April 25, 2016

Dealing with milk supply issues can be incredibly stressful for nursing mothers. A lactation consultant provides useful advice.


As a lactation consultant, I hear concerns about breast milk supply on a daily basis. Often these concerns are “false alarms.” If your baby is growing well on your milk, then you are making plenty!

By the time a baby reaches 1.5 to 2 months of age, your body has learned about how much breast milk to make. That is about the time that the full, tight breast phase goes away, which makes some moms worry that their volume is low. Also, at about this age, many babies become more efficient and feed more quickly, sometimes only nursing for 5-10 minutes.

You and your baby are becoming masters at breastfeeding, and it is often not a problem with the supply of breast milk. And the added cherry on the cake – the growth spurt! During normal growth spurts, babies nurse more to increase milk supply, but fortunately these are short-lived.

That said, sadly, sometimes the fear of low supply is for good reason. If you have a low milk supply, here are some things to do:

1. Check the latch: Bad latch equals less milk. If you are having pain or think the latch is off, then call your health care provider, lactation consultant or local health department. Or call the TN breastfeeding hotline 1-855-4BFMOMS (1-855-423-6667) for a list of resources in your area.

2. Breastfeed frequently: Allow the baby to feed for as long as he or she is actively feeding. Get that baby naked and rub the feet or back to keep him awake.

3. Switch nursing: Switch sides several times during feedings, each time the baby falls asleep or loses interest.

4. Use breast massage and compression during feedings to keep baby feeding longer: This is especially good for sleepy or distractible babies.

5. Take a breastfeeding “staycation”: Stay home, keep the baby skin-to-skin with you when you are awake, and breastfeed as often as possible.

6. Avoid anything but mom during the time that you are working on your milk supply — no pacifiers or bottles: If baby must be supplemented, talk with your lactation consultant or health care provider about alternative ways to offer supplements.

7. Take care of yourself: Sleep when the baby sleeps. Take deep breaths and try to relax. Drink liquids to thirst. Eat a reasonably balanced diet. One mom that I met used a visualization of Niagara Falls to get her milk to let down!

8. Consider pumping and/or hand expression after feedings: Keep pumping for 2 minutes after the last drops of breast milk to ensure that the pump removes the optimum amount of milk from the breast.

9. Avoid supply busters:

  • Stress
  • Smoking
  • Decongestants
  • Some herbal supplements
  • Skipped feedings or rigid feeding schedule
  • Estrogen-containing birth control, which can lower your supply; check with your healthcare provider if you think this may be an issue for you.

10. The return of your period is often accompanied by a dip in supply: However, if this is the cause, your supply will usually bounce right back up by the time the bleeding stops. Pregnancy can also cause a drop in the supply.

11. Talk to your health care provider or lactation consultant about medications or herbs that may help if the above measures do not seem to be helping.

If your milk drop occurred when you returned to work:

  • Take advantage of any time that you are with the baby to breastfeed often.
  • Try to squeeze in an extra pumping session at work or try to get away to breastfeed the baby.
  • Pump both breasts at the same time if you can.
  • A hands-free bra is helpful as it gives you a chance to massage and compress your breast while pumping.
  • Get into a good pumping routine and try to use the same routine each time you pump. Some studies have shown that listening to the same music each time is helpful.
  • Some moms have found success with warming their pump flanges in warm water before pumping.
  • Keep a pumping log with times and amounts of milk obtained to track your progress. There are also apps available for smartphones that can be helpful.

Congratulations on your commitment to giving your baby the very best start in life. Remember, your baby will not be a baby for long. Soon your baby will be walking, talking and eating table food, and these infant days will all seem like a blur. You’ll look back and be proud of yourself for overcoming obstacles to provide the very best for your baby.

Written by Carol Huber, a full-time lactation consultant in the NICU and at Monroe Carell Jr. Children’s Hospital at Vanderbilt. She and her husband are the parents of 4 wonderful children.

Vanderbilt Women’s Health cares for women at all stages of their lives, from annual examinations to pregnancy and delivery. Learn more here.