Signs and Causes of Low Milk Supply: What You Should Know

How do you know if your milk supply is low?

When you're bottle feeding, it's easier to know exactly how many ounces your baby is drinking each day. When you're breastfeeding, this can be more difficult. You can't see exactly how much milk your baby is drinking, so you need to rely on other signs to know if your baby is getting enough milk.

Low milk supply at night

Many parents avoid feeding their babies at night, since it's normal to feel tired and want to sleep. But your body produces more prolactin (the lactation hormone) during night feedings. Therefore, your overall prolactin levels could drop if you skip on night feedings, leading to a low milk supply. Additionally, breast milk tends to have a higher fat content at night, so it's very nutritious for your baby.

Signs of low milk supply

Having a low milk supply is quite rare. In fact, a third of women produce more milk than necessary. But if you're wondering if your milk supply is low, here are some signs that your baby is getting enough milk:

• There is adequate weight gain. It's normal for newborns to lose up to 5 percent to 7 percent (sometimes even 10 percent) of their birth weight in their first days of life. However, they should be back to their birth weight by days 10–14. Your baby should be gaining about 0.7 to 1 ounce every day during their first days. Take your baby to their pediatrician to ensure that they're gaining weight properly.
• Your baby's cheeks look full while feeding. If your baby's mouth is filling with milk, their cheeks will look puffy rather than sucked in while they're breastfeeding.
• Your baby's poop is normal for their age. A newborn should poop at least 3 to 4 times each day, and their poop should be creamy and mustard colored. As your baby grows older, they'll poop less often, but having wet-looking poops will still be a good indicator that they're getting enough milk.
• Your baby doesn't show any signs of dehydration. Signs of dehydration include dark urine, tearless crying, irritability, dry mouth, and sunken eyes and fontanelle. If your baby is showing any signs of dehydration, call your doctor immediately.
• Your baby makes gulping noises and swallows while nursing. These noises indicate that your baby is actively swallowing milk during a breastfeeding session. However, the absence of these noises isn't always a sign of low milk supply. If your baby eats silently but is still gaining weight and doesn't show signs of dehydration, there's probably nothing to worry about.
• Your baby is calm after a feeding and releases your breast on their own. A full, content baby will release your breast when they're done eating. It's very common for babies to fall asleep after they've been fed. If your baby is irritable and fussy after eating, it could be a sign of low milk supply.
• Your breasts feel soft after nursing. Your breasts will be drained of milk after a successful nursing session, which will make them feel softer. 

Causes of low milk supply

There are several different reasons why you could be experiencing a low milk supply. Some of the most common causes for a low milk supply include:

• Taking hormonal oral contraceptives
• Poor nipple latching
• Postpartum hemorrhages
• Retained placenta fragments
• Not positioning your baby correctly during feedings
• Poorly managed chronic conditions, such as diabetes, thyroid diseases, and polycystic ovary syndrome
• Previous breast reduction surgery or trauma
• Taking certain medications while breastfeeding, such as antihistamines
• Tongue-tie in your baby
• Supplementing with formula without manually expressing or pumping milk several times each day

How to increase your milk supply

Breastfeeding has many benefits for your baby, so it's normal to wonder if your baby is getting enough milk. Fortunately, there are many things you can do to increase your breast milk supply:

• Breastfeed or pump more often. Frequent milk expression leads to hormonal signals that stimulate more milk production. Make sure you're feeding your baby at least 8 to 12 times each day. If your baby doesn't want to eat every time, try pumping and storing the milk for later use.
• Avoid supplementing with formula during the first 6 months of your baby's life. Research shows that your milk supply tends to decrease when a baby is bottle fed. If you need to bottle feed your baby, make sure that you're still expressing milk at least 8 to 10 times per day.
• Alternate the breast you start with for each session. Switch breasts to feed your baby to ensure that each breast is emptied of milk and stimulated during each feeding. If your baby only drinks from one breast during a feeding, pump the other breast once they're done.
• Pump some milk after your baby is done nursing. Further stimulate your milk production by pumping or manually expressing milk when the baby is done. The extra milk can also be stored and used later!
• Feed your baby whenever they're hungry. Feed your baby on demand. Maintaining skin-to-skin contact can help you detect early signs that your baby is hungry so that you can feed them as soon as possible.
• Don't sleep on your stomach. Putting extra pressure on your breasts can slow down milk production.
• Stay hydrated, eat well, and get rest. Your body needs energy, fluids, and nutrients to create milk. Staying as healthy as possible can help your body produce enough milk for your baby. You should also avoid alcohol and nicotine.

It's normal to wonder if your milk supply is low. Fortunately, most women can increase their milk supply through some straightforward measures. Talk to a doctor or lactation consultant if you think that your milk supply is too low.