A mother’s body normally makes enough breastmilk to provide for her baby – he nurses, comes off the breast looking peaceful and satisfied and, after the first few days of life, gains about an ounce per day. But what if the production is low after the first week or so of breastfeeding?  Remember that in the first few days, the amount of colostrum – the very early milk – is very low in volume by design. The total volume, by day three is about 8-12 oz. per day.

What can be done if milk production is low and baby is not gaining?

It’s important to determine the cause of low production.  Various causes can be:

1. Inadequate milk removal due to strict feeding schedules.  A review of the baby’s nursing pattern is important.  Young babies will nurse about 8-10 times per 24 hours and nursing can last anywhere from 10-45 minutes in total. Sometimes, just nursing a baby more often can make a big difference.  However, if changing the nursing frequency doesn’t make a difference within 3-4 days, or if the baby is already nursing with appropriate frequency, then additional steps need to be taken.
2. A problem with the mother. Potential problems may lie with the mother and include issues such as breast surgery, thyroid problems, retained placental fragments, hormonal insufficiency, diabetes, polycystic ovarian syndrome, anemia, significant blood loss during birth or excessive stress. It is important to consult your physician straight away to get to the bottom of any underlying issues.
3. Problems with the baby’s ability to remove the milk effectively.  In some cases, a mother is making plenty of milk but the baby is not efficiently removing enough to grow. If a baby is not nursing well and milk is constantly being left behind in the breast, the production will automatically decrease.

When a mother is concerned about the possibility that her milk production is low, it’s important, if possible, to seek professional help with a Board Certified Lactation Consultant (IBCLC).  In the meantime, here are some ways to help increase production:

1. Increase breast drainage: The breast functions by the law of supply and demand. You should nurse at least 8-10 times per 24 hours and then pump afterward, using a high quality preferably hospital-grade pump.
2. Massage breasts during nursing and pumping.
3. Warm pump flanges prior to use or apply warm compresses during pumping
4. Drink to thirst and eat to appetite.
5. Consider herbal treatments which may help increase production: fenugreek (610 mg capsules – 3 capsules, 3 times a day), or More Milk Plus by Motherlove, or Mother’s Lactaflow, or various teas developed for increasing milk production.
6. Acupuncture has been shown to be helpful if used within the first 3 weeks after birth.
7. If all other natural remedies have been tried without success then consult your doctor regarding medications such as Domperidone (Motilium) and Metoclopramide (Reglan).

In many cases, trying the above suggestions will gradually increase milk production if the underlying problem is addressed. This means that the infant will grow and develop exclusively on breastfeeding and all the extra steps can be discontinued.

Note: To find a board certified lactation consultant (IBCLC), go to www.ILCA.org and click on ‘Find a Lactation Consultant’.

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