Dealing with Low Milk Supply: A Lactation Consultant's Guide

Low milk supply is a concern that many breastfeeding moms face, and it's often accompanied by a myriad of emotions: frustration, worry, and sometimes even guilt. But please know, you're not alone, and there's help available. As a lactation consultant, my goal is to guide you through these challenges and offer some actionable steps you can take to increase your milk supply. 

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The Emotional Toll of Low Milk Supply

First and foremost, it's essential to acknowledge the emotional weight that low milk supply can bring. The societal pressure to breastfeed successfully can sometimes feel overwhelming, creating a sense of inadequacy or failure. Take a deep breath and know that you're doing your best. Feeding your baby is a learning process for both of you, and it's completely okay to seek assistance.

Plan of Action: Consult a Lactation Consultant

The first step in addressing low milk supply is to get a professional evaluation. A consultation with a lactation consultant will help determine whether you indeed have a low milk supply and, if so, what might be causing it. This assessment will typically involve observing a feeding session, a weighted feed to evaluate how much milk your baby is transferring and an oral assessment of your baby to evaluate whether your baby may have ties. A lactation consultant can’t diagnose ties directly, but they can refer you on to providers who can further evaluate your baby.

Milk Removal: The Key to Increasing Supply

The fundamental principle of milk production is demand and supply. The more frequently and effectively milk is removed from your breasts, the more milk you'll produce. Here are some strategies to improve milk removal:

• Frequent Feeding: Aim for frequent feedings, roughly every 2-3 hours for newborns.
• Effective Latch: Ensure your baby has a deep latch that allows for better milk removal. Your baby’s latch should not be painful. If you are feeling a lot of pain with latching, dealing with bleeding or cracked nipples, and lipstick shaped nipples, these are all signs that your baby’s latch needs further support.
• Breast Compressions: Use gentle compressions to help your baby get more milk during feeds.
• Pump After Feeding: If your baby isn't effectively removing milk, consider using a breast pump after feedings to empty your breasts fully. It is important to be working with a lactation consultant when considering adding in pumping sessions after feeding your baby at the breast and navigating supplementation. Click here to book with a lactation consultant on our team today. 

Alternative Feeding Methods

Sometimes, despite your best efforts, direct breastfeeding may not be enough to provide your baby with the milk they need. In these situations, you might need to consider alternative feeding methods:

1. Bottles: If you're supplementing with expressed breast milk or formula, bottles are the most straightforward method. Just make sure to use slow-flow nipples to mimic the breastfeeding experience and minimize nipple confusion.
2. Supplemental Nursing System (SNS): An SNS is a container of supplemental milk attached to a tube that runs alongside the nipple. This allows your baby to get extra milk while breastfeeding, which can be especially beneficial for keeping them at the breast longer and encouraging more milk removal.
3. Syringe Feeding: For newborns who are struggling with latch or have a weak suck, syringe feeding is a method that allows you to feed small amounts of milk directly into the baby's mouth.

Risk Factors for Low Milk Supply

It is important to note low milk supply can be influenced by various factors, including both primary and secondary risk factors. Primary risk factors are those that directly affect milk production, while secondary risk factors are conditions or situations that indirectly impact milk supply. It's important to note that many mothers can still successfully breastfeed despite these risk factors with the right support and strategies. Here are some primary and secondary risk factors for low milk supply:

Primary Risk Factors:

1. Hormonal Issues: Hormonal imbalances, such as polycystic ovary syndrome (PCOS), thyroid disorders, or diabetes, and obesity can affect milk production.
2. Breast Surgery: Certain breast surgeries, such as breast reduction or augmentation, may disrupt the milk ducts or nerves, making it difficult to produce enough milk.
3. Breast Anatomy: Uncommon breast anatomical variations can hinder milk production. For example, insufficient glandular tissue (IGT) can lead to low milk supply.

Secondary Risk Factors:

1. Delayed onset of breastfeeding: if you are not able to breastfeed your baby early and often post birth and you are also unable to pump. 
2. Poor Latch or Positioning: An improper latch or poor breastfeeding positioning can result in ineffective milk transfer and reduced milk supply.
3. Scheduled Feedings: A rigid feeding schedule, instead of feeding on demand, can negatively impact milk production.
4. Supplementing with Formula: Offering formula supplements can lead to decreased demand for breast milk, which can result in lower milk supply.
5. Maternal Health: Maternal health issues, such as anemia, malnutrition, or dehydration, can affect milk production.
6. Baby’s risk factors: Premature birth, oral restrictions (like tongue-tie), or an infant's inability to latch properly can contribute to low milk supply.

Get Support Today

Dealing with low milk supply can be emotionally taxing, but remember that you're not in this alone. Consult a lactation consultant, create a plan tailored to your needs, and consider alternative feeding methods when necessary. With the right approach and a bit of perseverance, you can work to increase your milk supply and nourish your baby effectively.

Your journey with breastfeeding is unique to you and your baby. What's important is that you're both happy and healthy, so don't hesitate to seek the support you need.