One of the biggest concerns that parents have when I meet with them—whether prenatally or postpartum—is being able to produce enough milk for their baby. Low milk production appears in social media posts, product advertisements, and stories from other parents, so it’s absolutely understandable to have concerns! Most parents aren’t aware of the causes or reasons for low milk supply. Furthermore, common recommendations to address low milk production range from very easy, like adding in lactation cookies, drinks, or supplements, to very challenging, such as pumping after every breastfeed. It can be hard for parents trying to increase milk production to know which advice to take or which products to purchase.

An important part of fixing low milk production is confirming that there is low milk production, then figuring out the root cause. I have met parents who were told they had low milk production based on their baby’s behaviors, but upon further investigation, oversupply was confirmed instead! Products like supplements, drinks, and cookies can sometimes help increase milk production, but these do not get to the root cause of the issue. Some of these supplements can be very costly, or even worse—some of them can actually decrease milk production!

When thinking about the potential cause of low milk supply, remember that milk production levels are typically based on the supply-and-demand relation. The higher the demand for breast milk, the more milk will be produced. Notice that I said typically; in certain cases, there is adequate demand, but an underlying medical condition is causing the milk production issue and must be addressed. During assessments I do with parents, we take a very detailed history to confirm that the demand is adequate, although this is not always as clear-cut as it seems. 

A parent whose baby is latching the appropriate number of times per day (typically 8-12) and for the appropriate duration (typically 10-45 minutes based on age) but still has low milk production may mean that the baby is not providing adequate demand with the way they are feeding. With pumping, the conclusion is similar: a parent who is pumping the appropriate number of times per day (typically 8-12) and the appropriate duration (typically 20-30 minutes) but still has low milk production may mean that the pump is not providing adequate demand. 

Causes of low milk demand

Here are some common factors that can impact the “demand” portion of the supply-and-demand relation, leading to low milk production:

  • Infant low blood sugar
  • Infant jaundice
  • Infant being born before 39 weeks
  • Tongue or lip ties
  • Low muscle tone
  • Torticollis
  • Vacuum-assisted birth
  • Airway deep suctioning after birth
  • Improper flange fit
  • Elastic nipples
  • Improper care/cleaning of pump parts

Reasons for low milk supply

Potential reasons for low milk supply due to underlying medical conditions in the parent:

  • Postpartum hemorrhage or other birth complications
  • Thyroid disease or dysfunction
  • PCOS or other endocrine disorders
  • Anemia
  • Insufficient glandular tissue (importantly, breast size does not always correlate with the amount of glandular tissue)
  • Taking certain medications or supplements
  • History of breast or chest surgery/injury

For any parent that has concerns prenatally about milk production, I encourage them to take a breastfeeding class or have a prenatal consult to know what typical feeding patterns and behaviors look like, including cluster feeding. Cluster feeding is a very common, normal infant behavior but can definitely be alarming if you don’t know it is to be expected. For parents who are currently lactating and have concerns about milk production, I highly recommend a consultation with an IBCLC (virtual or in person) who has experience with identifying and treating low milk production.

Low milk production that cannot be treated is very rare compared to how it is often portrayed!

Author: Jennifer Black

Jennifer Black is an IBCLC with a BS in Maternal Child Health and has 9 years work experience in public health, private practice, outpatient, and as a hospital educator. Jennifer has 5 children and spent 110 months breastfeeding and pumping. She is also a Lamaze Childbirth Educator, Birth and Postpartum Doula, Certified Passenger Safety Technician, and AHA CPR/BLS Instructor. Jennifer’s specialties include LGBTQIA/Inclusive care, oral tethers (tongue, lip, and buccal ties), milk supply concerns, latch difficulties, holistic lactation, weaning, extended breast/chestfeeding, return to work/pumping, food intolerances, and infant weight concerns.

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Check out a few of our other posts on common issues encountered by breastfeeding parents!