Identifying & Improving Low Milk Supply

Are you worried about your milk supply? Many mothers believe that they have low milk supply based on their observations and some mothers think that they have low milk supply because:

• Their breasts don’t get engorged anymore
• Their babies seem to be fussy at the breasts
• They don’t feel a letdown as often or anymore
• Their babies suddenly feed more regularly or for a shorter period of time
• Your pump output has reduced
• Baby is still able to take in milk from bottle after latching

The good news is that the above do not, on their own, mean that you have a low milk supply! Most importantly, is that your baby is gaining weight and reaching his or her milestones. Babies who are receiving enough milk will also have a healthy flow of soiled and wet diapers.

Before we go on to share about actual low milk supply, let us discuss in depth about the points above to help allay your worries! 

1. Breasts do not get engorged / not feeling a letdown anymore

This usually happens when your milk supply has been regulated. This just means that your body is no longer overproducing milk, which typically happens for mums who have been breastfeeding exclusively since birth. This also happens when your baby reaches 3 months old or more. If your baby has been gaining weight steadily, the lack of engorgement simply means that your body is producing the amount that your baby is drinking.

Some mums may stop feeling that tingling sensation from a letdown as their babies grow. Do not worry! Your body is adapting very well in producing what your baby needed, especially if you have been breastfeeding on demand.

2. Babies seem fussy at the breast

While this can be telling about your supply, fussiness on its own could be due to many reasons. It is normal for you to feel worried over a fussy baby but observe him or her first. If your baby has reached 1/ 3/ 6 months and so on, your baby may be going through a growth spurt. Babies on growth spurts tend to drink more frequently because there are a lot of changes happening in the babies’ growing bodies. This is usually temporary and will go away on its own. Some very young babies become fussy at certain times of the day such as in the evening or at night.  This crankiness is similar to how adults are tired after a long day. This does not necessarily mean there is anything wrong with your supply. Babies may also cluster feed in the evening as a way to tank up for their long sleep at night.

3. Baby starts feeding for a shorter period of time

While you might have observed your newborn nursing at the breasts for hours back then, don’t be surprised when you find your older baby feeding very quickly now. Some mums have reported that their older babies may feed anytime between 7 to 10 minutes and are able to go without a feed for another 2 hours. This simply means that your baby has become more efficient at breastfeeding. With a bigger body, your baby’s tummy size has also grown bigger and is able to store more milk. Again, as long as your baby is gaining a good weight and is happy and active, there is no reason to doubt your supply.

4. Baby still takes milk from bottle after breastfeeding

For some new mothers, it might be frustrating to see your babies frequently asking to nurse. Some mothers might also cave in and feed their babies a bottle of formula or breastmilk after latching, thinking that their babies are not full and need more milk. If your baby has a healthy flow of wet and dirty diapers just from breastfeeding alone, there is actually no need to supplement with a bottle after every feed. Frequent nursing in the early days is actually a good way to prepare your body to produce more milk.

If your baby is also not rejecting a bottle after latching, it may be natural for you to think that there is something wrong with your supply. However, note that there is a risk of overfeeding when your baby is fed via the bottle. This alone does not indicate a low milk supply.

So, is low milk supply a real thing?

Yes, there are instances where a mother may experience a drop in their milk supply. The following are some situations where this is possible:

Pump output constantly drops after a period of time

Mothers who pump at work or exclusively pump for a long time may find their supply dropping after a period of time. For working mothers, lessening pump sessions at work or not being able to pump out the amount baby drinks when they are away from their babies can mean that the amount of breastmilk the babies actually drink is not being extracted from your breasts. This signals to your body to produce less milk over time.

For Exclusive Pumping (or EP) mums, similarly, if you drop or miss a pump constantly it can affect your overall milk supply. Mothers may also find their supply dropping when they are stressed, about to/are having their periods or have just recovered from a bout of mastitis or blocked ducts.

Poor milk transfer by babies

Some babies may not be able to drink well from the breasts due to some reasons. One of these could be an oral restriction such as a lip or tongue-tie. Some babies may also have other oral complications that only professionals can diagnose.

If you find that your baby’s latch is not improving even after weeks of trying and your baby’s weight is not gaining or dropping extensively, it is worth bringing your baby to be checked with your paediatrician. There may be a medical condition that is associated with it. You can also seek advice from your paediatrician on what to do next; for lip- and tongue-ties, there are simple procedures that can be done to release the ties. Many mums have reported improved latching and breastfeeding after these procedures.

Only started to breastfeed baby after a period of supplementing

Some mums may also only start latching their babies or pumping milk for their babies after a period of giving their babies other milk usually via milk bottles. These mums would not have sufficient stimulation of the breasts and may need some time to rebuild their bodies’ milk production.

Now that I know I have low milk supply! What can I do?
So if you have established that you need to increase your milk supply, here are some suggestions on what you can do:

1. Increase pumping/latching at the breasts

Because breastfeeding works by demand and supply, one of the most important ways to increase your supply would be to increase the time pumping and / or latching. You can do this via the following ways:

Offering baby the breasts more than once in a few hours

1. Pumping after each latching session or in between feeds
2. Power pumping – pumping for 20 minutes and stopping for 10 minutes, then pumping for 10 minutes for 2 more times. This mimics cluster feeding and tricks the body to produce more milk (do this a few times a day over a few days to see results

2. Avoiding bottles and pacifiers

Sometimes, the use of bottles and pacifiers can interfere with a baby’s keenness to feed. Using a bottle or pacifier can make a baby feel full. It can also lead your baby to prefer the quick flow of the bottle than the mother’s breasts. This means that your baby will only drink from your breasts or feel soothed by latching instead of using bottles and pacifiers. So just like in Point (1), avoiding the use of bottles and pacifiers is a good way to increase your baby’s latching at the breasts in the hope of increasing your milk supply and getting the most of his feeds from breastfeeding .

3. Feed on Demand; Do not schedule your baby’s feeds

Some mums may have been introduced to the idea that babies need to feed on a schedule. Unfortunately, this can lead to a reduction in supply in the long run. Some mums may also have been told to limit time at the breasts e.g. only feed for 15 minutes. This means that their babies were not able to consume much of the fattier milk content that comes at the end of a feed or on emptier breasts. This can also affect your baby’s weight gain. If you find yourself in this situation, stop scheduling and feed your baby on demand as and when he or she requires or when you think you can squeeze in an extra feeding session to help your baby drink more.

4. Offer Both Breasts During Feeds

Usually for mothers with normal supply, feeding from one breast alone per feed is what is recommended. This means that the baby gets a fair amount of the foremilk (watery milk that has high water content at the start of a feed) and the hindmilk (fatty milk as explained above). For mothers who have low milk supply, offering both breasts can be a strategy to help their babies drink more. If your baby seems very full already from one breast and if you do not feel that the breast has been emptied, you can do breast compressions during the feed to reactivate slow milk flow. Your baby will keep drinking more and will naturally unlatch when full. Again, this helps your body to receive more stimulation from your baby’s latch.

5. Nourish your health with TCM herbs

Traditional Chinese Medicine (TCM) also believes that a low milk supply is attributed by a deficiency of qi and blood, or stagnation of liver qi. This results in insufficient breast milk production (deficiency in qi and blood) and obstruction or thickening of breast milk.

From a TCM perspective, working to balance the Qi and enhancing blood circulation helps mothers to maintain good health and produce more milk. There are some nutritious TCM herbs and Pro-Lactation soup  that can help you to regain your energy. These can also provide you a better recovery and increase your milk supply as they help to build your energy and blood.

• Tong Cao 通草
• Huang Qi 黄芪
• Dan Sheng 党参
• Dang Gui 当归
• Jie Geng 桔梗
• Mai Dong 麦冬

6. Use TCM meridian points to boost milk production

To help boost your milk production and promote lactation, try these acupressure points for 2 to 3 minutes each time, several times a day. 

1. Tan Zhong – Midline of front chest, in between the 2 nipples
2. Ru gen – 1 inch directly below nipple
3. Yuan Ye – Located on the side of chest, 3 inches below armpit

7. Rest & Eat Well

Sometimes, fatigue and stress can affect your milk supply. We understand that motherhood can be a very stressful period of time but the presence of stress hormones can affect your body’s ability to make milk. We understand, too, that being a mother can be very exhausting. However, emotional health is very important and can impact your milk supply.

If you have not been eating and drinking enough, it may be worthwhile to pay attention to some self-care. Remember that nutrition is important to keep your body strong while making milk. Some mothers also try to consume milk boosters like oats, dates, red date tea and the likes to help increase milk. These are nutrient-dense foods which give vitamins and minerals to your body, as well as strength. Eating healthy food consistently can do wonders in helping your body heal and produce milk. It is also important that you continue to nurse or pump regularly even when consuming such foods. Demand and supply continue to be a very important factor to help your body produce enough milk for your baby.

While low milk supply can be something that is troubling, do know that every problem has a solution. Keep calm and Ask Madam Partum if you ever feel you need advice about your breastfeeding experience and discomfort. It is important to seek help so as to find a solution to your breastfeeding problems so as to ensure that you can get back to comfortably with your breastfeeding journey! 

When you are faced with these issues, know that you are not alone. WhatsApp Madam Partum at 81660060 to find out more. Madam Partum is with you all the way in your parenting and breastfeeding journey!