cues and nurse during the night. Mothers who safely co-sleep and dreamfeed their babies have been shown to get more sleep than if they are not in close proximity.(5) In many cultures the breastfeeding parent wears the baby during the day and sleeps next to the baby at night as the norm. Breastfeeding evolution evidence shows us that babies who are kept close to their nursing mother feed more often and up to 50% of their milk is received during the night, especially as they grow and are more distracted during the day.
Prolactin’s own circadian rhythm is naturally higher at night and lower during the day. Removing milk during this heightened time maintains overall milk production. Babies take in about 1/3 or more of their milk during the night. When they begin to suck, prolactin levels rise further and again, high prolactin levels means more milk.
Nutrition and hydration are critical for keeping your vitamins and mineral stores adequate and to produce a sufficient milk supply. Most cultures have certain foods they give the mother during the postpartum period that are known for establishing and supporting milk supply. All of the herbs and foods are highly nutritious and very hydrating.
Supplements by Legendairy Milk contain some of these traditional herbs which aid maternal and infant gut health, support milk production and improve the quality of your milk. Supplements can help improve your milk supply, but do not replace making adjustments to your food choices and lifestyle.
Some foods and beverages can reduce supply or make it hard to maintain supply. These anti-lactogenic foods include processed foods, drinks and foods high in sugar, citrus and astringent foods and caffeine. Sugar can sometimes help release milk when it is eaten immediately before nursing, but is not a good long term solution and can be a sign of underlying insulin resistance.(6)
Drinking water is a first step to hydration, but including foods that hydrate can be a game changer. In order for water to hydrate the body, it must be able to enter the cells before you pee it out. Foods and herbs that hold water hydrate the body at a cellular level. Oatmeal and chia seeds are great examples of hydrating lactogenic foods you can include in your day.
See an SACLC/IBCLC - Your SACLC/IBCLC can help you determine all the contributing factors to your milk supply and suggest milk management strategies and other changes to help you continue to breastfeed successfully. Sometimes there is more than one reason for your milk supply decreasing including tongue tie or oral tension in your baby or undiagnosed hormone imbalances you may be experiencing.
If more than a quick fix is needed, your SACLC/IBCLC can help co-create a care plan that makes sense for you and your baby’s individual needs.
For long term solutions, you need to address the root cause of what made your supply drop in the first place. Sometimes this can take more investigation and changes to your routine, menu plan or lifestyle, but the gains you experience will be well worth it.
Footnotes:
- https://www.cdc.gov/breastfeeding/faq/index.htm
- https://kellymom.com/bf/got-milk/basics/milkproduction/
- https://wicbreastfeeding.fns.usda.gov/how-breast-milk-made
- https://pubmed.ncbi.nlm.nih.gov/22424466/
- https://cosleeping.nd.edu/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968698/
Resources:
https://dhhs.ne.gov/Documents/LEARN-Breast-Massage-for-Better-Breastfeeding.pdf
https://kellymom.com/ages/newborn/bf-basics/importance-responsive-feeding/
http://www.mobimotherhood.org/lactogenic-foods-and-herbs.html
https://www.ncbi.nlm.nih.gov/books/NBK235589/
https://www.ncbi.nlm.nih.gov/books/NBK539790/
https://www.ncbi.nlm.nih.gov/books/NBK148970/
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