Increasing a low milk supply

Can I increase my low milk supply?

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.

Consider using our quick assessment tool, “How do I increase my milk supply?” to guide you through this concern.

A) Likelihood of milk supply increasing

Mothers can breastfeed with a low milk supply. However they often wish to increase their milk supply. Sometimes this is possible and other times not.

Mothers with a low milk supply may:

  • Not be able to increase their milk supply and need to continue supplementing with milk permanently.
  • Be able to increase their milk supply:
    • But still need to continue supplementing permanently.
    • And stop all supplements.

If the milk supply is able to increase and the baby is healthy and growing well, the supplements are gradually decreased and possibly stopped.

The ability of the breast to increase milk production depends on the cause of the low milk supply. Milk supply is more likely to increase if:

  • The milk came in well.
  • The milk supply has only been reduced for a short period.
  • The milk supply is not severely reduced.
  • The mother has not had aggressive breast surgery.

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.

There are specific steps to increasing a milk supply. In general, eating certain foods or drinking more liquids will not increase milk supply.

B) Tools for increasing milk supply

This baby had latching problems and was readmitted to treat jaundice and underfeeding. The mother started expressing but as her volumes were small, the baby was also given infant formula. At 23 days, the baby started breastfeeding which increased the mother’s milk production. Infant formula supplements were slowly decreased and then stopped.

Make sure that your efforts are actually increasing the milk supply. If not, stop.

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):

2) Optimize breastfeeding

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.

3) Supplement the baby appropriately

To supplement the baby appropriately:

4) Consider expressing

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:

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.

Severe stress can reduce milk supply. Mothers who are expressing frequently or exclusively are especially susceptible to a reduced milk supply when under stress.

References

McBride GM, Stevenson R, Zizzo G, et al. Use and experiences of galactagogues while breastfeeding among Australian women. PLoS One. 2021 Jul 1;16(7):e0254049