Have there been times during your breastfeeding journey you questioned your milk supply and if you were making enough milk? Some people experience a dip or drop in supply early, while others experience a change in their milk supply months into their breastfeeding journey and can come on quickly. Sometimes, the decrease in supply happens more slowly and may not be noticeable for a couple of weeks. Take a step back and look at the big picture, play detective and examine what may have led to the unwanted reduction in your milk supply, giving clues for what might help you to get back on the path of 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 continuing 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, people often make more milk than their baby needs. In the first few weeks, 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 begin 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 time. Prolactin begins to taper down but is still released anytime milk is removed. As your baby removes milk, the signal is sent to refill and 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 been regulated.
Reasons your milk supply can become low
Stress can 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
Using a pacifier
Swaddling can inhibit natural rousing patterns for your baby and decrease feeding frequency
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 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 resist nursing.
When the alveoli cells are full of milk, prolactin is not allowed in. There’s no more room is the message sent, and milk-making slows down. With more frequent removal, the milk production system refills more often, boosting your 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, 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 they 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 quickly. Use heat on your breasts to dilate the ducts for milk to release more easily.
Legendairy Milk’s Breast-Ease heat pack is designed to fit comfortably on your chest and conform to the breast. You can tuck it inside your nursing bra while pumping. Heat is also shown to help lower stress. Stress can delay milk let-downs and reduce the amount of milk you can express. (4)
Lightly tapping or stroking your breasts adds gentle stimulation and increases milk flow. A 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. Stimulate your breast tissue, tapping on all areas of the breast, including your armpit where there are ducts, lymph nodes and blood vessels.
Middle-of-the-night milk removal impacts the 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 at night sends the message to slow 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. 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 mother wears her 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 mothers 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 mean more milk is made.
Nutrition and hydration are critical for keeping your vitamins and mineral stores adequate and producing 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.
Drinking water is the first step to hydration, but including foods that hydrate can be a game changer. 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.
Galactagogues - Lactation supplements by Legendairy Milk contain many of these traditional herbs, which aid maternal and infant gut health, support milk production and improve the quality of breast milk. Supplements can help improve your milk supply but do not replace adjusting your food choices and lifestyle.
Anti-galactagogues - 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 it is not a good long-term solution and can be a sign of underlying insulin resistance. (6)
Make an appointment with an IBCLC - Your 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 breastfeeding 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. Your 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. While you are making more long-term changes, lactation supplements may be a helpful aid to boost your milk production and quality. Most of the time, your milk supply can recover from a dip with more milk removal and herbs to support your breastfeeding journey.