A healthy diet is vital during pregnancy, but it’s just as important while nursing. The body uses up a lot of calories and nutrients to make that amazing liquid gold for baby. But sometimes moms don’t make enough breastmilk to meet their baby’s needs and may need a little help getting their supply up.
Alternately, some moms think they have low supply but don’t. In this post I’ll discuss how to increase milk supply (and how to know if you need to).
Is Your Milk Supply Really Low?
Many moms think their breastmilk production is low when in reality it’s just fine. If baby is gaining well and having adequate wet and dirty diapers on breastmilk alone (whether it’s from the breast or a bottle), there’s no reason to think that supply is low.
So what is “adequate”? John Hopkins University gives some guidelines on what to expect from a breastfeeding baby the first days:
- Days 1-2: Expect to change only a few wet or dirty diapers. Baby’s digestive system is just getting started.
- Days 3-5: It’s normal for baby to drop a little weight at this stage. Changing only a few diapers a day is still normal. An easy guideline is 4 stools by 4 days of life.
- Around Days 4-5: The number of changes should start to increase as breastmilk comes in. Feedings may take longer, up to 30 or even 45 minutes. This is normal and it’s important to let baby nurse on demand to establish the right supply. (No pacifiers or bottles at this stage if you can avoid it.)
- Days 6-28: Look for 6 wet diapers and 3 stools in a 24 hour period, give or take. Baby should begin to gain at 1/2 an ounce to an ounce in weight each day. (The standard weight checks at the doctor will monitor this.)
Almost every mom wonders whether her supply is tanking at some point. I remember being worried about it the first few months postpartum especially. Luckily, there are a lot of other factors that may be at play and most moms have nothing to worry about!
Common Signs Mistaken for Low Breastmilk
Here are some things that make moms wonder if their supply is low, but are totally normal:
- Baby nurses frequently – Breastfed babies eat often since breastmilk is so quickly digested.
- Baby nurses more often or for longer periods – Often this means baby is having a growth spurt, but baby’s demand increases your supply. So you may feel “empty” but baby is doing her job to increase the milk when she needs it.
- Baby doesn’t nurse as long as she used to – As babies get older they don’t need to nurse for as long to remove the same amount of milk.
- Baby drinks a bottle after nursing – Many babies will take a bottle after a full feeding, especially if they are fed the bottle in a reclined position (baby lying back, bottle in the air) rather than paced.
- Your breasts feel softer, or you don’t feel a let-down – As the supply regulates you won’t feel as intensely full of milk. You also won’t have leaking and you may lose the feeling of let-down (or maybe you never had it).
A Note for Pumping While Breastfeeding
A breast pump is a great tool but can also make moms worry if:
- Baby seems uncomfortable – If baby acts unhappy even after drinking a full bottle, this can make us think he’s not getting enough. Often though, it’s a feeding issue. Bottles are typically much easier to drink from and babies can gulp it down too fast (then get a bellyache and cry from discomfort). Try these instructions for paced bottle feeding.
- You get little milk from pumping – If you’re pumping exclusively this can be concerning but it doesn’t necessarily mean you have a low supply. Some moms have a hard time removing milk with a pump. Getting a better pump (or replacing the parts), relaxing before a pumping session, and smelling or thinking about baby can all help let down milk.
Of course, it’s best to get help if you aren’t sure if what you’re experiencing is normal or not. Your family doctor or an International Board Certified Lactation Consultant (find one using this link) can help figure it all out.
Causes of Low Milk Supply
There are a number of reasons that breastmilk supply could be low. Without addressing these underlying causes, it can be hard increase milk supply, or it may be only a bandaid treatment.
If low milk supply really is the issue, consider whether any of the following factors is at play:
- insufficient removal of milk (either by baby or a pump)
- tongue tie or lip tie (which can cause insufficient removal of milk)
- insufficient pumping sessions
- over-feeding by caregiver (so it only seems like mom’s not producing enough)
- hormonal imbalance, other underlying health conditions like hypothyroidism
- supplementing or scheduled feedings (both interfere with the supply and demand cycle)
As mentioned, an IBCLC can help figure out why supply might be low and can help create a plan to improve it. If funds are tight, a La Leche League group is a great resource.
How to Increase Milk Supply
When underlying causes are addressed and milk supply is still low, there are many natural ways to improve supply.
- Improve milk removal. Breastmilk supply is directly reliant on the supply and demand loop, so without caring for that loop other ways of increasing milk won’t work (at least not for long). Work with an IBCLC to improve baby’s latch so she can remove as much milk as possible (which signals the body to create more milk!). Some of the ways an IBCLC can support a good latch is improving breastfeeding positioning, guidance on pumping and bottle feeding (if using), diagnosing a tongue tie, and removing pacifiers and nipple shields.
- Increase the number of nursing sessions, by letting baby nurse on demand and for as long as possible. This helps with the removal part of the supply and demand loop too. Let baby feed on one breast until its empty and then offer the other. Switch back to the first after the second is empty and keep going back and forth as long as baby wants.
- Avoid artificial nipples. At least until baby is back on track, offer the breast only.
- Sleep. I know… “haha,” right? Rest is so important for overall health and especially for postpartum moms. During the early days of a nursing relationship, it’s more essential than ever and infuriatingly hard to get. Consider setting aside a few days to do nothing but eat, sleep, and nurse baby. I know it sounds impossible but this is the time to lean on community and ask family and friends to help with older kids, or hire a sitter if you can. Sleep when baby sleeps and make changes to your nighttime routine if you’re not getting enough rest.
- Pump. If the milk supply is truly low, pumping can help improve the supply and demand feedback loop. Just be cautious… if you don’t have low milk supply and pumping in between feedings may be cause oversupply. This can cause latching problems or an overactive let-down reflex (not to mention mastitis).
Helpful Foods to Increase Milk Production
Along with the tips above, considering mom’s diet can be a huge help in making adequate milk.
Though the body is resilient and moms can make adequate milk eating as little as 1500 calories a day, the quality of the milk will be better if mom is getting the nutrients she needs to restore what milk production takes from her. Also, studies show that the food mom eats has an impact on the quality of her milk. For example, breastmilk has healthier fats in it when mom is eating healthy fats. Here are some things to keep in mind for a healthy breastfeeding diet:
- Lots of quality protein. Rely on high-quality sources like grass-fed beef, free-range poultry and eggs, and wild-caught, sustainable seafood. Organ meats from grass-fed sources are also wonderful for nursing and can help reduce the chance of anemia.
- Complex carbohydrates from starchy vegetables. You don’t have to have a high carb diet, it just shouldn’t be too low carb and they should come from quality sources like vegetables preferably.
- Large amounts of vegetables, especially green ones! Green veggies have folate, which is important for fetal growth, and are also high in many other nutrients. They help prevent the constipation that can sometimes occur during pregnancy, and are great for making sure nursing moms are getting enough vitamins.
- Healthy fats. Quality fats are essential for baby’s brain development, organ and tissue growth, and good milk production for mom. Healthy meats, coconut oil and coconut products, olive oil (not heated), avocados, and nuts are good sources of healthy fat.
- Other high-nutrient foods. Homemade bone broth, soups, fermented vegetables like homemade sauerkraut, and fruit (especially berries) are also great while breastfeeding.
- Water! You can’t make liquid without liquid. Most experts recommend about 100 ounces daily for nursing moms. (About 9-10 glasses of water depending on the size of your glass.)
Foods that increase milk supply are called galactagogues. Though there’s not much scientific evidence to support galactagogues for increasing milk supply (a review found results to mixed), the anecdotal evidence is strong. Many women find galactagogues help improve their milk supply.
Some of the most common galactagogues include:
- blessed thistle
- brewer’s yeast
- red raspberry leaf
- stinging nettle
There are also several good prepared lactation tea blends that have a combination of the above herbs.
Final Thoughts on Increasing Milk Supply
Many moms think they have a supply issue when they really don’t. Getting the help of a knowledgeable consultant can help pinpoint if there really is a problem. If supply really is low, try the suggestions above to optimize the supply and demand loop.
Finally, if a consultant or your doctor recommends supplementation, there are some better formula options out there that can help. If I ever need to supplement, here’s what I would do.
Have you ever struggled with low milk supply? What helped you?