5 Things That Might Be Hindering Your Milk Supply

Milk supply is one of the number one topics on the internet and in mom groups when it comes to breastfeeding. But why? It's very common to perceive you have low supply. Perceived low supply is the number one reason indicated when a person stops breastfeeding. Perceived low supply means you think you have low milk production largely based on your baby’s behaviors. It's common to think this especially because breastfed infants eat and wake often. You also can't see the milk going into your baby so of course it’s normal to worry.

Another reason so many parents worry about milk production is they aren't taught what an average milk supply looks like. So many parents never learned that the average breastfed baby over 1 month old eats just 3-5oz per feeding and that it’s normal for this volume to fluctuate from meal to meal, day to day.

However, there are very common things that can interfere with your body's production of milk and can sabotage your supply without you even knowing. The top 5 most common ones I see affecting my clients include:

Over the counter medicines

While many medications are safe when breastfeeding, some can reduce milk supply. Over the counter decongestants are one of them. The drug responsible for the nasal decongestant portion of the medicine (think daytime or nighttime cold relief) can actually reduce your supply. It doesn’t always affect everyone. It depends on your body’s sensitivity to it and how robust your milk production is. If you’re already concerned about milk production, it’s best to stick with a saline rinse. Allergy medications such as antihistamines can also reduce your body’s milk production.

It’s important to also mention hormonal birth control is another medication that can lower your milk production, especially estrogen-based pills. The mini pill is a progesterone only pill and while it’s considered safe for breastfeeding because there is very low infant risk, it can lower your milk production especially if it’s used prior to milk supply regulating between 6-12 weeks. Always discuss all your options with your primary care provider and work with a lactation consult if you have concerns.

Not feeding at night

Biologically, babies need to eat at night. Babies have short sleep cycles and breastmilk is digested quickly so they need to eat at night. This is normal and is expected to happen. Not feeding your baby at night can reduce your milk supply. Your milk making hormone prolactin is highest at night. When you’re not feeding at night (assuming your baby is waking up to eat and not naturally sleeping long stretches on their own) it spaces out feedings which tells your body to slow down milk production. There will always be babies who naturally sleep longer stretches overnight, early on.

If you have one of those babies, I would still encourage you to feed them when they cue they are hungry so your body adapts to producing less when they are sleeping for longer stretches. It's also normal for a baby who was previously sleeping longer stretches to begin waking more frequently. If you continue to feed your infant when they signal they're hungry, (including night wake ups) your body will again adapt to the changes in your baby’s request for milk.

Stress

Stress can inhibit milk production. It also inhibits oxytocin which makes it difficult for your milk to let-down and flow. Trying to reduce stress and relax encourages milk production. Being a new parent is hard. Sleep deprivation is a form of stress in and of itself. Add to that recovering from birth, caring for a newborn (and possibly older children) and it’s stressful on your body. Supporting milk production by reducing stress is about reducing your stress hormones and increasing oxytocin.

Meditation, yoga, and music have research to support reduction in stress levels. There’s also recent research supporting that music can help increase milk production. It’s about finding ways to calm and relax yourself. When your stress hormones are low, your body can optimize oxytocin and prolactin. This could mean listening to music you enjoy while feeding your baby. Or maybe using an essential oil you love while in the shower. Finding 5 minutes to sit still and deep breathe can also help. All these activities can naturally reduce stress hormones in your body and help to increase your milk production

Nipple shield

Nipple shields should always be used under the care of a lactation consultant. They can be an effective tool in some situations but can create more problems in others. The research has conflicting results about whether nipple shields will decrease milk production. Some research demonstrates a reduction in milk supply and is thought to happen because of reduced nipple stimulation. Some people do not experience a drop in milk supply but it's because they had an oversupply to begin with. It’s also important to work with a lactation consultant to find the root cause for needing to use the shield in the first place because there’s likely an underlying reason, they can help you and your baby work on.

A poor latch

A poor latch or rather an ineffective latch can reduce your milk supply. When a baby is latched well at the breast, it's comfortable for both of you. They can draw the nipple all the way to the back of their mouth and stimulate the nipple to induce a let-down and begin swallowing milk. Swallowing is a sign milk is being removed from the breast. When milk is removed from the breast, more milk is made.

If your baby has a poor latch or is latched in a way that is not allowing them to remove the maximum amount of milk, it will begin to negatively affect milk production. If they’re not latched well (it hurts or you can’t figure out if they’re swallowing) you’re not doing anything wrong! As parents we’re quick to blame ourselves when something isn’t going right but your baby could be having a physical challenge at the breast. The care and support of a lactation consultant can help you get a comfortable latch.

There are many other things that could be impacting your milk production. If you ever have concerns around how much milk you’re making or how much your baby is eating, connect with a lactation consultant to get the individualized support you need.

References:

Campbell, S.H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core Curriculum for interdisciplinary lactation care.Jones & Bartlett Learning.

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Contraceptives, Oral, Combined. [Updated 2021 Jun 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501295/

Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Pseudoephedrine. [Updated 2020 Apr 20]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501085/

Newman, J. & Pitman, T. (2014). Dr. Jack Newman’s Guide to Breastfeeding. HarperCollins Publishers Ltd.

Wildan, Moh and , Kiswati and , Jamhariyah and Primasari, Firdaus, Benefits of Yoga in Increasing Lactating Mother's Breast Milk Production (September 8, 2017). Cadwell & Maffei, 2011. Handbook of Lactating Management, Jakarta: EGC. Eveline & Djamaludin, 2010. Panduan Pintar Merawat Bayi dan Balita, Jakarta: PT Wahyu Media. Kementerian Kesehatan Republik Indonesia, 2014. Profil Data Kesehatan Indonesia, Jakarta: Kementerian Kesehatan RI. Manuaba, I.B.G.,, Available at SSRN: https://ssrn.com/abstract=3034570