What causes a low milk supply?

Most often low milk supply results from not draining the breasts effectively. This may happen if:

• You are separated from your baby during the first week after delivery–for example, if your baby is sick and you are not able to nurse or pump.
• Your baby doesn’t nurse often enough, suck well, or empty your breasts well.
• You regularly use infant formula supplement, which causes your baby to nurse less often.
• Your baby sleeps though the night (6 or more hours) without nursing.
• You have health problems after delivery, such as high blood pressure, anemia, or an infection.
• You are under a lot of stress or go on a weight-loss diet.
• You go back to work, which may decrease how often you can nurse or empty your breasts.
• You have very sore nipples or blocked milk ducts.
• You have had previous breast surgery, especially around your areola (the dark area around your nipple).

In general, the longer your milk supply has been low, the longer it will take to make more milk. In some cases, you may not be able to increase a very low milk supply to levels that will be enough for your baby to grow and gain weight.

How can I increase my milk supply?

Most women can make plenty of milk if their breasts are regularly and effectively drained by breast-feeding or breast pumping. The more milk you remove from your breasts, the more milk you will make. If your milk supply is low, there is a good chance you can increase it by stimulating and emptying your breasts more effectively.

• Try to nurse your baby more often.

  If your baby is sleepy, undress your baby to wake him up. Try switching breasts every 5 minutes.

  During feedings, support your breast with your thumb above and four fingers below. If your baby is sleepy or stops sucking when the flow of milk slows down, squeeze your breast firmly, but gently, to squirt some milk into your baby’s mouth. You do not need to squeeze constantly. Just squeeze and release, and then squeeze and release again. This can help your baby get more milk from your breasts.

• Pump your breasts.

  Use an electric breast pump to remove extra milk after feedings. Try to pump right after you nurse your baby. Use breast massage and hand expression during and after pumping to increase the amount of milk removed. You can go for up to 5 hours without pumping at night, but aim for 8 pumping sessions every 24 hours.

  Record the amount of milk you pump each time. The totals for each day will help you see how much your milk supply is increasing.

  Using an electric breast pump to stimulate and empty your breasts is especially important if your baby needs extra feedings of pumped milk. Babies getting extra feedings may nurse less often, and some who are fed with a bottle will nurse less effectively.

  To find where you can rent a pump, contact your healthcare provider or lactation consultant.

• Take care of your health.

  Drink plenty of liquids each day and eat healthy meals, plus healthy snacks. Try to get extra rest. Try not to get discouraged. Get help and support from friends and family.

If you have a medical problem, such as high blood pressure, anemia, or an infection, your milk supply may increase as your health improves.

How do I give my baby extra feedings?

If your baby is very underweight, your healthcare provider may advise giving extra breast milk or infant formula. Your baby may need extra feedings until you have a better milk supply. Your baby will probably nurse better once he reaches a healthy weight.