Why am I not producing enough breast milk?
Many women who choose to breastfeed find it difficult to get enough
milk. Production problems are one of the most frequently cited reasons why
breastfeeding mothers do not adhere to the recommended six-month breastfeeding
period.
Understanding the common causes of low breast milk production can help
you know if there are ways to increase your milk production as you work with
your doctor to develop the best feeding plan for your baby.
Common causes of not enough breast milk
Milk production problems often occur when mothers start breastfeeding,
but they can also occur after several months of successful breastfeeding.
Common causes of insufficient milk supply include:
Infrequent breastfeeding or
pumping. The production of breast milk is largely dependent on supply and
demand. As babies breastfeed more often, production increases so mothers can
produce more milk. Similarly, supply may decrease when feeding sessions are
discontinued. Mothers may also experience a decrease in milk production when
they return to work, especially if they are unable to express milk regularly
throughout the day.
Supplementation. Feeding a newborn formula while breastfeeding is
sometimes necessary for his health, but can interfere with milk production.
Breastfeeding mothers may find that their babies do not empty their breasts
often enough to maintain an adequate supply of milk.
Planned feedings. Breastfeeding on
demand can be uncomfortable, but over-planning can limit milk production. Production
increases rapidly when breasts are emptied regularly, but scheduled feedings
can be too far apart for this to happen. Similarly, breastfeeding sessions that
end too soon can interfere with milk production.
Stress. The relationship
between stress and breastfeeding is complex. Adrenaline released during times
of intense emotion can limit the production of oxytocin, a hormone that a
breastfeeding mother needs to successfully relax.
Dehydration. Remembering to
drink enough water or making time to prepare healthy low-sodium meals can be
tricky. However, without proper hydration, milk production can quickly decline.
Weight loss. On average, new
mothers lose more weight while breastfeeding, depending on the individual. Some
people find it easier to maintain their desired amount of breast milk if they
gain 2.5-5 kg more than their pre-pregnancy weight.
Rapid weight loss is likely to affect supply, so it's best to stick to a
slow, steady rate of losing 1kg per month. Once exercise is allowed, moderate physical
activity can speed up weight loss without affecting stores.
Obesity. Women who were
obese before pregnancy are more likely to struggle with a lack of milk.
Research suggests that insulin resistance may be to blame.
Problems with glucose tolerance can negatively affect several stages of
lactation, including breast development in early pregnancy and late onset of
lactogenesis.
Hormonal contraceptives. While most hormonal
contraceptives are safe to use while breastfeeding, they can cause a sudden drop
in production. The estrogen in these birth control pills can interfere with
milk production and even cause premature cessation of breastfeeding.
Cold medicine. Some medicines can
interfere with breast milk production. Decongestants such as pseudoephedrine,
for example, can adversely affect milk production in mothers in the later
stages of breastfeeding.
Polycystic ovarian syndrome. Women with
polycystic ovary syndrome (PCOS) often have trouble conceiving and carrying a
pregnancy. In addition, this condition
can cause problems with breastfeeding.
Although polycystic ovary syndrome can lead to limited milk production
in the early stages of breastfeeding, the problem often resolves with time.
Studies show that after three months, the frequency of breastfeeding is the
same in women with and without polycystic ovary syndrome.
What to do if you don't have enough breast milk
Before taking any steps to try and increase breast milk production, talk
to your doctor. A lack of milk can be difficult to diagnose on your own, and
your doctor can help you find out if you need to take steps to increase it.
Some common approaches include:
- Relaxation techniques. Massage and
meditation can help, as can body contact and even warm compresses.
- Drink more water. Breastfeeding mothers need to
increase their water intake, both because of the baby's fluid intake and the
increased calorie intake.
- Changing your contraception. The main
contraceptive options for maintaining breast milk supply include non-hormonal
intrauterine devices or barrier methods.
- Feeding and pumping often. Feed newborns very
often, up to 8-12 times a day for the first few weeks. If you miss a session,
pump to ensure continued production.
- Getting support. Reducing stress and mitigating
other factors that affect milk production may mean getting more help from
family members or therapy for mothers struggling with postpartum depression.
If your doctor agrees that your output is low, you may need to take supplements. But because formula supplementation can be both a cause and a solution to not getting enough breast milk, talk to a lactation consultant or doctor to determine what's best for you and your baby.