Mothers can breastfeed with a low milk supply. However, they often wish to increase the amount of milk they make. Their success depends on the cause of the problem. To increase a milk supply, mothers need to optimize their breastfeeding: ensure that the baby can latch and suck effectively, breastfeed when the baby is hungry, offer both breasts at each feed, and generally avoid pacifiers. Mothers also need to avoid unnecessary supplementing. If the baby is not breastfeeding or is not breastfeeding well, mothers will need to express every time the baby is unable to breastfeed effectively. For some mothers, expressing can help to increase milk supply even if they are breastfeeding effectively.
In our clinic, we have often been amazed by the breast’s ability to increase milk production. We have regularly seen mothers supplementing large amounts of infant formula over many weeks, resulting in a severely reduced milk supply. Within one month and with proper management their milk supply can return to normal and their babies no longer need infant formula.
It is also possible for a mother to have a permanently low milk supply. For example, mothers with insufficient glandular tissue or mothers who have had breast reduction surgery usually need to combine breastfeeding and milk supplements for the long term. It is also possible for a mother to have a reduced milk supply that will not increase. For example, this may happen after having a large breast abscess that was treated surgically.
Mothers who wish to restart breastfeeding or breastfeed adoptive children will have various degrees of success in increasing their milk supply.
If changes are made to the baby’s feeding pattern or the amount of supplement is decreased, the baby must be seen regularly by a health-care provider to make sure the baby is growing well and is not underfed.
These are the steps to increase milk supply:
1) Address the cause(s) of the low milk supply
Mothers may be able to increase their milk supply by removing the cause(s):
The first step to increasing milk supply is optimizing breastfeeding by allowing a healthy baby to breastfeed normally at each feeding. The baby will still need supplementing while the milk supply remains low.
Allow the baby to breastfeed whenever the baby gives hunger signs.
a) Express if the baby is not breastfeeding or not breastfeeding effectively
Express after each of the baby’s feeds if the baby is not breastfeeding effectively.
Express for all periods of mother-baby separation.
b) Consider expressing even after effective breastfeeding
Expressing after breastfeeding helps helps some mothers increase the amount of milk they make. It increases the amount of milk taken out of the breast and this can increase the amount of milk made. However, it is time-consuming and may be ineffective.
If you are expressing, make sure it is effective and consider short-cuts to reduce your efforts.
5) Consider medication and herbs
Mothers can consider the use of medication to increase their milk supply if the above steps are not effective and they:
Do not interact with other foods or citrus fruits the mother is taking.
Mothers using medication should not exceed the recommended dosages and stop them when they are no longer useful or are causing side-effects.
Mothers can also consider herbs if they are safe and effective.
Unfortunately, many mothers unnecessarily worry that they are not making enough milk and resort to herbs, medication, or lactation cookies. This was as high as 60% in one study of Australian mothers (McBride 2021).
6) Reduce stress
Stress and other difficult feelings can have a negative impact on the individual and the family.