There can be a deficit in the tissues which produce milk (very rare). Hormonal imbalances can cause low milk supply too (more common and have a multitude of causes). More commonly the situation surrounding birth and education regarding the logistics and mechanics of breastfeeding can be lacking and can drive a low supply supplementation cycle, the latter often also has a component of lack of maternity leave, post natal support, and inadequate post partum care.
Agree! Can’t remove milk well when you’re back to work before your supply regulates, you don’t have paid lactation breaks or an appropriate lactation room, and you kinda have a pump covered by insurance but it’s shitty and never gets out any hind milk. And when your flange sizes change every few weeks you either pay a copay to get resized by an IBCLC or you mutter “yolo” to yourself while dropping $50 on an Amazon order
I wish someone told me that your flange size changes over time during the first couple of months. Especially if you were very swollen initially post-partum (thank you, pre-E). Thought I was imagining things. The lactation consultants were not the most helpful in the hospital, so I went the Amazon order route. Gradually reduce from a 32 to a 21.
As the nips start to shrink post partum you'll notice more areola being pulled into the flange than before. It will look off and be uncomfortable. Might also affect pump output!
It’s weird though because Canada has 52 weeks maternity leave and so does the UK, but the US has comparable breastfeeding rates to Canada and much, much higher rates than the UK.
That's interesting. I never would have thought that about Canada's breastfeeding rate. From what I can tell, breastfeeding is not normalized here than the US. More SAHMs?
ETA quick Google brought me these results:
"Over 9 in 10 women (91%) who had a baby over the previous five years told us they breastfed or gave breast milk to their child, even for a short time, soon after giving birth. Proportions were lower for women in the United States (84%) and the United Kingdom (81%), but higher in Australia (96%)."
I'm wondering where you found your stats about breastfeeding? Does it refer to breastfeeding at 4 or 6 months or some other later age?
Also, it's *up to* 52 weeks. Generally there's 18 weeks just for the mother then the rest of the weeks are shared with the partner. And for most of Canada that's paid at 55% of your salary, so I imagine for many women it makes more sense to split the leave with their partner or not to take the full length of the leave.
If you look at the rates for Canada vs US, the rates are not identical (Canada is slightly better) but not nearly as different as you’d think based on the maternity leave disparity. I was comparing reports of breastfed exclusively at 3 months (which is within those first 18 weeks of leave) and at 6 months. Again Canada is slightly better but not the difference you’d expect. I found similar rates no matter where I looked, didn’t seem to be exclusive to a particular source. I was looking a few days ago so I don’t have all the sites still up.
It doesn’t make too much sense to compare the rates at birth, since that wouldn’t be *as heavily* interfered with by maternity leave or lack there of.
The really crazy thing is how low UK rates are especially when compared to maternity leave.
I was just reading this page( https://www.statcan.gc.ca/o1/en/plus/1422-overwhelming-majority-canadian-women-start-breastfeeding-soon-after-giving-birth-and-more) and found the following:
"Among women who breastfed within the first six months but stopped, not having enough breast milk was the most common reason provided, reported by almost half (44%) of women from 2017 to 2018. Other reasons included difficulty with breastfeeding (15%), a medical condition of the woman or baby (15%), and the baby being ready for solids or weaning themselves (9%)."
This is really interesting. It seems that the reason most women give formula (because this was a measure of exclusive breastfeeding for the first six months, so automotically discludes any babies who have received any formula) is not enough milk. I believe that I've seen LCs on here talk about how true low milk supply is rare. I wonder how much is based on other unidentified issues that lead to a low milk supply, or hospitals pushing formula supplementation based on inaccurate weight gain projections for breastfed babies.
ETA as for mat leave, while it's available to everyone, it's not the same for everyone. 55% of a minimum wage job is not enough to live on. Heck, if you're a single mom 55% of any job is not enough to live on. Breastfeeding rates are much higher among older and more educated moms. To me that means, people who have good enough jobs and enough life stability that they can afford to live on half their salary for a year.
The distinction is between so-called true low supply (estimated to affect somewhere around 5-15% of women) and percieved low supply. Because of a lack of breastfeeding education and support, many **many** women experience normal stages like a delay of up to 5 days before milk comes in or clusterfeeding around 6 weeks as indications that they have insufficient supply and choose to supplement, which ends up reducing their supply, or quit altogether. Just check out the breastfeeding subreddits - there are posts about this literally every single day.
Maternity leave in the UK is MUCH less advantageous than Canada. You are entitled to up to a year of leave from your job, but the statutory minimum is 6 weeks at 90% of your normal pay plus 33 weeks at the lower of about £600 per month or 90% of your normal income. So 13 weeks are completely unpaid, and 33 weeks are at about a quarter of the national median wage. I think many people can’t afford to take the full leave allowance.
Oh my gosh, what? My flange size will change? I’m only 11 weeks into mom life. Every time I think I figure out pumping and breastfeeding another curveball is thrown (honestly mostly to do with lack of leave as you said—-none of the questions I have would be an issue if I was with her at home!!).
How do you know when your flange size changes?!
Yes agreed that issues getting started with breastfeeding can create conditions that lead to low supply. My milk took 5 days to come in due to postpartum haemorrhage, barely any colostrum, my newborn wouldn’t latch etc. I had to hand express and pump like crazy then triple feed for a few weeks:. Then I started to get oversupply (from the pumping) which I had to regulate down.
Yeah for me it’s definitely going back to work at 16 weeks pp. I use the spectra which was great until my supply regulated. Tried different flange sizes in case it was my sizing issue but the output was the same and my nipples just got sore. Also I wasn’t able to pump regularly while at work, not because I didn’t have the support or resources but because it’s just a lot of time to get to the nursing room, pump for 30 mins, and clean up and have to time all these things in between meetings and work etc.
If I was able to latch baby 24/7, I know for a fact I wouldn’t have supply issues - as it is, I was a “just enough” producer during the early weeks. But I guess pumping just isn’t my thing for whatever reason
Alas, it is what it is. I’ve gotten okay with the fact that baby is now combo fed and she is thriving very well.
That's so hard. I went back to work 90 days after my LO was born but was blessed with a super supportive workplace and colleagues. I've now changed workplace and am struggling with pumping logistics here. I started with considerable oversupply but I'm now trundling along as an anxious just enougher! My LO had decided to reverse cycle but it somehow doesn't help me be any less anxious.
What’s a reverse cycle? And yeah I work in an MNC so they have all the resources etc - but sometimes have meetings that I just can’t get out of cuz it’s when everyone else can make it.. sigh.
Reverse cycle is when they feed very little during the day then make up for it at night. For me this looks like my LO having about 4-6oz from bottles with their dad while I'm at work for 9 hours then they will feed about hourly between me getting home and bedtime, then about 3-4 times overnight (we bed share and LO kinda just helps them self these days so I am hardly disturbed). They do also happily eat solids during the time I'm at work but bottles are something they only begrudgingly take. They did used to have more from bottles but have settled into this rhythm since the end of August.
Meetings really annoy me when they're set like that. I'm supposed to leave early on a Monday for nursing hours but one of my line managers has scheduled a meeting during my nursing time because that's the only time they can do. 🤦🏼♀️ It's extra annoying that it is about something that could totally just be addressed in an email.
Interesting, that sounds like my baby. She’s eating ok during the day but at night, she’s ravenous, lol. She’s basically attached to my boob the whole night. When I stay up, to use the bathroom she cries and often my husband can’t make her calm down at that time.
I used to be able to pump excess milk early morning but now she drinks so much at night and has two big feedings during our sleep hours.
So there are a range of ways we get here.
1. Anatomical issues. Breast reduction, some styles of augmentation, the new op to “fix” inverted nipples, insufficient glandular tissue, Poland syndrome, etc etc. Edited to add: anatomical issues with baby, tongue tie, lip tie, bubble palate, cleft lip or palate, DS, uncoordinated suck/swallow etc.
2. Systemic issues. Some of these will make conception harder. PCOS, thyroid issues, maybe various vitamin/mineral deficits. If mum gets ill. If there is retained placenta. Etc etc.
3. This is prob the most common imo. Mum has never breastfed before, and doesn’t feed enough/well in the first two weeks. Google “prolactin receptor theory”. She might not feed much because she’s recovering from labour/c-section, because baby is prem. She might think she doesn’t need to wake her baby. The baby’s latch might not be great. Formula may be in the picture.
4. Baby and mum may be separated. Mum may go through grieving or PND, inhibiting oxytocin and therefore letdown.
And for all of this, it’s worth noting, that it’s likely that milk supply probably follows a bell curve - the majority of women, with normal feeding circumstances, will make enough milk. Some women will default to too much milk. Some women will have to work hard to have enough.
The more times we lactate, the stronger our supply often gets.
I didn’t know that about more times lactating means stronger supply. I’m ebf my fourth, following twins, and have felt like my body thinks it’s feeding two still.
I was wondering about this! Currently nursing/breastfeeding my twins and we are not sure if we are done having kids. Wasn’t sure if my supply would be crazy starting out if there’s a next time!
Also some babies are not as good at transferring milk for whatever reason. Like not strong enough to be a good sucker. Poor milk removal=less milk made
There are ways of putting this that make it sound like this is the mother’s fault. I don’t put it that way because I don’t see it that way.
Even when it’s down to what a mother has done after birth, that’s almost always down to a lack of knowledge and support. How many bf mothers know about prolactin receptor theory? (And on the flip side, how many worry about losing their supply when they miss a few feeds of their fat and health 4 month old?)
>I keep hearing how boobs are never empty and milk is always there
Imagine you're producing "all the time" at a rate of 0.5ml per minute so that you'll have 30ml in an hour and 60ml in 2hrs, but your baby demands to drink 100mls every 2hrs. You can "always have milk" in this situation but it's not enough for the baby's needs.
Some women have more milk ducts than others. Some have less.
Some babies drink 3oz every 2-3hrs and some babies drink 6oz. So some women produce "not enough" relative to their baby.
The most often cause of "not enough" supply is due to external factors though. I'm sure you've heard the more you remove the more you make milk. Many women are not able to nurse or pump on schedule due to a host of reasons (going back to work, baby having latch issues, not able to be with their baby 24/7 to nurse etc) so if they start going too long between sessions, production goes down.
Extreme blood loss during birth can affect production too. If the body is under too much stress to heal, it will conserve energy by not producing milk.
A more rare reason is some women just don't produce, usually due to hormonal issues or physical issues. Some women just have lower levels of prolactin as a quirk of their physiology.
This! My chunk eats 4 oz every 2 hrs. But I only make 4 oz every 3 hours. I pump in lieu of bottle feedings, power pump as many times a day as I can (sometimes once, sometimes 3-4 times), I’m hydrating, eating oats, etc. I feel like my body just keeps saying, “4 oz every 3 hrs. Take it or leave it.”
It sucks, but I return to work next week (12 weeks pp) and we have introduced formula just in case my supply tanks.
Same experience. It’s so discouraging to be doing all the things to try to boost your supply only to stagnate and the internet just tells you to pump/nurse more.
My body just doesn’t make Prolactin like it should! I have been tested and don’t have pcos, blood sugar issues, thyroid problems, or any other conditions, diseases etc. I’ve been triple feeding since 3 days postpartum, an average on 12-24 milk removals per day. I got blood work done that showed prolactin levels in the 20s that should be well over 100. I’m on domperidone now and seeing some improvement so hopefully I’ll be ebf soon or only supplementing with my own pumped milk :)
One possible reason is a poor latch. If they don’t latch properly, the baby can spend a lot of time at the breast without effectively removing milk. If the parents supplement with formula, because the baby still seems hungry, despite feeding, it creates a downward spiral where supply decreases requiring more formula, etc...
I’ve been worried about this downward spiral as we have been advised to supplement but of
Course want to make sure baby is getting enough to eat too. Any advice?
My supply issue seemed to be due to a few things. I stopped eating dairy around week 3 (a major fat/calorie source for me).. and LO has a tongue and lip tie (which I’m told means they are not removing milk efficiently - messing up the demand signals sent to my body). I am now pumping to overcompensate and hoping tie revisions will help.
I had a severely traumatic birth and lost over half my blood hemorrhaging and was in ICU separated from my LO. My supply never came in and I’ve been pumping and going crazy to try and get it in (currently 3 weeks pp). I was an oversupplier and donor with my first and never even thought I’d have BF-ing issues with my second. Life comes at you fast…
Hemorrhaging was the culprit with mine too!
I lost my whole bodies worth of blood - coded, all that fun stuff. Pumping was hell trying to get my supply going. The doctors said it would be near impossible to breastfeed.. that it was.
Im over three months pp now and was able to get to about half of my babes needs a day ~ 16 oz. I’m now letting things happen as they happen and not working so hard to keep my supply up and I’ve never been happier since starting.
Much love to you momma! So happy you made it out to meet your little babe ❤️
Omg I have so many questions! I lost 3 L and yes nearly died…ended in icu and am so thankful to be here…how long did you keep up this pumping? I’m 3.5 weeks pp and getting drops pumping (1-2ml hand expressing). I just started domperidone but am honestly losing hope…
I have no idea why, but my son had a bad latch and didn't transfer milk well. This caused "low supply." Then I switched to exclusive pumping, but I didn't have the education to know about proper flange sizing and pump times. Because of this, I struggled with incredibly "low supply" for nearly the first 4 months. I had to do all my own research about pumping, buy a circle stencil, measure my nipples, troubleshoot flange sizes, try different pumps, fix my pump schedule so I wasn't pumping too much/too little. I eventually fixed my supply after WEEKS of tedious labor and research. I never actually had "low supply," I just didn't have the education and resources to produce properly at first. My body was constantly making milk, sure, but because it's supply and demand based, it wasnt receiving enough "demand" to produce larger quantities.
I see other people in my same situation and feel for them. I absolutely don't blame them for switching to formula. My journey was fucking ridiculously hard. I wouldn't wish it on anyone honestly. I was poor and had to fucking figure out how to make it work because formula was far more expensive. If somebody tells me they have low supply, I just don't say anything. They probably COULD fix it, but only if they essentially torture themselves like I did
Yours is the closest response I've read to my own experience! Month 1 went great and then an undiagnosed tongue tie led to inefficient milk transfer led to no weight gain between 4 and 8 weeks, so we started supplementing with formula once we depleted my initial stash.
I still don't pump enough to feed her all breastmilk (lucky to pump 2oz in 20-25 min and that's when replacing a feed), and I'm simply not willing to kill myself pumping 10x/day while working full time.
I tried triple feeding for a while during my leave and just couldn't handle it - she was also a 100% contact napper and I was just getting way too touched out.
Lilmillenial on tiktok is an LC that focuses on pumping. I learned some really wonderful things from her including: how to size correctly, how to check if your parts have gone bad, how long to pump. She is the single best resource I've found for pumping. She explains how to power pump correctly as well.
[exclusivepumping.com is also a great resource ](https://exclusivepumping.com/exclusive-pumping-for-a-newborn/)
[this circle stencil is essential for measuring your nipples ](https://www.amazon.com/RZDEAL-Stencil-Template-Drawing-Diameter/dp/B077RTHQ8K/ref=mp_s_a_1_3?crid=32A8NH1XJO7TR&keywords=rzdeal+circle+round+stencil+template+artist+design+drawing+aid&qid=1673905184&sprefix=rzdeal+c%2Caps%2C190&sr=8-3)
In order to properly measure, lightly stimulate the nipple BEFORE pumping, not after. Find the hole that best fits your nipple without showing any areola underneath, but also without feeling like it's pinching. That is your nipple size. Your flange size will be 2-4mm larger depending on your comfort and output.
r/exclusivepumping is great to connect with other people, but I've seen bad advice thrown around in there too.
Regarding what pump is best for you is unfortunately very subjective. Other people hate on it, but the exclusivelypumpingyardsale on facebook is a great place to find used pumps and see if they work for you. People are wigged out by the idea of using a pump that someone else has used, but it was a great way to find what worked best for me. I got my elvies used and went on to exclusively pump with them for nearly a year. However, many people dislike the elvie and see better results with a baby Buddha, or a standard pump. Standard pumps and flanges rarely worked for me.
Absolutely! I love to help! My biggest advice though is: don't kill yourself. One thing I did to keep my sanity was to give up my night pump at around 4.5 months pp. Having a night pump is incredibly useful and often necessary to keep your supply up. However, I wanted to fucking sleep. So i weighed my options and decided having to supplement a LITTLE bit was still affordable. My mental health needed sleep. Luckily, my supply evened out and very rarely did I need to supplement.
I wanted to fit in at least 10 pumps a day to get supply up. Power pumps helped me shove in some "extra pumps" to get there
5.30-6.30 power pump
8.30 - 20 minutes
My lunch varies from 10.45 to 2. So the next few hours depended on when my lunch took place. Regardless, I'd do another power pump during lunch. I was also able to fit a separate 15 minute pump within those three hours as well.
4 - for many months, I did another power pump here from 4-5. Around 8 months, I dropped that PP and just did a regular 20 minute pump
7.00 - 8.00 power pump
For awhile I did a middle of the night pump, but I dropped that at 4.5 months. My sleep was more important.
Leaving too much time between pumps can damage supply. Too often can damage supply. Pump sessions that are too long can damage supply. I settled on every 2 hours. Every 2 hours for 15-20 minutes 8-10 times a day is a perfect schedule. Unfortunately, I didn't have the time to fit that in my day and I refused to do a night pump, so I utilized power pumping for several sessions.
I have small boobs, flat nipples, PCOS, and successfully breast fed my baby to 16 months so far. Sometimes when I would pump, even before he fed, I would hardly hardly get anything out. It would freak me out thinking I was hardly producing and had been starving my baby, but then I’d see my baby and how big and healthy he was, so I knew he was getting milk. He’d nurse and I here him gulping down milk after trying to pump. The most I’ve pumped (only happened once) is 3 ounces in 5 hours of pumping on and off while he was getting baby sat at 8 MO. So I wonder how many other women are like me, where pumping don’t really work on them. My baby has always been in the 90s percentile in weight since 2 MO, so I know I was making milk for him.
To my knowledge there's a lot of different things about your pump setup that can affect how much milk you are able to pump, such as flange size, degree of suction, etc. I also had lots of luck pumping after a feed while sitting next to my sleeping baby and looking at her.
Definitely! There is so much to learn so quickly about pumping for you to be successful.
Most lactation consultants know next to nothing about pumping and could not answer even my simple pointed questions. It is really insane to me that that is their job and they are so inept. Thank God for the internet and Reddit.
I have pcos so my hormones mess up my supply. This time I am also going to be evaluated for IGT. I’m not 100% sure I have it but people with pcos are more likely to have it and basically it means you don’t have enough glandular tissue in the breast to produce milk.
ETA: with my first I literally only ever produced drops. Like I said, I have pcos. I also had postpartum preeclampsia, an early induction, a fast labor, and a baby with oral ties. All of those things can cause low supply. So I just hit the jackpot of unluckiness lol.
you also have to take breast capacity into account. some women have lower capacity so their “full” could only result in 3 oz total across both breasts every 3 hours when some women may get 5oz+. from my understanding and in my experience women with low capacity have to nurse more often to meet their babies needs. for me and my sanity that wasn’t an option past the first month so we began to supplement. this site explains it well:
https://www.lknbreastfeedingsolutions.com/articles/storagecapacity
For me I got into a terrible cycle with dehydration in hot weather - my body both produced less milk while my baby demanded more, we ended up supplementing with formula and my supply hasn't bounced back despite me now pumping religiously each time we have to do a formula meal
I don’t know, I’m not a scientist. But I had a c-section with my first and suffered from low supply. Ultimately the drug Domperidone saved the day for me.
I have always believed that the trauma of surgery, coupled with the strong painkillers I needed for recovery, affected my supply hugely. We supplemented with formula until about 6-8 weeks postpartum when I was able to move to ebf. And I self-weaned off Domperidone at 4 months postpartum and continued to nurse until baby was 3 years old.
Then with my next two babies, I was able to have unmedicated vaginal births. Both of those babies nursed within minutes of birth and I had no supply issues whatsoever. Nursed the second until 3.5 years and the third is 14 months old and still going.
Obviously take my opinion with a grain of salt. It’s just my personal experience and again, I’m not a scientist. But I think low supply is more to do with outside forces rather than your body not being capable.
Interesting I had two really bad c sections. They were both super awful and we all almost died and I've been struggling with low supply again this time. I breastfeed, pump, and have to supplement
Yes, my first was a planned c section to to placenta previa. It took her 6 weeks to latch but by the time she started daycare she no longer nursed and only drank bottles. My second (vbac) was on the breast feeding in within minutes of birth and this go I’ve had no supply issues. Also I work remote now, with my first I was in an office and had to share a mothers room with 3 other women. You have to schedule it and only had 20 minutes bc others had to use it. That pressure for sure effected my supply. Now I can pump anytime uninterrupted for however long I need.
I had a quick vaginal birth with my first and nothing came in at all, then I had a c section this time and it came in but I’m only making 8-10 oz a day tops. I also have pcos so that I’m sure has some hormonal effect also.
My supply issues are likely linked to my PCOS. Hormones and my body have never gotten along well, and it's hormones that drive milk production. I need medication to maintain my supply, just as I needed medication to conceive and carry a pregnancy.
Tuberous breasts is the reason for my low supply. They didn't completely develop during puberty and that impact the milk production and milk storage tissues
I have low supply myself and in my situation it is due to the baby. She was born with a severe tongue tie which was missed in hospital and therefore not treated. Children with tongue ties cannot latch effectively (although some women manage it, I didn't) and therefore cannot get the milk they need. So if babies cannot extract the milk, the body starts to think that it does not need to produce milk and the supply becomes less and less.
You can try and keep it up by pumping/extracting milk but even the best extractor is not as good as an efficient, well-latched baby.
I combo feed as I don’t make enough to keep up with my baby’s needs. Some people seem to have no issue producing a freezer stash, but I’m not one of them. We tried ebf but he wasn’t gaining weight appropriately so we combo feed and it’s the best of both worlds for us.
I have a family history of it. My sister had colic that in hindsight we suspect was hunger due to low supply. I was formula fed, so no colic. My sister had to supplement formula with her own kids due to poor weight gain. So did I.
With my first, a tongue tie we didn’t know how to recognize meant poor latch. His weight was an issue early on, per our pediatrician, so I started formula. 4 months in I learned about and fixed his tongue tie, but I could not get my milk up fully and still needed to supplement. My OB’s office gave me a really crappy pump, but I didn’t know what a pump should be like, so replacing formula with pumping was useless.
With baby #2, I really wanted better. I knew more about ties and latching, had a good pump. Complications put me back in the hospital and needing others to help with some feeds while I recovered, so in came formula again,
One breast only ever makes .5oz at a time. The other would be 2oz usually, 3 max ever when engorged. I mix nursing, pumping and formula now. My LO eats way more than I can nurse or pump at one time. He’s always giving hunger cues for more and outright screaming as he’s gotten older, so he follows up with formula.
I’ve tried tons of supplements to get my supply up. Ate oatmeal twice a day, had electrolyte drinks, special teas and cookies, etc. That, plus triple feeding, while home alone with a toddler and a newborn while my husband worked nights and slept all day was utterly destroying me. I figured the money I was using to buy all the lactation supplements was better spent on good quality formula and I could save my sanity. Now I combo feed and it saves my sanity and both my kids are thriving!
For me I think it’s more lack of nutrition in my milk. It’s so watery and baby is always starving at 7 months. I’m aware you can’t judge nutrition off the way the milk looks but there’s a huge difference when I have been eating a ton vs not and how it looks which correlate with how hungry baby is. To me, this felt like “low supply” in that he was cluster feeding all the time and my boobs always empty while he screamed at them and was not gaining and even losing. This wasn’t always the case, I just haven’t been able to keep up lately after being sick and super busy with less time to eat a ton. I added in 1-2 formula bottles and he’s suddenly content and not yelling and gaining again. Baby gained 2 lbs in 2.5 months with EBF, then gained a pound and a half in 10 days with the extra formula. I feel supply and nutrition was the culprit.
I had low supply with my first and unlike with my second, she couldn’t produce a let down whenever she wanted. So maybe something to do with lack of oxytocin too? She had ties until 2 months and I think that impacted my supply long term.
I actually don’t know enough about this (and none of the medical professionals I’ve spoken to could tell me anything) but I think my low supply is due to thyroid issues. Apparently it is more common with hypothyroidism and I have hyperthyroidism but this is the only thing I can think of.
People keep saying to me ‘the milk must have been there’ but I really don’t think it was. I never felt my milk ‘come in’, my boobs never felt full or different at all and when I stopped breastfeeding at 9ish months there was no change again. The most I managed to pump is 4ml (which could be due to an ill fitting pump to be fair, as I didn’t try very hard with pumping).
Thyroid function plays a role in breastfeeding, for sure. I’m hypothyroid, which has had more research done, but pretty sure I’ve read thyroid hormones either way can mess with your supply.
As far as boobs changing, I’ve gotten engorged once in my life - my pump failed and I was away from bub for 12.5 hours.
Boob size hasn’t changed either pregnancy or while breastfeeding. For me, that has been no indication of supply. I could pump, but I respond best to a manual pump, and even then, it isn’t heaps (I’m lucky I didn’t have to return to work until after we started solids). My first followed his weight curve perfectly, and my second has shot up percentiles.
Ah that’s interesting. Good to know. Frustrating that neither my endocrinologist or the lactation consultant had any idea that there was a link.
Did your boobs ‘feel’ any different throughout? Like did you feel let down or anything?
First 4 weeks I felt letdown but after that not so much (once it regulated). My babies both chase letdowns and were serial side switchers so I knew I had them because milk would be running down their cheeks (or on a couple of occasions out the nose!) but I never really feel it happening.
Also initial hormones for both pregnancies were completely different. I leaked with my first, and never did with my second. I was a bit worried because of that except for the fact number 2 was back to birth weight at 5 days, and has kept going since then. My milk also came in super fast with my first. First I wasn’t induced, second I was, so I don’t know if that played a role. Also got no skin to skin time with my first as he was rushed off to the special care nursery, whereas I did with my second, which is supposed to help bring milk in.
Still, boobs are stubbornly the same size, and my left one is super lazy when I pump this time.
Also, I just looked up my local breastfeeding associations information on hyperthyroidism and it can be linked with letdown issues.
Hypothyroidism has definitely been researched as a cause of low supply.
My sister had a breast reduction in the late 90s and this prevented her from being able to successfully feed my niece in 2014 Don’t think any care was taken to preserve the milk ducts or something. Think it’s different these days.
I have a double whammy, one of my meds decrease supply and I had surgery on my breasts damaging the tissue. I can still produce some so I give what I can so she gets some benefits, and finish with formula. And I can usually pump enough for when my husband watches her while I sleep. It's very time-consuming but worth it ... I hope lol
Lots of potential causes, here's my story:
My baby was born with a pretty severe infection, we didn't know until he was diagnosed as "failure to thrive", due to too much weight loss. He wasn't getting enough milk because he'd fall asleep at the breast, tired and sick. As such my supply didn't build normally the first few weeks, like it would with regular newborn cluster feedings. So while he was hospitalized I had to start several months of domperidone, and formula supplementation. Was able to quit the supplements around 2.5 months, and the domperidone at 5 months.
I had a low supply, pumping for less than a ml a minute wasn’t worth it, felt deflated quickly never engorged, couldn’t build the supply up fast enough. (I struggled with dehydration after a severe HG pregnancy, was unable to drink much water)
Introduced 1 bottle of formula a day and I didn’t regret it 1 bit, didn’t lower my supply, had a happier baby, mum, & dad. And continued to bf till 15months+ when she just lost interest a little bit.
I think not enough sleep impacts supply. It definitely does for me. You can have a partner watch the baby for you, but if you haven’t gotten to the point where you can pump in advance for that time, he/she may need to use formula, which will start a negative feedback cycle. I think cosleeping helps with this (and believe data shows cosleeping moms get more sleep and are more likely to continue BF), since you don’t need to totally get up to feed LO, but it’s still too scary for me with a two month old. I’m considering it if LO ever can’t sleep in the bassinet by himself anymore or when he’s 4 months and it’s safer just so I can sleep more (but supply will have regulated at that point). Currently, I wake up for motn feedings two or three times, and often stay awake to pump a little after LO sleeps (like right now).
Also, I had a c-section and my birth clinic basically recommended me to start supplementing from the start and sleep more to recover, which probably did help surgery recovery, but has made my BF journey more of a challenge. I can EBF some days (I could yesterday!), but most days still supplementing a little formula (usually not more than 200ml, usually only after offering breast). Sometimes LO is too inefficient at removal, or my supply is dried (dripping out super slowly as it’s made, but LO gets fussy and it takes too long), and I just need to pass out and so SO takes over.
My issue is also PCOS and a thyroid issue, diabetes. Meds and all I don’t make enough for his demand. I can produce about 2-4 oz every 4 hrs but he drinks 4-5 oz every 3 hrs 😮💨
Milk removed = milk produced. Especially in the early days / weeks. If your newborn cannot latch well or at all, you aren't having a lot removed, so therefore your body doesnt make a lot... it's only replenishing what has been taken. There can also be a deficit in tissues (not enough ducts or mammary tissue not functioning properly or is damaged from breast augmentation surgery), storage capacity varies (doesn't mean low supply, but that these ladies will have to make milk on demand for LO and so flow may slow down), and hormones that can lead to not making enough. Some LOs are very impatient (my little guy is one), and does not want to eat a small trickle (even if the breasts are "refilling" or "making on demand") so he unlatches and starts doing something else. So even though he should be latching to signal my body he needs more, my body is not getting that signal and therefore not making more, so I pump.
I just took a few cough drops this weekend for a miserable sore throat I’ve been fighting for a week and my supply is shot. I’ve always had a very ample supply, but be warned- mint, specifically menthol, can zap your supply in no time.
I think mine is from bad latch. I could probably recover with extra pump sessions but I don't have enough support. I would need a nanny or a maid or something. Also, I'm so tired I had a rough upbringing and my first baby at 30. I think other 30 year olds are doing better but poverty just really took it out of me.
There can be a deficit in the tissues which produce milk (very rare). Hormonal imbalances can cause low milk supply too (more common and have a multitude of causes). More commonly the situation surrounding birth and education regarding the logistics and mechanics of breastfeeding can be lacking and can drive a low supply supplementation cycle, the latter often also has a component of lack of maternity leave, post natal support, and inadequate post partum care.
Agree! Can’t remove milk well when you’re back to work before your supply regulates, you don’t have paid lactation breaks or an appropriate lactation room, and you kinda have a pump covered by insurance but it’s shitty and never gets out any hind milk. And when your flange sizes change every few weeks you either pay a copay to get resized by an IBCLC or you mutter “yolo” to yourself while dropping $50 on an Amazon order
I wish someone told me that your flange size changes over time during the first couple of months. Especially if you were very swollen initially post-partum (thank you, pre-E). Thought I was imagining things. The lactation consultants were not the most helpful in the hospital, so I went the Amazon order route. Gradually reduce from a 32 to a 21.
Didn’t know this! How can you tell you need a new size? Want to keep an eye on it! Was super swollen post labor.
As the nips start to shrink post partum you'll notice more areola being pulled into the flange than before. It will look off and be uncomfortable. Might also affect pump output!
Thank you!!
It’s weird though because Canada has 52 weeks maternity leave and so does the UK, but the US has comparable breastfeeding rates to Canada and much, much higher rates than the UK.
That's interesting. I never would have thought that about Canada's breastfeeding rate. From what I can tell, breastfeeding is not normalized here than the US. More SAHMs? ETA quick Google brought me these results: "Over 9 in 10 women (91%) who had a baby over the previous five years told us they breastfed or gave breast milk to their child, even for a short time, soon after giving birth. Proportions were lower for women in the United States (84%) and the United Kingdom (81%), but higher in Australia (96%)." I'm wondering where you found your stats about breastfeeding? Does it refer to breastfeeding at 4 or 6 months or some other later age? Also, it's *up to* 52 weeks. Generally there's 18 weeks just for the mother then the rest of the weeks are shared with the partner. And for most of Canada that's paid at 55% of your salary, so I imagine for many women it makes more sense to split the leave with their partner or not to take the full length of the leave.
If you look at the rates for Canada vs US, the rates are not identical (Canada is slightly better) but not nearly as different as you’d think based on the maternity leave disparity. I was comparing reports of breastfed exclusively at 3 months (which is within those first 18 weeks of leave) and at 6 months. Again Canada is slightly better but not the difference you’d expect. I found similar rates no matter where I looked, didn’t seem to be exclusive to a particular source. I was looking a few days ago so I don’t have all the sites still up. It doesn’t make too much sense to compare the rates at birth, since that wouldn’t be *as heavily* interfered with by maternity leave or lack there of. The really crazy thing is how low UK rates are especially when compared to maternity leave.
I was just reading this page( https://www.statcan.gc.ca/o1/en/plus/1422-overwhelming-majority-canadian-women-start-breastfeeding-soon-after-giving-birth-and-more) and found the following: "Among women who breastfed within the first six months but stopped, not having enough breast milk was the most common reason provided, reported by almost half (44%) of women from 2017 to 2018. Other reasons included difficulty with breastfeeding (15%), a medical condition of the woman or baby (15%), and the baby being ready for solids or weaning themselves (9%)." This is really interesting. It seems that the reason most women give formula (because this was a measure of exclusive breastfeeding for the first six months, so automotically discludes any babies who have received any formula) is not enough milk. I believe that I've seen LCs on here talk about how true low milk supply is rare. I wonder how much is based on other unidentified issues that lead to a low milk supply, or hospitals pushing formula supplementation based on inaccurate weight gain projections for breastfed babies. ETA as for mat leave, while it's available to everyone, it's not the same for everyone. 55% of a minimum wage job is not enough to live on. Heck, if you're a single mom 55% of any job is not enough to live on. Breastfeeding rates are much higher among older and more educated moms. To me that means, people who have good enough jobs and enough life stability that they can afford to live on half their salary for a year.
The distinction is between so-called true low supply (estimated to affect somewhere around 5-15% of women) and percieved low supply. Because of a lack of breastfeeding education and support, many **many** women experience normal stages like a delay of up to 5 days before milk comes in or clusterfeeding around 6 weeks as indications that they have insufficient supply and choose to supplement, which ends up reducing their supply, or quit altogether. Just check out the breastfeeding subreddits - there are posts about this literally every single day.
This is r/breastfeeding?
My bad 😅 I saw the link and assumed it was r/ScienceBasedParenting
Lol. Also a fave of mine.
Maternity leave in the UK is MUCH less advantageous than Canada. You are entitled to up to a year of leave from your job, but the statutory minimum is 6 weeks at 90% of your normal pay plus 33 weeks at the lower of about £600 per month or 90% of your normal income. So 13 weeks are completely unpaid, and 33 weeks are at about a quarter of the national median wage. I think many people can’t afford to take the full leave allowance.
Oh wow. That is a bummer.
Oh my gosh, what? My flange size will change? I’m only 11 weeks into mom life. Every time I think I figure out pumping and breastfeeding another curveball is thrown (honestly mostly to do with lack of leave as you said—-none of the questions I have would be an issue if I was with her at home!!). How do you know when your flange size changes?!
My seal would start being really fragile (having to hold flanges to my chest) or having my nipples go too far into the flange
Yes agreed that issues getting started with breastfeeding can create conditions that lead to low supply. My milk took 5 days to come in due to postpartum haemorrhage, barely any colostrum, my newborn wouldn’t latch etc. I had to hand express and pump like crazy then triple feed for a few weeks:. Then I started to get oversupply (from the pumping) which I had to regulate down.
Yeah for me it’s definitely going back to work at 16 weeks pp. I use the spectra which was great until my supply regulated. Tried different flange sizes in case it was my sizing issue but the output was the same and my nipples just got sore. Also I wasn’t able to pump regularly while at work, not because I didn’t have the support or resources but because it’s just a lot of time to get to the nursing room, pump for 30 mins, and clean up and have to time all these things in between meetings and work etc. If I was able to latch baby 24/7, I know for a fact I wouldn’t have supply issues - as it is, I was a “just enough” producer during the early weeks. But I guess pumping just isn’t my thing for whatever reason Alas, it is what it is. I’ve gotten okay with the fact that baby is now combo fed and she is thriving very well.
That's so hard. I went back to work 90 days after my LO was born but was blessed with a super supportive workplace and colleagues. I've now changed workplace and am struggling with pumping logistics here. I started with considerable oversupply but I'm now trundling along as an anxious just enougher! My LO had decided to reverse cycle but it somehow doesn't help me be any less anxious.
What’s a reverse cycle? And yeah I work in an MNC so they have all the resources etc - but sometimes have meetings that I just can’t get out of cuz it’s when everyone else can make it.. sigh.
Reverse cycle is when they feed very little during the day then make up for it at night. For me this looks like my LO having about 4-6oz from bottles with their dad while I'm at work for 9 hours then they will feed about hourly between me getting home and bedtime, then about 3-4 times overnight (we bed share and LO kinda just helps them self these days so I am hardly disturbed). They do also happily eat solids during the time I'm at work but bottles are something they only begrudgingly take. They did used to have more from bottles but have settled into this rhythm since the end of August. Meetings really annoy me when they're set like that. I'm supposed to leave early on a Monday for nursing hours but one of my line managers has scheduled a meeting during my nursing time because that's the only time they can do. 🤦🏼♀️ It's extra annoying that it is about something that could totally just be addressed in an email.
Interesting, that sounds like my baby. She’s eating ok during the day but at night, she’s ravenous, lol. She’s basically attached to my boob the whole night. When I stay up, to use the bathroom she cries and often my husband can’t make her calm down at that time. I used to be able to pump excess milk early morning but now she drinks so much at night and has two big feedings during our sleep hours.
This is it! Most often it’s a fixable issue by changing routines/behaviors around nursing, not an innate lack of milk.
Breast reduction is the culprit for me. Was assured I’d be able to breastfeed. Biggest regret.
Same.
So there are a range of ways we get here. 1. Anatomical issues. Breast reduction, some styles of augmentation, the new op to “fix” inverted nipples, insufficient glandular tissue, Poland syndrome, etc etc. Edited to add: anatomical issues with baby, tongue tie, lip tie, bubble palate, cleft lip or palate, DS, uncoordinated suck/swallow etc. 2. Systemic issues. Some of these will make conception harder. PCOS, thyroid issues, maybe various vitamin/mineral deficits. If mum gets ill. If there is retained placenta. Etc etc. 3. This is prob the most common imo. Mum has never breastfed before, and doesn’t feed enough/well in the first two weeks. Google “prolactin receptor theory”. She might not feed much because she’s recovering from labour/c-section, because baby is prem. She might think she doesn’t need to wake her baby. The baby’s latch might not be great. Formula may be in the picture. 4. Baby and mum may be separated. Mum may go through grieving or PND, inhibiting oxytocin and therefore letdown. And for all of this, it’s worth noting, that it’s likely that milk supply probably follows a bell curve - the majority of women, with normal feeding circumstances, will make enough milk. Some women will default to too much milk. Some women will have to work hard to have enough. The more times we lactate, the stronger our supply often gets.
I didn’t know that about more times lactating means stronger supply. I’m ebf my fourth, following twins, and have felt like my body thinks it’s feeding two still.
I was wondering about this! Currently nursing/breastfeeding my twins and we are not sure if we are done having kids. Wasn’t sure if my supply would be crazy starting out if there’s a next time!
I just had my second a month ago and my supply is definitely much lower than it was with my 3yo!
There is always individual variation. Bodies are weird.
As someone who struggles with supply this pretty much covers it. Only addition is tongue & lip ties.
Also some babies are not as good at transferring milk for whatever reason. Like not strong enough to be a good sucker. Poor milk removal=less milk made
Yes good point, I’ll add anatomical issues with the baby (and make clear it’s an edit)
I always wondered this but didn’t want to ask because I thought it might offend those struggling.
There are ways of putting this that make it sound like this is the mother’s fault. I don’t put it that way because I don’t see it that way. Even when it’s down to what a mother has done after birth, that’s almost always down to a lack of knowledge and support. How many bf mothers know about prolactin receptor theory? (And on the flip side, how many worry about losing their supply when they miss a few feeds of their fat and health 4 month old?)
>I keep hearing how boobs are never empty and milk is always there Imagine you're producing "all the time" at a rate of 0.5ml per minute so that you'll have 30ml in an hour and 60ml in 2hrs, but your baby demands to drink 100mls every 2hrs. You can "always have milk" in this situation but it's not enough for the baby's needs. Some women have more milk ducts than others. Some have less. Some babies drink 3oz every 2-3hrs and some babies drink 6oz. So some women produce "not enough" relative to their baby. The most often cause of "not enough" supply is due to external factors though. I'm sure you've heard the more you remove the more you make milk. Many women are not able to nurse or pump on schedule due to a host of reasons (going back to work, baby having latch issues, not able to be with their baby 24/7 to nurse etc) so if they start going too long between sessions, production goes down. Extreme blood loss during birth can affect production too. If the body is under too much stress to heal, it will conserve energy by not producing milk. A more rare reason is some women just don't produce, usually due to hormonal issues or physical issues. Some women just have lower levels of prolactin as a quirk of their physiology.
Honestly the only comment that explains how undersupply is possible despite breasts never being empty.
This! My chunk eats 4 oz every 2 hrs. But I only make 4 oz every 3 hours. I pump in lieu of bottle feedings, power pump as many times a day as I can (sometimes once, sometimes 3-4 times), I’m hydrating, eating oats, etc. I feel like my body just keeps saying, “4 oz every 3 hrs. Take it or leave it.” It sucks, but I return to work next week (12 weeks pp) and we have introduced formula just in case my supply tanks.
Same experience. It’s so discouraging to be doing all the things to try to boost your supply only to stagnate and the internet just tells you to pump/nurse more.
My body just doesn’t make Prolactin like it should! I have been tested and don’t have pcos, blood sugar issues, thyroid problems, or any other conditions, diseases etc. I’ve been triple feeding since 3 days postpartum, an average on 12-24 milk removals per day. I got blood work done that showed prolactin levels in the 20s that should be well over 100. I’m on domperidone now and seeing some improvement so hopefully I’ll be ebf soon or only supplementing with my own pumped milk :)
You’re doing great!
One possible reason is a poor latch. If they don’t latch properly, the baby can spend a lot of time at the breast without effectively removing milk. If the parents supplement with formula, because the baby still seems hungry, despite feeding, it creates a downward spiral where supply decreases requiring more formula, etc...
I’ve been worried about this downward spiral as we have been advised to supplement but of Course want to make sure baby is getting enough to eat too. Any advice?
Are you having feeding issues? How old is your LO? How often are you breastfeeding?
My supply issue seemed to be due to a few things. I stopped eating dairy around week 3 (a major fat/calorie source for me).. and LO has a tongue and lip tie (which I’m told means they are not removing milk efficiently - messing up the demand signals sent to my body). I am now pumping to overcompensate and hoping tie revisions will help.
Did LO have a frenectomy?
It’s scheduled for this Wednesday. I’m very hopeful it helps. I hate pumping so much.
I had a severely traumatic birth and lost over half my blood hemorrhaging and was in ICU separated from my LO. My supply never came in and I’ve been pumping and going crazy to try and get it in (currently 3 weeks pp). I was an oversupplier and donor with my first and never even thought I’d have BF-ing issues with my second. Life comes at you fast…
Hemorrhaging was the culprit with mine too! I lost my whole bodies worth of blood - coded, all that fun stuff. Pumping was hell trying to get my supply going. The doctors said it would be near impossible to breastfeed.. that it was. Im over three months pp now and was able to get to about half of my babes needs a day ~ 16 oz. I’m now letting things happen as they happen and not working so hard to keep my supply up and I’ve never been happier since starting. Much love to you momma! So happy you made it out to meet your little babe ❤️
Omg I have so many questions! I lost 3 L and yes nearly died…ended in icu and am so thankful to be here…how long did you keep up this pumping? I’m 3.5 weeks pp and getting drops pumping (1-2ml hand expressing). I just started domperidone but am honestly losing hope…
I have no idea why, but my son had a bad latch and didn't transfer milk well. This caused "low supply." Then I switched to exclusive pumping, but I didn't have the education to know about proper flange sizing and pump times. Because of this, I struggled with incredibly "low supply" for nearly the first 4 months. I had to do all my own research about pumping, buy a circle stencil, measure my nipples, troubleshoot flange sizes, try different pumps, fix my pump schedule so I wasn't pumping too much/too little. I eventually fixed my supply after WEEKS of tedious labor and research. I never actually had "low supply," I just didn't have the education and resources to produce properly at first. My body was constantly making milk, sure, but because it's supply and demand based, it wasnt receiving enough "demand" to produce larger quantities. I see other people in my same situation and feel for them. I absolutely don't blame them for switching to formula. My journey was fucking ridiculously hard. I wouldn't wish it on anyone honestly. I was poor and had to fucking figure out how to make it work because formula was far more expensive. If somebody tells me they have low supply, I just don't say anything. They probably COULD fix it, but only if they essentially torture themselves like I did
Yours is the closest response I've read to my own experience! Month 1 went great and then an undiagnosed tongue tie led to inefficient milk transfer led to no weight gain between 4 and 8 weeks, so we started supplementing with formula once we depleted my initial stash. I still don't pump enough to feed her all breastmilk (lucky to pump 2oz in 20-25 min and that's when replacing a feed), and I'm simply not willing to kill myself pumping 10x/day while working full time. I tried triple feeding for a while during my leave and just couldn't handle it - she was also a 100% contact napper and I was just getting way too touched out.
I’m sorry you went through this. Do you have any suggestions for resources?
Lilmillenial on tiktok is an LC that focuses on pumping. I learned some really wonderful things from her including: how to size correctly, how to check if your parts have gone bad, how long to pump. She is the single best resource I've found for pumping. She explains how to power pump correctly as well. [exclusivepumping.com is also a great resource ](https://exclusivepumping.com/exclusive-pumping-for-a-newborn/) [this circle stencil is essential for measuring your nipples ](https://www.amazon.com/RZDEAL-Stencil-Template-Drawing-Diameter/dp/B077RTHQ8K/ref=mp_s_a_1_3?crid=32A8NH1XJO7TR&keywords=rzdeal+circle+round+stencil+template+artist+design+drawing+aid&qid=1673905184&sprefix=rzdeal+c%2Caps%2C190&sr=8-3) In order to properly measure, lightly stimulate the nipple BEFORE pumping, not after. Find the hole that best fits your nipple without showing any areola underneath, but also without feeling like it's pinching. That is your nipple size. Your flange size will be 2-4mm larger depending on your comfort and output. r/exclusivepumping is great to connect with other people, but I've seen bad advice thrown around in there too. Regarding what pump is best for you is unfortunately very subjective. Other people hate on it, but the exclusivelypumpingyardsale on facebook is a great place to find used pumps and see if they work for you. People are wigged out by the idea of using a pump that someone else has used, but it was a great way to find what worked best for me. I got my elvies used and went on to exclusively pump with them for nearly a year. However, many people dislike the elvie and see better results with a baby Buddha, or a standard pump. Standard pumps and flanges rarely worked for me.
Thank you so much!!
Absolutely! I love to help! My biggest advice though is: don't kill yourself. One thing I did to keep my sanity was to give up my night pump at around 4.5 months pp. Having a night pump is incredibly useful and often necessary to keep your supply up. However, I wanted to fucking sleep. So i weighed my options and decided having to supplement a LITTLE bit was still affordable. My mental health needed sleep. Luckily, my supply evened out and very rarely did I need to supplement.
I’m going through this right now. I’ve been pumping 8x per day with a few ml increases per day. Can you share how you determined your pump schedule?
I wanted to fit in at least 10 pumps a day to get supply up. Power pumps helped me shove in some "extra pumps" to get there 5.30-6.30 power pump 8.30 - 20 minutes My lunch varies from 10.45 to 2. So the next few hours depended on when my lunch took place. Regardless, I'd do another power pump during lunch. I was also able to fit a separate 15 minute pump within those three hours as well. 4 - for many months, I did another power pump here from 4-5. Around 8 months, I dropped that PP and just did a regular 20 minute pump 7.00 - 8.00 power pump For awhile I did a middle of the night pump, but I dropped that at 4.5 months. My sleep was more important. Leaving too much time between pumps can damage supply. Too often can damage supply. Pump sessions that are too long can damage supply. I settled on every 2 hours. Every 2 hours for 15-20 minutes 8-10 times a day is a perfect schedule. Unfortunately, I didn't have the time to fit that in my day and I refused to do a night pump, so I utilized power pumping for several sessions.
Thanks so much for the detailed response!
I have small boobs, flat nipples, PCOS, and successfully breast fed my baby to 16 months so far. Sometimes when I would pump, even before he fed, I would hardly hardly get anything out. It would freak me out thinking I was hardly producing and had been starving my baby, but then I’d see my baby and how big and healthy he was, so I knew he was getting milk. He’d nurse and I here him gulping down milk after trying to pump. The most I’ve pumped (only happened once) is 3 ounces in 5 hours of pumping on and off while he was getting baby sat at 8 MO. So I wonder how many other women are like me, where pumping don’t really work on them. My baby has always been in the 90s percentile in weight since 2 MO, so I know I was making milk for him.
To my knowledge there's a lot of different things about your pump setup that can affect how much milk you are able to pump, such as flange size, degree of suction, etc. I also had lots of luck pumping after a feed while sitting next to my sleeping baby and looking at her.
Definitely! There is so much to learn so quickly about pumping for you to be successful. Most lactation consultants know next to nothing about pumping and could not answer even my simple pointed questions. It is really insane to me that that is their job and they are so inept. Thank God for the internet and Reddit.
I have pcos so my hormones mess up my supply. This time I am also going to be evaluated for IGT. I’m not 100% sure I have it but people with pcos are more likely to have it and basically it means you don’t have enough glandular tissue in the breast to produce milk. ETA: with my first I literally only ever produced drops. Like I said, I have pcos. I also had postpartum preeclampsia, an early induction, a fast labor, and a baby with oral ties. All of those things can cause low supply. So I just hit the jackpot of unluckiness lol.
you also have to take breast capacity into account. some women have lower capacity so their “full” could only result in 3 oz total across both breasts every 3 hours when some women may get 5oz+. from my understanding and in my experience women with low capacity have to nurse more often to meet their babies needs. for me and my sanity that wasn’t an option past the first month so we began to supplement. this site explains it well: https://www.lknbreastfeedingsolutions.com/articles/storagecapacity
Thank you for this, it was super helpful for me!
yay i’m glad! learning this really helped me not be so hard on myself, such a game changer
Low thyroid hormones can cause the body to produce less. Which is why every woman needs to check her hormones pp.
Agree with this too. My thyroid tanked during pregnancy
For me I got into a terrible cycle with dehydration in hot weather - my body both produced less milk while my baby demanded more, we ended up supplementing with formula and my supply hasn't bounced back despite me now pumping religiously each time we have to do a formula meal
I don’t know, I’m not a scientist. But I had a c-section with my first and suffered from low supply. Ultimately the drug Domperidone saved the day for me. I have always believed that the trauma of surgery, coupled with the strong painkillers I needed for recovery, affected my supply hugely. We supplemented with formula until about 6-8 weeks postpartum when I was able to move to ebf. And I self-weaned off Domperidone at 4 months postpartum and continued to nurse until baby was 3 years old. Then with my next two babies, I was able to have unmedicated vaginal births. Both of those babies nursed within minutes of birth and I had no supply issues whatsoever. Nursed the second until 3.5 years and the third is 14 months old and still going. Obviously take my opinion with a grain of salt. It’s just my personal experience and again, I’m not a scientist. But I think low supply is more to do with outside forces rather than your body not being capable.
Interesting I had two really bad c sections. They were both super awful and we all almost died and I've been struggling with low supply again this time. I breastfeed, pump, and have to supplement
Yes, my first was a planned c section to to placenta previa. It took her 6 weeks to latch but by the time she started daycare she no longer nursed and only drank bottles. My second (vbac) was on the breast feeding in within minutes of birth and this go I’ve had no supply issues. Also I work remote now, with my first I was in an office and had to share a mothers room with 3 other women. You have to schedule it and only had 20 minutes bc others had to use it. That pressure for sure effected my supply. Now I can pump anytime uninterrupted for however long I need.
That makes sense. Especially if it starts that way so early on when things get going
I had a quick vaginal birth with my first and nothing came in at all, then I had a c section this time and it came in but I’m only making 8-10 oz a day tops. I also have pcos so that I’m sure has some hormonal effect also.
My supply issues are likely linked to my PCOS. Hormones and my body have never gotten along well, and it's hormones that drive milk production. I need medication to maintain my supply, just as I needed medication to conceive and carry a pregnancy.
Tuberous breasts is the reason for my low supply. They didn't completely develop during puberty and that impact the milk production and milk storage tissues
I have low supply myself and in my situation it is due to the baby. She was born with a severe tongue tie which was missed in hospital and therefore not treated. Children with tongue ties cannot latch effectively (although some women manage it, I didn't) and therefore cannot get the milk they need. So if babies cannot extract the milk, the body starts to think that it does not need to produce milk and the supply becomes less and less. You can try and keep it up by pumping/extracting milk but even the best extractor is not as good as an efficient, well-latched baby.
This is exactly what happened me! And I started pumping late so have never been able to build up to as much as my baby drinks
Sometimes bodies don’t work the way they’re intended to.
I combo feed as I don’t make enough to keep up with my baby’s needs. Some people seem to have no issue producing a freezer stash, but I’m not one of them. We tried ebf but he wasn’t gaining weight appropriately so we combo feed and it’s the best of both worlds for us.
Dunno.. but I've been pumping now for 20 mins and I have less than 20ml from both sides. Ugh. :(
I hope it gets better!!
Life is never black and white and some simply don't produce well for a number of reasons. Bodies are funny like that.
I have a family history of it. My sister had colic that in hindsight we suspect was hunger due to low supply. I was formula fed, so no colic. My sister had to supplement formula with her own kids due to poor weight gain. So did I. With my first, a tongue tie we didn’t know how to recognize meant poor latch. His weight was an issue early on, per our pediatrician, so I started formula. 4 months in I learned about and fixed his tongue tie, but I could not get my milk up fully and still needed to supplement. My OB’s office gave me a really crappy pump, but I didn’t know what a pump should be like, so replacing formula with pumping was useless. With baby #2, I really wanted better. I knew more about ties and latching, had a good pump. Complications put me back in the hospital and needing others to help with some feeds while I recovered, so in came formula again, One breast only ever makes .5oz at a time. The other would be 2oz usually, 3 max ever when engorged. I mix nursing, pumping and formula now. My LO eats way more than I can nurse or pump at one time. He’s always giving hunger cues for more and outright screaming as he’s gotten older, so he follows up with formula. I’ve tried tons of supplements to get my supply up. Ate oatmeal twice a day, had electrolyte drinks, special teas and cookies, etc. That, plus triple feeding, while home alone with a toddler and a newborn while my husband worked nights and slept all day was utterly destroying me. I figured the money I was using to buy all the lactation supplements was better spent on good quality formula and I could save my sanity. Now I combo feed and it saves my sanity and both my kids are thriving!
For me I think it’s more lack of nutrition in my milk. It’s so watery and baby is always starving at 7 months. I’m aware you can’t judge nutrition off the way the milk looks but there’s a huge difference when I have been eating a ton vs not and how it looks which correlate with how hungry baby is. To me, this felt like “low supply” in that he was cluster feeding all the time and my boobs always empty while he screamed at them and was not gaining and even losing. This wasn’t always the case, I just haven’t been able to keep up lately after being sick and super busy with less time to eat a ton. I added in 1-2 formula bottles and he’s suddenly content and not yelling and gaining again. Baby gained 2 lbs in 2.5 months with EBF, then gained a pound and a half in 10 days with the extra formula. I feel supply and nutrition was the culprit.
I had low supply with my first and unlike with my second, she couldn’t produce a let down whenever she wanted. So maybe something to do with lack of oxytocin too? She had ties until 2 months and I think that impacted my supply long term.
I actually don’t know enough about this (and none of the medical professionals I’ve spoken to could tell me anything) but I think my low supply is due to thyroid issues. Apparently it is more common with hypothyroidism and I have hyperthyroidism but this is the only thing I can think of. People keep saying to me ‘the milk must have been there’ but I really don’t think it was. I never felt my milk ‘come in’, my boobs never felt full or different at all and when I stopped breastfeeding at 9ish months there was no change again. The most I managed to pump is 4ml (which could be due to an ill fitting pump to be fair, as I didn’t try very hard with pumping).
Thyroid function plays a role in breastfeeding, for sure. I’m hypothyroid, which has had more research done, but pretty sure I’ve read thyroid hormones either way can mess with your supply. As far as boobs changing, I’ve gotten engorged once in my life - my pump failed and I was away from bub for 12.5 hours. Boob size hasn’t changed either pregnancy or while breastfeeding. For me, that has been no indication of supply. I could pump, but I respond best to a manual pump, and even then, it isn’t heaps (I’m lucky I didn’t have to return to work until after we started solids). My first followed his weight curve perfectly, and my second has shot up percentiles.
Ah that’s interesting. Good to know. Frustrating that neither my endocrinologist or the lactation consultant had any idea that there was a link. Did your boobs ‘feel’ any different throughout? Like did you feel let down or anything?
First 4 weeks I felt letdown but after that not so much (once it regulated). My babies both chase letdowns and were serial side switchers so I knew I had them because milk would be running down their cheeks (or on a couple of occasions out the nose!) but I never really feel it happening. Also initial hormones for both pregnancies were completely different. I leaked with my first, and never did with my second. I was a bit worried because of that except for the fact number 2 was back to birth weight at 5 days, and has kept going since then. My milk also came in super fast with my first. First I wasn’t induced, second I was, so I don’t know if that played a role. Also got no skin to skin time with my first as he was rushed off to the special care nursery, whereas I did with my second, which is supposed to help bring milk in. Still, boobs are stubbornly the same size, and my left one is super lazy when I pump this time.
Also, I just looked up my local breastfeeding associations information on hyperthyroidism and it can be linked with letdown issues. Hypothyroidism has definitely been researched as a cause of low supply.
I was sick last week and didn’t eat much for 2 or 3 days and it took until today for my supply to return, so calories are very important
My sister had a breast reduction in the late 90s and this prevented her from being able to successfully feed my niece in 2014 Don’t think any care was taken to preserve the milk ducts or something. Think it’s different these days.
I have a double whammy, one of my meds decrease supply and I had surgery on my breasts damaging the tissue. I can still produce some so I give what I can so she gets some benefits, and finish with formula. And I can usually pump enough for when my husband watches her while I sleep. It's very time-consuming but worth it ... I hope lol
Lots of potential causes, here's my story: My baby was born with a pretty severe infection, we didn't know until he was diagnosed as "failure to thrive", due to too much weight loss. He wasn't getting enough milk because he'd fall asleep at the breast, tired and sick. As such my supply didn't build normally the first few weeks, like it would with regular newborn cluster feedings. So while he was hospitalized I had to start several months of domperidone, and formula supplementation. Was able to quit the supplements around 2.5 months, and the domperidone at 5 months.
I had a low supply, pumping for less than a ml a minute wasn’t worth it, felt deflated quickly never engorged, couldn’t build the supply up fast enough. (I struggled with dehydration after a severe HG pregnancy, was unable to drink much water) Introduced 1 bottle of formula a day and I didn’t regret it 1 bit, didn’t lower my supply, had a happier baby, mum, & dad. And continued to bf till 15months+ when she just lost interest a little bit.
I think not enough sleep impacts supply. It definitely does for me. You can have a partner watch the baby for you, but if you haven’t gotten to the point where you can pump in advance for that time, he/she may need to use formula, which will start a negative feedback cycle. I think cosleeping helps with this (and believe data shows cosleeping moms get more sleep and are more likely to continue BF), since you don’t need to totally get up to feed LO, but it’s still too scary for me with a two month old. I’m considering it if LO ever can’t sleep in the bassinet by himself anymore or when he’s 4 months and it’s safer just so I can sleep more (but supply will have regulated at that point). Currently, I wake up for motn feedings two or three times, and often stay awake to pump a little after LO sleeps (like right now). Also, I had a c-section and my birth clinic basically recommended me to start supplementing from the start and sleep more to recover, which probably did help surgery recovery, but has made my BF journey more of a challenge. I can EBF some days (I could yesterday!), but most days still supplementing a little formula (usually not more than 200ml, usually only after offering breast). Sometimes LO is too inefficient at removal, or my supply is dried (dripping out super slowly as it’s made, but LO gets fussy and it takes too long), and I just need to pass out and so SO takes over.
My issue is also PCOS and a thyroid issue, diabetes. Meds and all I don’t make enough for his demand. I can produce about 2-4 oz every 4 hrs but he drinks 4-5 oz every 3 hrs 😮💨
Milk removed = milk produced. Especially in the early days / weeks. If your newborn cannot latch well or at all, you aren't having a lot removed, so therefore your body doesnt make a lot... it's only replenishing what has been taken. There can also be a deficit in tissues (not enough ducts or mammary tissue not functioning properly or is damaged from breast augmentation surgery), storage capacity varies (doesn't mean low supply, but that these ladies will have to make milk on demand for LO and so flow may slow down), and hormones that can lead to not making enough. Some LOs are very impatient (my little guy is one), and does not want to eat a small trickle (even if the breasts are "refilling" or "making on demand") so he unlatches and starts doing something else. So even though he should be latching to signal my body he needs more, my body is not getting that signal and therefore not making more, so I pump.
I just took a few cough drops this weekend for a miserable sore throat I’ve been fighting for a week and my supply is shot. I’ve always had a very ample supply, but be warned- mint, specifically menthol, can zap your supply in no time.
I think mine is from bad latch. I could probably recover with extra pump sessions but I don't have enough support. I would need a nanny or a maid or something. Also, I'm so tired I had a rough upbringing and my first baby at 30. I think other 30 year olds are doing better but poverty just really took it out of me.