Low Milk Supply: Understanding, Identifying, and Overcoming Breastfeeding Challenges

Low milk supply affects approximately 10-15% of nursing women, yet up to 50% of breastfeeding mothers worry about producing enough milk at some point during their journey. If you’re concerned about your breast milk production, you’re not alone—and more importantly, most milk supply challenges can be improved with the right support and strategies.

At the heart of successful breastfeeding lies understanding that milk production operates on supply and demand. Your body is designed to produce enough breast milk for your baby, and with proper techniques and support from a certified lactation consultant, most mothers can overcome low milk supply concerns.

This post will help you distinguish between perceived and actual low milk supply, identify the underlying causes, and implement evidence-based strategies to increase your milk production and support your breastfeeding goals from a holistic postpartum care perspective.

What Is Low Milk Supply?

Low milk supply, medically known as lactation insufficiency, occurs when breast milk production is insufficient to meet your baby’s nutritional needs for healthy growth and development. True milk supply problems are far less common than many nursing parents believe, affecting only 10-15% of mother (Source).

The key distinction lies between perceived low supply and actual low milk supply. Many breastfeeding concerns stem from normal newborn behaviors like frequent feeding (called cluster feeding), growth spurts, or natural variations in how breasts feel softer as milk production adjusts to your baby’s needs.

Most mothers can produce adequate breast milk with proper support, even those who initially struggle with milk production. Your body’s ability to make milk making tissue and respond to your baby’s demands is remarkably adaptable, especially in the early days and weeks following birth.

Signs Your Baby Is Getting Enough Milk

Rather than focusing on how much milk you can pump or whether your breasts feel full, watch your baby for these reliable indicators of adequate milk intake, from La Leche League:

• Baby regains birth weight by 2 weeks of age and continues gaining weight steadily (150+ grams per week for the first 3 months)
• At least 6 wet diapers per day after day 5, with pale yellow urine
• Regular bowel movements—frequent in breastfed babies, especially in early weeks
• Baby appears content and relaxed after feeds, with good muscle tone
• You can hear audible swallowing during feeds, indicating good milk flow
• Baby releases the breast spontaneously when finished feeding

Remember that breast fullness is not an indicator of adequate supply. As your milk production adjusts to your baby’s needs over weeks and months, your breasts naturally feel softer between feeds.

Warning Signs of Low Milk Supply

Seek help from your child’s pediatrician or lactation consultant if you notice these concerning signs:

• Poor weight gain or continued weight loss beyond the normal post-birth drop
• Fewer than 6 wet diapers per day after day 5
• Dark yellow urine or signs of dehydration in your baby
• Baby appears constantly hungry, fussy, or unsettled after feeds
• Minimal or no audible swallowing during nursing sessions
• Baby slows significantly during feeds or loses interest quickly
• Signs of dehydration: dry mouth, sunken fontanelle, lethargy

These warning signs may indicate your baby isn’t getting enough breast milk and requires immediate professional evaluation.

What Causes Low Milk Supply?

Breast milk production operates on a sophisticated supply-and-demand system controlled by frequent milk removal from your breasts. Understanding the physiological mechanisms behind milk production helps identify why supply issues develop.

Causes fall into two categories: intrinsic factors (anatomical or hormonal issues within the nursing parent’s body) and extrinsic factors (external influences on feeding patterns and milk drainage).

Medical and Anatomical Causes

Several medical conditions can impact your ability to produce enough milk:

Insufficient glandular tissue (breast hypoplasia) affects the amount of milk making tissue available. Signs include tubular-shaped breasts, wide spacing between breasts, or minimal breast growth during pregnancy.

Previous breast surgery can damage milk ducts or nerves essential for milk production and flow. This includes breast reduction, augmentation, or surgeries involving the nipple area that may have affected glandular breast tissue.

Hormonal imbalances significantly impact breastmilk production. Conditions like thyroid disorders, polycystic ovary syndrome (PCOS), diabetes, and obesity can interfere with the hormones needed for milk production. Retained placental fragments prevent normal hormonal transitions necessary for full milk coming in.

Medications that suppress prolactin—the primary milk-producing hormone—can reduce supply. These include certain birth control containing estrogen, some antihistamines, and medications for high blood pressure.

Maternal health factors like severe postpartum hemorrhage, premature birth complications, or significant stress can impact the nursing parent’s body’s ability to establish adequate milk output.

Feeding and Lifestyle Factors

Most low milk supply cases stem from factors that reduce frequent milk removal:

Poor latch or positioning prevents effective milk drainage. Baby feeds should involve deep latching and coordinated sucking patterns. Issues like tongue-tie, premature birth, or other conditions affecting the baby’s ability to feed effectively can reduce stimulation to the nursing parent’s breasts.

Infrequent breastfeeding disrupts the supply-and-demand cycle. Scheduled feeding routines, early introduction of pacifiers, or long periods between feeds signal your body to produce less milk.

Early supplementation with infant formula or other feeds reduces the baby’s demand for breast milk, leading to decreased production over time.

Lifestyle factors including maternal stress, inadequate nutrition, smoking, and insufficient rest can impact milk production slowly but significantly over time.

How to Increase Your Milk Supply

Frequent stimulation and milk removal are the foundation of increasing milk supply. Most mothers see improvement within 3-5 days of implementing consistent strategies, though some may need 1-2 weeks of dedicated effort.

Working with a certified lactation consultant provides personalized guidance and support throughout this process. They can assess your specific situation and recommend targeted interventions.

 

Feeding Strategies

Increase feeding frequency to 8-12 times per 24 hours. Follow your baby’s hunger cues rather than watching the clock, as babies naturally cluster feed during growth spurts and in the evening hours.

Ensure proper latch and positioning for effective milk removal. Your baby should have a deep latch with their mouth covering both nipple and areola. You shouldn’t experience ongoing nipple pain during feeds.

Use breast compression during feeds to maximize milk flow and keep baby actively nursing. Gently compress your breast when you notice baby’s sucking pattern slowing down.

Offer both breasts at each feeding session, allowing baby to finish the first breast before switching. This ensures complete milk drainage and maximum stimulation.

Practice skin to skin contact frequently. Hold baby skin to skin between feeds, keeping just baby’s diaper and baby’s shirt on while you’re topless. This intimate contact stimulates hormones that support milk production.

 

Pumping and Expression

Add pumping sessions between or after feeds to increase overall milk removal. A hospital grade pump typically provides the most effective stimulation for increasing milk supply.

Try power pumping: Pump for 20 minutes, rest 10 minutes, pump 10 minutes, rest 10 minutes, then pump 10 minutes more. Do this once daily for 2-3 days to signal increased demand.

Learn hand expression techniques as an effective alternative or supplement to pumping. Many mothers find combining hand expression with pumping increases milk output.

Ensure proper pump fit: Incorrectly sized flanges can reduce pumping effectiveness and cause discomfort. Work with a lactation consultant to ensure optimal pump setup.

Time pumping strategically: Many mothers find pumping most effective in early morning hours when prolactin levels are naturally highest.

 

Medical Interventions and Supplements

When feeding strategies alone aren’t sufficient, medical interventions may help address underlying causes of low milk supply. Always work with your healthcare provider to address any medical conditions affecting milk production.

 

Medications (Galactagogues)

Domperidone is the most studied medication for increasing breastmilk production, though availability varies by country. It works by increasing prolactin levels and has shown effectiveness in clinical studies, though effects typically stop when the medication is discontinued.

Important considerations: Medical interventions work best when combined with frequent milk removal strategies. They’re not a substitute for addressing feeding techniques or underlying issues affecting milk drainage.

At PPCU we always advocate for natural remedies and proper nutrition first. If you’re concerned that nutrient depletion may be a cause of low milk supply, schedule an appointment with our team so we can get you on the right supplement and nutrition plan based on root-cause lab analysis.

 

Herbal Remedies

Traditional herbs like fenugreek, milk thistle, and blessed thistle have long been used to support milk production, though scientific evidence for their effectiveness remains limited.

Important safety notes: Herbal remedies can have side effects and may interact with other medications. Some mothers experience a sick feeling or digestive upset with certain herbs. Always consult your healthcare provider before starting any herbal supplements.

Realistic expectations: While many mothers report positive experiences with herbs, they work best as part of a comprehensive approach that includes frequent nursing and pumping.

Visit our supplement shop to see what supplements we often recommend for postpartum moms.

When Supplementation Is Necessary

Sometimes immediate supplementation protects your baby’s health while you work on increasing milk supply. Recognize when this step becomes necessary rather than harmful.

Immediate supplementation indicators: Significant poor weight gain, signs of dehydration, or medical advice from your healthcare professional warrants prompt action. Your baby’s safety always comes first.

Preferred supplementation methods: Donor milk provides ideal nutrition when available through milk banks. When donor milk isn’t accessible, infant formula meets your baby’s nutritional needs safely.

Maintaining breastfeeding during supplementation: Use supplemental feeding methods that don’t interfere with nursing. Consider at-breast supplementers, cup feeding, or finger feeding rather than bottles when possible.

Gradual reduction strategy: As your milk supply improves through consistent nursing and pumping, work with your lactation consultant to slowly reduce supplementation while monitoring your baby’s weight gain and contentment.

For mothers with permanent conditions like insufficient glandular tissue, long-term combination feeding can provide the benefits of breast milk while ensuring adequate nutrition.

 

Will Your Milk Supply Improve?

Most low milk supply situations can improve with proper support and consistent effort. Understanding realistic timelines helps set appropriate expectations and maintain motivation during challenging periods.

Typical improvement timeline: Most mothers notice initial improvements within 3-5 days of implementing consistent strategies. Significant increases in milk production often occur within 1-2 weeks, though some situations require longer dedicated effort.

Factors influencing success: Your body’s response depends on the underlying cause of low supply, how quickly you implement interventions, consistency of milk removal, addressing any medical conditions, and the support system available to you.

Be patient with the process: Increasing milk supply requires patience and consistent effort. Sometimes milk production increases slowly, and there are a few normal fluctuations along the way.

When to accept supplementation: In cases involving insufficient glandular tissue, significant breast surgery, or certain medical conditions, some degree of supplementation may always be necessary. This doesn’t diminish the value of any breast milk you can provide.

Support throughout the journey: Working with healthcare professionals, connecting with other nursing parents, and accessing professional medical care when needed provides the foundation for success.

 

 

Conclusion

True milk supply problems are less common than perceived, affecting only 10-15% of nursing parents, though we know and appreciate the stress many moms feel around feeding their babies. With proper support from certified lactation consultants and healthcare providers, most mothers can improve their milk production and meet their breastfeeding goals.

The key lies in understanding that frequent breastfeeding and effective milk removal form the foundation of adequate supply. Whether you’re dealing with feeding technique issues, medical conditions, or simply need reassurance about normal breastfeeding patterns, help is available.

Remember that any amount of breast milk provides valuable benefits to your baby, even when supplementation is necessary. Many successful breastfeeding relationships include some combination of breast milk and formula feeding.

Don’t struggle alone with breastfeeding concerns. Seek help early from lactation consultants, healthcare providers, and breastfeeding support groups. With the right guidance and support, most low milk supply challenges can be overcome, allowing you to achieve a satisfying breastfeeding experience that works for both you and your baby.

The World Health Organization recommends exclusive breastfeeding for the first six months when possible, but every situation is unique. Focus on what works for your family while accessing the professional support you deserve throughout your breastfeeding journey.