37: Causes of Low Milk Supply
Last week, we covered the basics that are necessary to build and establish your breastmilk supply. If you missed it, I encourage you to listen to Episode 36 first. Today we’ll take a deep dive into what factors can block, inhibit, or wreck your breast milk supply.
A quick note before we tackle this list. Mothers who give birth prematurely may have delayed milk production. This is not unusual and I encourage you to ask for lactation support to help you establish a pumping plan and provide support if feeding your baby your breastmilk milk is your goal. Now onto the list.
Here are some things that can inhibit your milk supply:
Your feeding or pumping schedule is less than 8 times in a 24 hour period. I know, I know… we covered this in the milk supply basics episode last week, but it’s worth repeating because this is so common among mothers who plan to breastfeed, and for whatever reason it doesn’t go smoothly at the hospital. So they are sent home with formula and a commonly unhelpful football hold to practice… What ends up happening is that they start pumping and are attempting to keep up with the feeds and the pumping. Then without realizing it, they are skipping pumps or just pumping in the spaces between all the other things and only pumping like 6 times a day. Because it’s a lot to keep up with.
Unfortunately, this just isn’t enough to build a supply on, and by the time they call someone for help, at least a week of stress, effort, and opportunity has passed. So I’ve said it once, and I’ll say it again. Please know who you are calling before you give birth. Be picky about who it is. Plan to have them come within days of getting home and definitely do not skip this if you have had to deviate from your feeding plan.
You skip nursing or pumping during the high prolactin period somewhere 1-5 am. Different moms have different sensitivities to this one, but especially in the beginning breastfeeding or pumping during this window is important. Usually, if your baby doesn’t wake you up your breasts will.
Your pump isn’t working properly to provide the right suction or frequency levels. If your pump is broken, it can’t do its job.
If your pump isn’t fitting properly it will impact milk removal. This includes flanges that are too small, which can put pressure on the ducts thereby blocking milk flow. Also ill fitting flanges (too big or too small) can cause painful pumping and tissue damage to your nipples which do not exactly encourage supply. And also, ouch!
Likewise, if for any reason your baby is unable to effectively nurse not only do they get less milk, but your breasts get the message that less milk is to be made.
Wearing tight fitting bras, tight straps, or anything else pressing on the breast tissue even on the sides can be detrimental, cause inflammation, and other breast issues.
Smoking is known to cause decreased supply.
High doses of Vitamin B6 as well as some medications such as cold medications that dry you out for example can also reduce breast milk production. This could even include drinking a lot of tea that is known to have drying effects, such as peppermint, but you’d have to drink quite a lot so don’t go tossing out all your Celestial Sensations unless you are really going to town.
Early use of birth control or a new pregnancy can also impact milk supply because they change the hormone levels in your body.
If you suspect something deeper, here are some other underlying factors that can impact milk supply:
Iron deficiency
Sheehan’s Syndrome
Retained placental fragments. This is when part of the placenta was not delivered and is still inside of you after the birth. This will not only delay milk coming in, but is a serious health risk. Other signs include a fever, foul smelling vaginal discharge, large pieces of tissue coming out of the vagina, and pain. If you experience these, get help immediately.
Hypo or hyperthyroidism and PCOS are also known to impact lactation.
If you are insulin dependent with diabetes, it’s not uncommon for your milk to come in a little late.
Tissue trauma to the breast glands, from a previous accident or a surgery for example, can create scar tissue and physical changes that may or may not impact lactation.
And lastly, breast abnormalities which reduce the glandular tissue (meaning there is less milk making tissue available to make milk) can of course be a cause for low supply. Now, this is NOT the same as having small breasts. In fact, breast size and bra size do not equate to how much milk you can make and there are plenty of smaller chested women who in fact have oversupply. Instead this is about the glandular tissue within a breast of any size.
Now, hopefully you don’t run into any of these issues, but if you do then please reach out to your IBCLC or OBGYN for help ASAP.
And with that, I’ll be back next week!