What causes a low milk supply during breast-feeding?

Answers from Elizabeth LaFleur, R.N.

Various factors can cause a low milk supply during breast-feeding, such as waiting too long to start breast-feeding, not breast-feeding often enough, and use of certain medications. Sometimes previous breast surgery affects milk production. Factors such as premature birth, maternal obesity and insulin-dependent diabetes can also affect milk production.

But take heart. Although many women worry about low milk supply, insufficient breast milk production is rare. In fact, most women make one-third more breast milk than their babies typically drink.

To boost milk production:

  • Breast-feed as soon as possible. Waiting too long to start breast-feeding can contribute to a low milk supply. Hold your baby skin to skin right after birth and your baby will likely breast-feed within the first hour after delivery.
  • Breast-feed often. For the first few weeks, breast-feed your baby at least every two to three hours round-the-clock. Breast-feeding less often can contribute to a low milk supply.
  • Be alert to feeding problems. It's OK for your baby to nurse on only one breast at a feeding — but if this happens regularly, your milk supply will decrease. Pump the other breast to relieve pressure and protect your milk supply until your baby begins taking more at each feeding.
  • Don't skip breast-feeding sessions. If you spend time away from your baby or choose to give your baby formula, pump your breasts to help protect your milk supply.
  • Hold off on the pacifier. If you choose to give your baby a pacifier, consider waiting until four to six weeks after birth. This will give you time to settle into a regular nursing routine and establish your milk supply.
  • Use medications with caution. Certain medications decrease milk supply, including medications containing pseudoephedrine (Sudafed, Zyrtec D, others). Your health care provider might also caution against certain types of hormonal contraception, at least until breast-feeding is firmly established.
  • Avoid alcohol and nicotine. Drinking moderate to heavy amounts of alcohol can decrease milk production. Smoking can have the same effect.

Maintaining your milk supply during breast-feeding is important for your baby's health and growth. If you're concerned about your milk supply or your baby's feedings, talk to your doctor, your baby's doctor or a lactation consultant.

With

Elizabeth LaFleur, R.N.

Oct. 30, 2012 See more Expert Answers