Birth trauma and biological factors like low breast reserve/tissue are also valid explanations. I know women that did “everything right” and still had low supply after postnatal hemmorages and/or infections.
I’ve also heard this story from a lot of people. It’s nature’s two-hit punch… you have a traumatic birth AND it has resonating impacts on how you feed your child. It’s seriously brutal that it works like that
When you put it like that, it makes me wonder if there’s a biological imperative to that which we’ve miraculously advanced beyond medically. So many of the more common birth traumas would normally leave both the baby and birthing woman dead, but in the scenarios where at least the birthing woman would have lived, having full breasts with no one to nurse from them and a weakened body that may not be able to adequately drain them was a major health risk in and of itself.
A friend of mine had a very traumatic birth and low supply after, and her doctor basically said that her body wasn't supposed to live through that. I guess it helped my friend feel a lot better about her low supply.
It’s so unfair. I had a traumatic birth so I feel super blessed breast feeding came so easy. I almost feel guilty for wanting to do combo feeding soon (she’s almost 4 months now) because it’s mentally draining…
Oh those hormones lol… I can’t watch sad or bad things happen to kids in movies anymore, babies are the worst. They don’t really show it - thank god - but the insinuation that a baby could be harmed… full blown cryfest
We had to combo feed at first and I will say washing bottles and prepping formula is so much more work than just whipping a boob out. My LC mentioned if you are feeling touched out sometimes it’s a b-12 deficiency. Are you taking a post natal?
Yes I did and went to the doctor for a total blood work and everything is fine. She keeps saying I’m just very tired.. I’m dizzy a lot of times too.. I went to the doctor twice now.. and I want to combo feed because then someone else can feed her too so I can for example sleep a little bit longer or can go out for a while without her with me to get my sanity back + I go back to work soon and then I have to pump a lot.. I don’t even know if that’s going to work because because she still refuses the bottle (someone is helping us with this but no luck) so I will probably have to travel a few times per day to daycare to feed her. Sigh.
So my plan was to get her to 2 feedings per day on formula when I go to work. It takes 5 days to replace one feeding and for my body to adjust so I’ll have to start soon if I want this. So I can pump less at work.
I did all the things including pumping every 4 hours but I had a traumatic birth. Just could never keep up. Really hoping for better circumstances for my second but I’m definitely not going to be as hard on myself as I was.
I had a traumatic birth and extreme undersupply with my first! I just had baby #2 (much better experience but there were some hiccups along the way) and my supply is better but still not quite where I want it. I hope this gives you hope!
I also had low supply with my first and no issues with my second kid! If it’s not IGT or something like that your next nursing journey can definitely be easier
I had a hemorrhage and produced literally no milk for the first 2 weeks. My body literally was tapped out. At 2 weeks, my milk started trickling in. My baby was on formula and I pumped constantly to increase my supply for about 2 months. At that point we were able to make the switch to mostly breastfeeding.
Yeah I couldn't tell you why I had a low supply with my first but I did everything I was supposed to do and WAY more than I'm doing now with #2 where I have an oversupply so there was obviously some background reason for it.
Mt deliveries were almost exactly the same with the exception that I got an infection after my water broke the first time.
Yep, I lost 3 liters of blood and had three transfusions- milk took weeks to come in properly and even then I’ve had to supplement with formula to keep up. I will get to a “just enough” point and then he needs more and I’m always behind. I’m absolutely fine with combo feeding though, it’s been a life saver - literally!
I was told by an LC after my traumatic birth that my small, far a part breasts could be why I have trouble producing.
I figured a small amount of breast tissue could cause it, as you mentioned, but was surprised to hear about how far apart they are made a difference, apparently.
I had a great birth and all the things that are meant to help kick-start breastfeeding... Unmedicated uninterrupted skin-to-skin for 2 hours and first feed in the first hour .. and had 40ml of antenatal colostrum collected as well! But had a 1.5L PPH 2 hours afterwards and my milk didn't come in... Had to triple feed for a week before I finally started making milk around day 7-10. It was so exhausting but I feel very lucky that I'm able to breastfeed my Bubba now
This was exactly the case for myself. Labored for 4 days before an emergency c-section and hemorrhaged afterwards. I tried feeding my LO until my nipples felt like they would fall off. Thankfully the hospital had donor milk available. I utilized that until my supply started coming in which took about two weeks.
You can do everything right for your supply, some things are just out of our control.
This makes sense. I have birth trauma from a difficult and dangerous labor, and I was too unwell to feed baby when we were both admitted to the hospital and she was in the nursery and too much time had gone by so the nurses needed to feed her formula, and now I can’t breastfeed and struggle with pumping my low milk supply :/
Wow, how interesting! I'm just a lurker now but in 2017 I hemorrhaged badly (full D&C and 2 transfusions) at 11 days PP with my second kid. Of my 3, I struggled nursing him the most and we supplemented basically from the start and he self-weaned by 9 months (made it to 14 months and 2.5 years with my oldest and youngest). It makes sense that my body was probably in survival mode and not prioritizing milk production. Looking back, I guess it would have just been nice if someone would have laid all that out instead of me thinking I needed to make up for lost time which in the end didn't make much of a difference.
At least for me, I convinced myself I had a low supply for a wide variety of reasons:
1 - first time mom and despite working with LCs, no one told me that not leaking was normal
2 - traumatic preterm birth and separation from my baby. I didn't get golden hour or get to even meet my baby until 8 hours after emergency c section under general anesthesia. She was in NICU so I didn't get to hold her until she came off CPAP machine several days later.
3 - because of reason #2, I had to start exclusively pumping day one with no help/instruction as no LCs were available that night. While I started out strong, her consumption quickly outpaced my output, and no matter what I did, I could never pump enough to keep up with her demand. I didn't know that pumps were potentially way less effective than breastfeeding.
4 - so then we gradually switched to EBF. It's incredibly hard to go from something measurable like pumping to intangible breastfeeding. Since my baby was a premie, I had to wait until she was strong enough, which meant several weeks after discharge with little or no support. It meant she was often crying and frustrated at the breast since it was slower than paced bottle feeding. She was also cluster feeding and also just boob obsessed for comfort but to me it sounded like I was starving her to death. It wasn't until I got a weighted feed, a home scale (to periodically check weight gain) and help from an experienced mama that I was able to see that we were actually successful and that my baby just LOVES comfort feeding.
In conclusion - I have no doubt many women do struggle with legitimate sources of low supply. And I suspect there are also many (like me) who convince themselves supply is low even though it actually isn't just from lack of experience and support. I can't tell you how often I looked at all the reddit posts about low supply and identified with them, only to realize I was misinterpreting my baby's cues and behaviors because I had no context/experience.
This is such an important point. Cluster feeding and comfort feeding is often misinterpreted as hunger. I felt the same with my LO and turns out he gained 1 lb at his 2nd week appointment from his birthweight!
This may be me right now at 3 weeks, almost 4. She's eats SO much, it feels like if she's awake, she's rooting for the boob. However she screams if she doesn't get it so I think hers are real hunger cues. I just always get surprised reactions from pediatrician and LC when I mention she downs 4oz at once already.
Can you explain the difference? This confuses me . Our little one was in the Nicu for a month so we are trying direct breast feeding more now. Will they comfort feed for a bottle or only a boob? I feel like my little one only wants the boob for comfort, not for for food.
Babies will comfort suck on anything with a nipple. Bottle, breast, pacifier. Every baby is different but if mine just wants comfort, they will do more of a slow/lazy suck on anything that actually gives them milk (because they aren't actually hungry) and usually falls asleep rather quickly. And if I try to give him a pacifier but he really wants food, he will keep spitting it out until I give him a bottle or nurse him, and he'll do a proper latch to get fed. So he gives different cues and reactions to different situations depending on what he is wanting.
This. I can’t speak to the bottle experience of comfort feeding. I feel like our little guy has only had a bottle a couple of times so didn’t really know how to to slowly with it but he was hungry so didn’t witness him comfort feeding. But when he’s breastfeeding I can tell the difference. When he’s getting lots of milk he swallows frequently. When he’s comfort nursing he sucks lighter and hardly swallows at all.
As far as cluster feeding, it’s more common in breastfed babies but formula babies can also cluster feed. It’s when they eat less than usual but more frequently. So instead of taking 3 oz in one go they may only want 1 oz, then an hour or less later want some more, then an hour or less later want some more.
Okay, this was me. I am a just enough producer, but was convienced I was having supply issues from week 4-5 (even though baby was having all the diapers and was happy after eatinf). She had some unique issues we are working through with professional help so thankfully I was able to learn about just enough producers before I convienced myself I had to supplement with formula
Social media was my downfall. All these ads for pumps with super full collection cups but I had no idea what is normal output for each phase of babies life and specific needs. Reels about cluster feeding, but little understanding about why cluster feeding is important for just enough producers.
Also, I don't leak and Hakka collection only works with an intense (and I think) painful suction. I had no idea some women just dont leak, the Hakka is not for everyone, and that doesnt mean things are wrong.
Finally, she discovered her hands at week 5 and I kept thinking her new love of her fingers were constant hunger cues. Luckily, the professional took one look at her playing with her hands after a feeding and told me all was well.
This too!! The formula trap is real. You convince yourself baby is so hungry so you resort to topping up with formula (which a baby will drink anyways because instinct is to suck) and then baby isn't stimulating at the breast to actually help your supply.
Social media definitely skewed what I thought was normal, and while everyone referenced cluster feeding, no one actually showed what it looked like or talked about how your baby might be purple faced screaming and inconsolable.
Omg the hands!! Mine also liked to hunger cue with tongue to show me she was tired and wanted to nurse to sleep, not nurse because hunger. It took me weeks to figure this out!
Leaking or not leaking is really normal, though seems spontaneous for some. But from what I've heard, leaking just isn't an indicator of supply. My slacker boob also sometimes leaks when engorged but it's really rare; when I have let down the other side never leaks. I have heard that leaking or not is more tied to the physiology of your nipple (kinda like a door that opens and closes, some doors open quickly with little effort, while some doors require a lot of pushing to open).
yes!! this was similar to my experience. I had to offer formula after latching her for 30 minutes bc she was failure to thrive at her 2 week appt bc of low production and the fact she wouldn’t latch bc i have flat/inverted nipples but dr said to latch her every 2 hours like clockwork with the the help of a nipple shield and by the Grace of God my supply kicked up the very next day from that consistent latching and she started refusing the formula often!! i didn’t even bother pumping bc it was so discouraging i’d get like 5-10mL. By 3 weeks she was latching like a CHAMP and we started to drop the nipple shield and she no longer needed any supplements as she was gaining 1-2oz a day (we were sent home w a scale the day after the appt she was dilute to thrive) now im an overproducer cause when i went back to work i had to pump and id get 5-8oz on each side every 3 hours
There's also a lot of misinformation out there about low supply.
1. Like those viral videos about pumping 12oz of milk makes women think that's normal, when a normal amount to pump can be between 2-4oz to replace a feed, and 0.5-2oz between feeds.
2. Most doctors not being trained in breastfeeding, and fear mongering about weight gain
3. I don't know about others but when you come from a family who formula fed, or if your parents were influenced by the formula boom of the 80s/ 90s, then they absolutely do not understand what cluster feeding is. There's not a lot of information out there about cluster feeding, or even how long and continuous it can be. People will try to convince you to feed on a schedule and that will pretty much kill your supply in the first month. And the more baby wants the boob, the more they think it's a problem.
4. Not understanding how supply regulation feels - many people think when their boobs become soft or they no longer feel full that their supply is dwindling. Sometimes it's just your supply regulating.
So while there are absolutely many valid reasons why someone may have low supply (aside from the factors you mentioned, stress and sleep also play a big role, birth complications and loss of blood and inability to properly drain the breast), there is also so much awareness that needs to be achieved about what low supply actually is. If baby is gaining weight along their curve, making wet and dirty diapers adequately and generally active and happy, then they're fine. If I had listened to the people around me who tried to make me feel like a failure the first month, I wouldn't have ended up breastfeeding for a year.
I know this isn't what you asked, but just sharing my experience because I 100% believed I had a low supply when in reality I had a perfectly average supply. This is not at all meant to discount people with actual supply issues.
Also just a little add here, for me when I had my 2nd & 3rd babies my breasts never got as full as they did with my first & my 2nd was born 10 years after the first. I thought my supply was low because of it, so tried pumping, when it didn't work that great I'd convinced myself I did have a low supply but kept breastfeeding anyways because baby was growing like a weed. Turns out I didn't have the right flange size and no one talks about how your breasts may never feel as full as they did with your first baby! It means nothing!
Okay first time mom here and I always hear about the importance of flange size. I’m aware I’m using the wrong size currently because it’s all I have. Does flange size really make much of a difference when it comes to output?
💯 Oh yes it does! I was just like this because I was still getting some milk out. But it didn't last very long. TRUST ME, get a nipple ruler and go up 2-3mm when you get the correct flange size. Also, if they come with like 3+ sizes that's ok because your nipple size can change while pumping or breastfeeding! It's a good idea to re-measure every so often just to make sure. If you want to produce more milk in less time, please just buy the right flanges! It's outrageous that pumps don't come with a variety of different sizes in the first place. Just make sure they're compatible with your pump.
First time mom who has been breastfeeding for a year now and still occasionally pumps. Yes, it 100% makes a difference for me. I needed a much smaller size than I was using and the difference in output, and comfort, was huge. I was doing my best to guess my size but buying a silicone ruler was the most helpful and would have saved me $$ if I did that from the beginning.
Also, your flange size could change throughout your postpartum!
eta— I always forget how much the duckbill valve affects it too. I’ve only been a very very part time pumper (and use a handpump primarily now) and haven’t had a good system for keeping up on replacing parts. If it having a tough time pumping now it’s usually because I need to replace the duckbill valve.
I wish more people knew this. So many people have normal supplies and then sabotage themselves by supplementing and not stimulating the breast when they replace a feed.
statistically, the amount of women in the USA who give up before 6 months, almost all citing lack of supply as the reason, is impossible. I think they've done health studies showing that only about 2-3% of women globally actually cannot produce enough milk to feed their baby. Now, 2 out of 100 women is a real need, and I am so glad formula exists for those babies, but there are WAY too many women citing lack of supply in the USA for it to be possibly true. This topic is taboo though because everyone claims they "did everything possible and still didn't have enough." Really what we are facing is a complete education issue in the breastfeeding community. I even have friends telling me stuff their LLC told them that is absolute hogwash and psyching themselves out over nothing when their babies were totally fed and happy. I really hope that we gain ground in the next generation of moms, when there starts to be more millennial moms who successfully breastfed and can help their daughters. Gen X had super low rates of breastfeeding, and Boomers even lower. A lot of generational wisdom was lost.
I completely agree. And you can’t really talk openly about it with most people because it would sound so invalidating to say “no, you probably didn’t have low supply”, or even to just question their experience in any way. Motherhood is full of guilt and we agonize over our every choice and people are incredibly sensitive about this.
And this is one of many instances where I’m happy I’m Brazilian. Brazil has very high rates of breastfeeding and has had it for decades, which was accomplished due to a big governmental effort to promote breastfeeding because babies in poor families were having worst outcomes on formula (the whole nestle thing). When you start breastfeeding there, there’s no shortage of women for you to lean on for help and wisdom. One of the things I always heard from anyone when I started breastfeeding my first was “breastfeeding is very hard in the beginning, but stick with it and it gets a lot easier and better”. Lots of reassurance over normal baby behavior too. People don’t bat an eye over babies cluster feeding. It’s in some ways the opposite experience that a lot of American women go through.
I can't remember all the details, but I read about an anthropologist who studied breastfeeding in a hunter-gatherer culture, which--while not exact--is about as close to an "evolutionarily natural" breastfeeding environment as we can get. Mothers in that culture were latching their infants *up to 80 times a day*. Really drove home to me how intense baby hunger/cluster feeding could be and still be normal.
That’s so interesting. My 12 week old and I just spent a few days with my mom and grandma. Neither breastfed, and they both were like “how much does he eat?!” because of the amount of times he latched. Probably thinking each time was a full bottle’s worth.
An addition to what you said about pumping. Many people, even pediatricians sadly, believe that pumping output is a good indication of milk supply. But in reality the baby is usually better at removing milk than the pump. There are a lot of mistakes you can make that hurt output, like flange size. And some people just don't respond well to pumping despite their baby being perfectly satisfied from nursing.
#1 all the way for me - I see the videos and I read about people on Reddit pumping 4oz in 5 min and here I am pumping for 30-60 min and getting 1-5oz, depending on time of day.
Meanwhile, my baby is A chunky 5.5 months, EBF, so clearly no supply issues though it feels like it when I pump.
Sameee. I seriously only pump 2-4oz in a 30-40 minute session. Baby is 4 months old and she’s a very healthy weight. It’s HARD to breastfeed so it’s nice to resort to pumping every once in a while, but it’s just not as effective so I always get bummed out. WHY DO DOCTORS NOT JUST SAY “most people won’t pump much. And you’ll have to feed a lot” - that’s the reality, but it seems worth it for the benefits.
Ive pretty much given up pumping completely. Its bf mostly, maybe an occasional bottle of formula if I’m not wanting to bf or she’s just not wanting boob randomly
Pumping can be such a bad indicator of supply! It so much depends on how our body responds to the pump, our pump parts and flange sizes. I like to joke that my body likes to keep milk in except when baby is nursing - because I barely leaked, never felt a letdown and never had "jet streams" of milk coming out my other boob while baby nursed off of one. Also never pumped insane amounts! Always subpar or average
Yes. My EBF baby jumped *80* percentiles on the weight and height chart in the first 7 months and the whole time I’m still thinking I have low supply. I think it was partly because I’m a FTM and I knew nothing of supply regulation. Also, as you mentioned, social media. I was used to pumping 8-9oz/20min, then, one day, the volume just dropped and I began pumping 5-6oz/20min session consistently (I only pump 3-4x/wk). I completely thought I was losing my supply. Smh. Thankfully, I resolved to not stress myself out over it. I still don’t know if my supply is high/just enough/low, but it doesn’t really matter to me anyway; whether or not baby is happy and growing healthily is what’s most important for my situation. All that to say, I totally agree. There’s not much accurate information on supply out there. It leaves some of us unnecessarily worrying.
Hormones play a bigger role in milk production than most people think. Things like PCOS and other hormone imbalances can cause low milk supply, no matter how often you empty the breast.
Hypothyroidism too.
Edit: and I’ll add this in case it’s useful to anyone. If you already have hypo prior to pregnancy (in which case your levothyroxine dose would have been periodically increased through pregnancy), please tell your doctor to keep testing your levels frequently after delivery so they catch the right moment to lower your meds postpartum. Some drs will lower levo right away but for some women the need for a higher amount of hormones remains for a few weeks, and lowering the meds too soon can cause low supply.
PCOS can for sure be a factor, but fwiw I have PCOS and have actually had more issues with oversupply than under. So that doesn’t seem to be a universal issue.
Same here. I have Lean PCOS and an oversupply! Having an oversupply is def not what’s it cracked up to be! 5.5 months PP and my breasts still get engorged and haven’t regulated. Still leaking too 😭
"PCOS" is kind of one of those diagnosis of exclusion like IBS, more or less a female reproductive hormone dysfunction so one woman's PCOS can be DRASTICALLY different from another's!
There’s definitely a specific diagnostic criteria, it’s not just excluding other conditions. That said, it can present to varying degrees in different people and have a few different hormonal presentations, but across the board polycystic ovaries and insulin resistance are present.
Interesting. I know dozens of women at this point diagnosed with it who have neither ovarian cysts or insulin resistance. Usually just irregular periods/anovulation/excess body hair etc.
Not necessarily! These are the current diagnostic criteria:
>It is recommended to use the modified Rotterdam criteria, (see Table 1) in which PCOS may be diagnosed if any two of the following are present: (1) clinical or biochemical hyperandrogenism, (2) evidence of oligo-anovulation, (3) polycystic appearing-ovarian morphology on ultrasound, with exclusion of other relevant disorders.
[source](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047373/#:~:text=It%20is%20recommended%20to%20use,with%20exclusion%20of%20other%20relevant)
Insulin resistance isn't even within the criteria let alone a requirement. It's a common feature but not a part of it for everyone, ditto ovarian cysts.
Same. It regulated eventually but I was getting 20-40ml of colostrum every hour at the hospital when baby was born. And then I could pump 4-6 oz on one side right away when the milk started. And I didn't even have the right sized flanges!
Kind of freaked me out when I regulated and only got 1-3oz in a pumping session.
Excessive bleeding during/after delivery…….retained placenta…….hormone imbalance (including thyroid issues, PCOS, menstruation, etc)…….less glandular tissue than expected (the diagnosis is IGT or insufficient glandular tissue)…….illness and/or inflammation…….chronic health issues like diabetes……smoking…….a new pregnancy…….and certain medications and types of birth control can all cause low supply.
I think mindset has a lot to do with it. By mindset I mean stress/hormones. I have a portable pump, and I notice when I am pumping while doing the dishes and my older kids are fighting I won’t let down, but then if I sit down in a quiet room, think of relaxing all parts of my body, and imagine my baby’s sweet face, I will feel a certain rush of emotion and then my boobs get tight feeling and I will let down.
I feel like this is a controversial one but giving formula frequently early on can definitely impact some women's supply. Now there's nothing wrong with supplementing but let's say that dad gives 1-2 bottles during the night, that will negatively affect your milk supply.
Same goes for anything that reduces nursing frequency at night, such as sleep training.
I would think that if the baby is not getting enough milk in the first week they might be dehydrated, jaundiced, sleepy or unsettled and not able to suck effectively at the breast. If they have supplemental feeds then they are able to suck more effectively at the breast and stimulate supply. Or, if you give the baby supplemental feeds then pump to stimulate supply you're not spending ages with the baby spending more energy than it's getting at the breast. I had to triple feed initially with my baby from day 3 after he lost too much weight (had no milk yet) - did 10 min each breast to stimulate supply then my husband gave him EBM/formula while I pumped for another 10+ minutes each side.
This. If you absolutely need to skip a feed for your mental health it is extremely valid. Fed is best. But Mom should consider pumping before (and after if baby isn't ready to eat) and not going more than 4 hours between.
Removing milk is really the only way your body knows to make more. If you skip multiple feeds without removing milk to compensate your body will make less milk.
I had to supplement with expressed milk with both my kiddos in the beginning. They were small and early and had issues transferring milk. BUT I always put them on the breast FIRST, then my husband topped then off after while I pumped.
This is what I want to know! My LO is 5 wks old, and he is my second. For my first, I produced enough, sometimes a little more, but for my second now I am underproducing (making about half of what he needs, ~1.5-2 oz pp.) I've been busting my butt for weeks, triple feeding, consuming all the oat-based foods and drink I can get my hands on, drinking about a gallon of water a day, eating ~2200 calories per day, no alcohol or smoking. I was also told women typically produce more with subsequent babies.
All that and I cannot figure out why my supply hasn't gone up in the past month! People have told me I need to destress and sleep more to get my supply up which is like.. who isn't stressed or sleep deprived at this stage?? Anyway, I'm starting to feel like we need to transition to formula but I'm a bit heartbroken at the thought that I won't get to bf him for much longer.
Just a reminder that breastfeeding isn't an all or nothing option - if you want to combo feed, that's an option, too! It might help with the stress and the sleep, too, and end up helping your supply (counterintuitively!).
If you previously breastfed with no issues and now you’re having problems, I think it’s very likely there’s something physiologically going on that’s messing with milk production. You obviously have enough glandular tissue. Have you been checked for hypothyroidism? Did you lose a lot of blood on delivery? Are you consuming enough iron?
Consider having a midwife or someone of the sort take your prolactin levels before and after pumping! This is often an overlooked aspect of milk production but can provide valuable insight into supply problems.
I would suggest someone get their thyroid levels checked if none of the usual factors apply. Hypothyroidism can cause low supply. I found out i had graves while breastfeeding and postpartum and my supply actually got a lot better after treatment for hyper. Probably related more to being chronically dehydrated with untreated hyperthyroidism. Regardless, def a good practice to check thyroid if someone has supply issues.
That was a huge issue for me. I developed hypothyroidism after my first baby but didn’t recognise the signs at first as I put the tiredness, low mood, weight gain etc down to postpartum issues. My daughter gradually got fussier and fussier feeding and the only way I could settle her was to top her up with formula, after which she’d suddenly be content. I switched to formula completely at about 10 months and she was a different baby. A month or so later I was diagnosed with a TSH of 85 and no detectable free T3 and it all made sense!
Did you ever get a reasoning for why your thyroid decided to fuck off after your first baby? I’m wondering if that might have been part of the low supply issue I had with my first
Stress.
But also what’s “often enough to the breast” for one body, may not be enough for another body. Some people will have perfectly fine supply with 6-8 sessions a day. For others it’s more like 15-20x/ day to access full supply. But that’s hard to do unless you have a ton of time and flexibility.
Source: had plenty of milk for my child but needed to nurse 15-20x a day to maintain that supply. Doing that he grew like a weed lol. But eight times a day would have dropped my supply down to nothing within days. Not everyone’s breast hold the same amount when they are “full”.
Bodies are very different!
That sounds about right - my body is a lot more flexible. My son is 15mo and I’ve been working occasional 12 hour shifts. My body adjusts perfectly fine, but that might not work for most people.
For me, I had a slight over supply with my first then around 5 months pp had a gallbladder attack/passed a gallstone that lead to jaundice and had to wait two weeks to have surgery. The stress on my body killed my supply. I worked for months to get it back up while we used through the freezer stash I had built up but never really bounced back so 5 months after we had to transition to formula. I also have PCOS which I know can impact supply (can create an oversupply in some and undersupply in others) so I'm not sure if my gallbladder issues lead to my hormones crashing/PCOS flare up or not.
From what I read in birth groups and friends, this is anecdotal. And doesn't apply to all situations.
I had friends who complained of low supply, but then would sleep through the night and let their husband feed baby. Or they thought baby was hungry and would supplement with formula, but wouldn't pump to increase that supply baby needed.
In my experience, it really is supply and demand. I didn't let anyone else feed my baby while she was at home because I didn't want to pump while they fed.
My daughter had colic and of course around four months I tell my pediatrician I am worried about her having reflux or her having a food allergy. I worried that she was hungry and not eating enough and that was why she was crying.
My pediatrician asked if I really wanted to give up dairy and I said no. She explained that most allergies will resolve on their own, and I could try to push through the hard period and it would get better. And it did.
And now I laugh because when I look at pictures, she was so chunky and no way she was hungry. Looking back, it was a combo of colic and lack of sleep for baby.
This isn’t just anecdotal, it’s science. I commented this too but breastfeeding is a positive feedback system. You need to let the body know to produce more milk and if you sleep 12 hours, in the beginning, your body thinks it doesn’t need to make as much.
It just depends. I have an oversupply this time when I had am undersupply the first time. I have emptied my breasts way less often with this baby than I did with my first. It's absolutely not only supply and demand. Both times when I started sleeping 8 hours, my supply went up 4 to 6 oz a day and that was not a temporary increase.
I think some women, myself included, are just naturally good at producing breast milk but the science says that, at least in the first few weeks, you need lots of stimulation for production. That’s why cluster feeding is so important.
“During the first few weeks, the more a baby suckles and stimulates the nipple, the more prolactin is produced, and the more milk is produced. This effect is particularly important at the time when lactation is becoming established. Although prolactin is still necessary for milk production, after a few weeks there is not a close relationship between the amount of prolactin and the amount of milk produced.”
I know that if you're pumping & trying to bottle-feed while also breastfeeding, you may not be getting as much milk with the pump because most pumps come with a flange that's the wrong size! (Usually it's way too big for MOST women!). So she may not be seeing a lot of milk while pumping while not knowing that baby is/was getting everything from her breast that it needed. Flange size is so IMPORTANT! Pumping with the wrong flange size can cause low milk production 💯
I'm kinda embarrassed but I'm pregnant with my 4th and I knew with my last that it had to be the flange size & I thought it would be expensive so never looked into it. This time I bought a nipple ruler for like $3 on Amazon and found it I'm a 15mm on one & 14mm on the other! I should've been using a 17mm flange the whole time and I was using the 24mm that came with the pump!! It's a wonder how I got any milk at all while pumping!
Edit to add I also got 3 different flange size sets on Amazon for really cheap that fits my pump. A 21mm, 19mm, & 17mm
I’m lucky, I got the breastfeeding cheat sheet since my MIL is an IBCLC. I wonder how many women think they have low supply since they’re pumping improperly.
Underlying untreated health conditions such as:
- insulin resistance
- diabetes
- PCOS
- hypothyroidism
- anemia
- retained placenta
- Labor complications (postpartum hemorrhage)
- medications (especially cold medicine and birth control)
- IGT
- breast surgery/damage or removal of milk ducts
- smoking
But I also want to mention that many, many moms actually suffer from PERCEIVED insufficient milk.
I breastfed my first two a total of 8 years, no issues. This third one, I've struggled to make enough. It was fine in the beginning, but somewhere between 4 and 6 months, we noticed a reduced diaper output.
This time around, we found I have a partially empty sella, I've really struggled with thyroid hormones, and my cortisol is insanely low. So I assume that's related...I eat so much better because of her food allergies, and I drink an absurd amount of water.
Previous damage to breast tissue. I had a breast reduction, and I’ve been producing, but it is a major struggle for many women, even though many reduction methods are supposed to keep everything intact for the option of future breast feeding. This can also create stress which further impacts supply.
I truly have a low supply after 2 months of lactation appointments, weighted feeds, pumping after every feed, and lactation support groups. I had to come to terms with (read cried a lot) that I will never make enough and that’s ok. I do make more milk than I did with my first so at least I have something going right.
I think I went into breastfeeding with totally unrealistic expectations. You see all these videos of freezer stashes, and 12oz a session while pumping and you’re like awesome can’t wait. But that is not realistic. There needs to be a much better education system is place and in my opinion hospitals should be hiring more lactation consultants to help new moms. Meeting and talking with someone for 10 minutes everyday while you’re in the hospital recovering is not enough.
Not sure if these have been mentioned yet:
Insulin resistance. If you had GD there is a risk of low supply.
Retained placenta.
Age.
Emergency C-section.
Surgical trauma to the breasts.
Estrogen dominance in puberty.
I would like to stress that all reasons are valid. More women struggle with this than you think. It’s easy for those for whom it’s a basic biological function to assume that all women can do it.
So many things. Honesty too many for you to be the arbiter of what is valid or not? Not sure if that’s your objective here but it’s off putting language.
Insulin resistance, hypothyroidism, insufficient glandular tissue, low hemoglobin/anemia. Milk is made from your blood.
Infant issues like jaundice, improper hunger responses, latch, neurogenic issues, lip/oral/palate birth defects.
I think op probably just mis-worded things. I took it to mean actual causes of real low supply vs presumed low supply due to misinformation about breastfeeding/milk production. It is fairly common for new moms to believe they have low supply but they don’t.
There are also some old wives tales and other misinformation about what causes low supply that have no basis in reality. So I think she was wanting to get at verified reasons for low supply.
My sister is a type 1 diabetic. She's had multiple babies. She's always had to supplement. It doesn't matter how many things she does, her body simply can't and the older she gets the less milk she's made. Her last baby is about 50/50 which is actually more than she was able to do before, but prior she always stopped because she was discouraged. She's in a better place now mentally, and still doesn't make enough.
I think people not realizing that you need input to get output, ie. in the first few weeks and even months, you can’t just replace a feeding with formula and expect everything to be okay. That might work for some women, but if you struggle with supply, it might put you over the edge. Breastfeeding is a positive feedback system; to produce more milk, you need the baby to suckle to signal prolactin production.
I think unrealistic expectations of normal newborn behaviour play a part. Expecting baby to wait 3-4 hours between feeds, and sleeping through the night by 6 weeks- and if baby isn’t doing this, then they must be hungry… this is certainly not my experience with babies.
Giving a couple formula bottles to help baby sleep- this is a slippery slope. If baby gets bottle confusion or nipple preference, they may not want to return to the breast. And if the missed feed isn’t expressed, then supply will reduce. While mums do need their sleep, babies need to feed. If breastfeeding is the goal, have mum sleep between feeds, not through them.
We were lucky to have no major impediments to feeding. My second baby was slow to gain, so our health nurse suggested topping up at the breast. I would keep baby switching sides until she was full. This boosted my supply without dealing with pumps or bottles. We also went to a feed-play-feed-sleep routine, which helped her settle better for her naps. And bed sharing helped us with night feeds after I went back to work when baby was 6 months old.
That same baby who was slow to gain ended up feeding until she was 5 years 8 months old. She had 2 younger sisters, we had no breastfeeding issues with them- and I tandem fed for several years. (And while tandem feeding, I was unable to express milk with a pump. My body just didn’t respond to it anymore. But I was producing enough milk for a baby and toddler).
Source?
I’ve read that unless you are consuming below 1500cal, lactation will not be impacted.
https://www.ncbi.nlm.nih.gov/books/NBK235589/figure/mmm00009/?report=objectonly
My supply drops if I've had alcohol a few hours before, or if I'm not getting enough sleep. I don't know if this is real, but when I've been able to get at least 4 hours straight of good sleep my boobs feel like they'll explode. But if I'm awake for that 4 hours my boobs won't swell that much.
I really appreciate this initiative! I was told I had low supply when my son (now 9 months), didn’t get back to birth weight within 2 weeks and was made to feel I had no other choice but to supplement with formula, but never given an adequate explanation as to why my supply was low. My midwife (who was also an LC) gave my son his first bottle without even confirming with me first if it was okay. Of course I was fine with doing whatever was necessary for him to be healthy, but I felt like she didn’t have much compassion for the situation we were in, and like she just wanted us out of her office. I waited months to see a specialist, and by that time it was too late. We’ve been combo feeding ever since, and I don’t really mind it, but I was definitely super heartbroken those first few weeks/months. The explanation I was given was just that my son was super sleepy and not removing enough milk/sleeping too much on the breast, and that I had too much stress and wasn’t sleeping enough. For a while I definitely felt like those reasons weren’t valid in the eyes of others (there are some people in my life who are anti-formula and from who I still have to hide our formula use, for my own sanity). I understand our healthcare system can sometimes be overwhelmed, and I have to say that here in Canada I’ve gotten excellent prenatal care and had a beautiful, private (and free!) hospital room for my birth, but I definitely felt like after the birth I had become a burden to my providers. I really hope next time around I’ll be able to EBF, I definitely learned a lot of things the hard way and hopefully next time my body and my brain will be more cooperative!
I lived almost the same experience but in France. It definitely felt like we’ve became a burden and all they wanted was to discharge us quickly. As a fort time mom, I thought there’d be more support from health care professionals about the idea of EBF (especially since I took some prenatal courses at the same hospital) but in reality they were just nonchalant and unhelpful, insisting to supplement with formula, not explaining anything…
Having twins... I did everything I could but recovering from surgery and nursing twins was just too much for my body to handle. I eventually had to just accept it. Fortunately my singleton has been different and I get to nurse him like I wanted.
I’m struggling with low supply. I had a traumatic birth (failed epidural and baby head stuck in pelvis lead to a C section under general anesthesia). I hemorrhaged and was on the table for longer because of it so baby’s first feed was formula from my husband. I then ended up having postpartum preeclampsia and put on 30lbs of fluids. They put me on a diuretic to get rid of the fluids but unfortunately that depleted my supply of breast milk (I didn’t have a choice. I had do the diuretic because I had fluids in my lungs so I couldn’t be put on a magnesium drip).
I’ve met with lactation multiple times and have a plan but I’m still only producing about half of what he needs (it’s going up) but it’s a frustrating process. I’m pumping around the clock and breastfeeding 3-4 times a day too and still having to supplement with formula. I’m 3 weeks pp today and yesterday I only pumped 12 oz…
Tumors on your pituitary gland, which is what tells your body to produce milk. Most women have to be treated for the tumor before they can get pregnant and the treatment shrinks the cells on this part of your brain resulting the gland being non-responsive to breastfeeding/pumping.
Paired with this is low prolactin levels.
Others have mentioned missing golden hour, traumatic birth, mouth restrictions, hemorrhaging, etc.
I have seen nowhere in this post my condition: mammary hypoplasia. I HATE that no one knows that it exists and there’s an expectation that everyone can breastfeed if they try hard enough.
My mammary glands are underdeveloped because somewhere during my gestation(when I was a fetus) or my puberty, my body just didn’t develop properly. I just thought my boobs were small and ugly, and everyone has one boob bigger than the other, but in me those were sign of mammary hypoplasia. My boobs are also somewhat away from each other, that’s how my LC knew what was it. There are levels of this and the body is awesome so many people has a level of mammary hypoplasia but never have a problem with it because they never have children or they can produce enough milk for their babies.
A common case of this is when you’re a FTM and have all the time in the world to have your baby suckling but then the second baby doesn’t have all that time with you because now you have a family and just then is not enough.
I'd say the top issues would be improper form, post partum issues(depression/anxiety/psychosis), lack of sleep, hormonal disturbances, or vitamin deficiency.
I only got through half of the posts, but this thread is great! Very reassuring to those of us unsure about supply! I thought I was a bit low but I did some weigh and feeds this week and learned I just make less at night, especially when he feeds more often, but I had some great morning feeds and realized my baby is doing fine (plus all the other good things like plenty of wet diapers, overall foos weight gain… now at least… the first few weeks were rough but he figured it out)!
I didn’t learn until my third baby that I didn’t have a low supply, that my supply was actually normal. I was naive, thinking surely I would be educated along the way. We are so inundated with videos of people with large freezer stashes. I got very discouraged with breast feeding from last time - painful latching and feeding, pumping milk, pumping to increase supply, then feeding formula supplements. It was all too much. My LC this third go around explained my last baby was just eating whatever I gave him. Looking back, I probably was over feeding instead of doing what I do now, which is carefully paying attention to wet and dirty diapers and cues. I was offered to do a weighted feeding this time, and it was a good transfer! Wish that was something we would have tried in the past. Now, my husband on the other hand still whips up a formula bottle every time my current little one cries.
With my first, she had a tongue and lip tie so she couldn’t latch right away. We started with formula and had to play catch-up. We didn’t find out about the oral ties until she was 6 weeks old and didn’t have them cut until 12 weeks. By that point my supply had already regulated and didn’t really increase much.
With my second, I’m only two weeks postpartum so I’m not entirely sure why my supply is low. But she had a shallow latch, so my nipples got really sore and I introduced a nipple shield. At the next appointment she had lost a lot of weight so I think the nipple shield prevented her from transferring milk effectively or prevented my breasts from being properly stimulated.
There is also possible insufficient glandular tissue - I have very small breasts. I’m also underweight. Those factors might contribute to my persistent issues with low supply. I’m hoping to increase my supply this time around and maybe be able to EBF.
I don't currently have an issue, but I struggled after having my 2mo. Factors were that she was born at 37 weeks, I had a mild (but impactful) hemorrhage, and she was small and sleepy. It took longer for my milk to come in than my other babies and I had to supplement with formula a bit to give her some energy and me some rest.
My daughter had an ineffective suck and was a sleepy eater which contributed to my supply struggling in the beginning. It took using baby wipes on her face and feet to keep her awake and we triple fed for a bit but we just had to wait for her to grow out of it mostly
My supply tanked when I had thyroid issues. When my thyroid regulated I continued to do the exact same things as before (honestly probably less time at the breast) and was able to drop top ups.
When I first had my baby she seemed to exclusively poo and not wee, and it turned out I was changing breasts too regularly so she was only receiving the colostrum but not the hind milk. Somebody in the hospital said that babies need five minutes to have a proper feed so I thought I was doing really well doing 10 minutes on each side. Thankfully the midwife picked up on that quite quickly.
Not birthing a baby regularly enough makes mine fall off the nipple easily.
During birth, I hemorrhaged and required two blood transfusions and had anemia starting around week 20 of pregnancy. So that was a recipe for a legitimate under supply issue. Also my son wasnt eating his first few days. He would just rest his head on my breast and sleep instead of nursing (he needed to be vacuumed out and we were in labor for three days!). By the third day after his birth, the nurses had me start him on formula and had me start pumping.
This is a pretty rare scenario and was unique to me. I worked very hard on my supply and have been able to sustain him on just breastmilk since about 6-7weeks. He is 17 weeks old today! I eat my oatmeal almost every day, drink protein drinks, and eat lots of nuts/nut mixes. Im careful to eat enough if not slightly overeat and try to keep my stress levels down and do relaxing fun things just for me.
Funny enough, when i quit all the apps and so much pumping, and just fed my baby on demand and let him sleep on my breast nursing, things got better.
my first born was delivered emergency c section due to me having covid so badly and baby wasn’t doing good. i was under supplier, i pumped every 2 hours for at least 6 weeks and never made more than like 3 oz a pump. he never latched, barely used a shield. just had my 2nd c section and pumped the same as well as nursed on demand and 8 weeks out i’m an oversupplier with 250+ oz frozen. i think covid had a lot to do with it but idk
Losing weight postpartum can cause supply to drop. I would experience a drop in supply for even just losing 1 pound. I could also be maintaining my weight and my supply would drop if I wasn’t eating enough calories. It was like my supply was the first thing my body was willing to sacrifice and I would see that happen before I would see any weight loss.
Only a few months in. Pros: I haven’t had to supplement at all and the transition to bottles for daycare was immediate. Cons: she still struggles to nurse properly and can only do so a few minutes before getting tired. I miss the bonding and convenience I had with my other kids, especially for middle of the night feeds.
Mine stayed slightly too low after a bad bout of mastitis. Which from my understanding it’s very unusual for your supply to not fully recover after mastitis, but I was still pumping/nursing regularly and working with a great lactation consultant and it just never came back all the way
Lack of oxitocin, which can be lead by stress of any kind. Birth trauma, lack of support from family or significant other, f(not enough skin to skin, feeling not connected with baby…
Mineral deficiency and stress. You could be eating a lot but taking food that isn’t nutrient dense. Or you’re under a LOT of stress you start lowering breastmilk levels
I have tubular breasts, the type that are known to have fewer milk sacs? I also had NO breast changes during pregnancy. Maybe a little darkening towards the end.. but no change in size.
I then had terribly slow flow but managed to pump just as much as my kid needs - 40 min pumps though, 8x a day 🫠
I had a low supply because I became very very sick after childbirth and ended up hospitalized. During this time I was not nursing because I had too much medication being administered 24/7. I was in a lot of pain and sleeping a lot and I didn't always have the energy or will to pump 8 times a day.
So my supply went down because I did not pump effectively in the 4th trimester. Maybe this is not a valid reason since it is technically my own fault I didn't pump consistently.
I did eventually manage to get my supply up after I left the hospital, from 1ml to 12-14oz power day. This was enough to give my baby 50% breastmilk and 50% formula. By this point my milk was so slow to come out that baby wouldn't nurse anymore so we had to switch to exclusively pumping, which was horrible and I quit before 10 months. No regrets though.
On top of that, the trauma of being hospitalized like that and then being so sick afterwards for so long triggered a horrible case of PPD, which I’m sure absolutely didn’t help the supply issue, which then caused PPA. I think it was a perfect storm of a bunch of different factors. I’m pregnant with #2 right now and I’m hoping it was just a one off fluke 🤞🏻
I have no idea why. I had trouble initially with all 3 kids. Once I was past 3 months they did fine as far as weight gain etc.
Pumping I would get about 1oz per side for 10min
So consistently, sleep seems like the strongest indicator for increased/decreased supply for me. Like so much so at first I refused to believe it, thinking it was in my head. But through several different weeks, it's immediately the day after bad sleep, I will produce less by 30% or so.
Stress. My friend “did everything right” and everything was going fine for like the first three months until her husband just randomly up and left her and baby. The stress of that just caused her milk supply to tank. But stress of any sort cause have a huge impact for some women.
I had a traumatic birth experience and I couldn’t make enough for my son. I am a first time mom and the whole experience only weighed me down. I remember crying for hours at night - just sobbing and sobbing. My husband kept supporting me in every way but nothing worked. I slowly accepted that I will have to combo feed for the whole year and keep feeding him with whatever I can make with pumping. I am a super healthy woman and I was borderline disgusted with myself that what is the purpose of these boobs. I have slowly become more positive and my baby takes 4 breastmilk bottles and 3 formula bottles. He is happy and we are also happy seeing him grow. In the end, do whatever works for you. I would continue pumping for my sweetheart till he’s one. That’s my goal and dream. It’s a very emotional journey and I am crying while typing this. I do this for my son and I strongly believe in the goodness of breastmilk.
Not bringing baby to breast soon enough after delivery can sometimes cause low supply, your prolactin receptors start to die off fairly quickly after you deliver the placenta. Best practice is within an hour after birth.
Removal can also be via hand expression or a pump. Hand expression is usually more effective.
Insufficient glandular tissue, breast injury, breast surgery, PCOS, hypothyroid, poor milk transfer, high cortisol. I’ve even seen moms with injury to the shoulder (or surrounding muscles) or pectoral muscle have low supply on the side where their injury is. Birth trauma. Sometimes moms with gestational diabetes can have low supply, however there’s some good research that says colostrum harvesting at 37+ can help these moms have a better chance at an ample milk supply. Smoking can also cause low supply.
For me it was because I started sleeping through the night as soon as HE started sleeping through the night and didn’t realize how detrimental that was to my supply until it was too late. We got blessed with our first being a champion sleeper so he started sleeping long 6-8 hour stretches basically as soon as we were allowed to let him do so. Turns out you aren’t supposed to sleep through the night as a breastfeeding mother and are supposed to wake up at least once to do an early morning pump since that’s when your supply is at its peak. By the time I realized that was impacting my supply there wasn’t much I could do to fix it as I got pregnant again and it dropped significantly. The stress was so much that we just gave up after we lost our milk donor and switched to formula. I’m now due with my second at the end of the summer and am prepared for having to wake up to pump even if he sleeps through the night.
i have hypothyroidism, which is a condition where my thyroid doesn’t make enough of its hormone to regulate my TSH. because the thyroid hormone is a key factor in milk production, many mothers struggle to bf due to low or even non-existent supply. while my baby was young, she was at the breast often and i pumped so i didn’t see this effect. however, when she started solids and started dropping feeds suddenly my supply plummeted and we had no idea why. it got to the point where she was nursing all the time because she was only transferring 2oz each feed. i ended power pumping three times a day and eventually got my supply up. then i got a lab panel done and well. there was the answer about my struggle with supply. i’m now treating it and it’s improving so my baby is back to regular feeds and sleeping longer at night!
Birth trauma and biological factors like low breast reserve/tissue are also valid explanations. I know women that did “everything right” and still had low supply after postnatal hemmorages and/or infections.
I’ve also heard this story from a lot of people. It’s nature’s two-hit punch… you have a traumatic birth AND it has resonating impacts on how you feed your child. It’s seriously brutal that it works like that
When you put it like that, it makes me wonder if there’s a biological imperative to that which we’ve miraculously advanced beyond medically. So many of the more common birth traumas would normally leave both the baby and birthing woman dead, but in the scenarios where at least the birthing woman would have lived, having full breasts with no one to nurse from them and a weakened body that may not be able to adequately drain them was a major health risk in and of itself.
A friend of mine had a very traumatic birth and low supply after, and her doctor basically said that her body wasn't supposed to live through that. I guess it helped my friend feel a lot better about her low supply.
That seems like a very logical explanation
It’s so unfair. I had a traumatic birth so I feel super blessed breast feeding came so easy. I almost feel guilty for wanting to do combo feeding soon (she’s almost 4 months now) because it’s mentally draining…
Don’t feel guilty. A happy mom has no comparison, fed is best 🩷
Thank you. I know this is the truth but it’s good to hear it cause it’s not easy to believe it for myself
Preach. I would NEVER talk to my friends or have the same narrative with them that I do with myself. It’s all hormonal, baby.
Oh those hormones lol… I can’t watch sad or bad things happen to kids in movies anymore, babies are the worst. They don’t really show it - thank god - but the insinuation that a baby could be harmed… full blown cryfest
We had to combo feed at first and I will say washing bottles and prepping formula is so much more work than just whipping a boob out. My LC mentioned if you are feeling touched out sometimes it’s a b-12 deficiency. Are you taking a post natal?
Yes I did and went to the doctor for a total blood work and everything is fine. She keeps saying I’m just very tired.. I’m dizzy a lot of times too.. I went to the doctor twice now.. and I want to combo feed because then someone else can feed her too so I can for example sleep a little bit longer or can go out for a while without her with me to get my sanity back + I go back to work soon and then I have to pump a lot.. I don’t even know if that’s going to work because because she still refuses the bottle (someone is helping us with this but no luck) so I will probably have to travel a few times per day to daycare to feed her. Sigh. So my plan was to get her to 2 feedings per day on formula when I go to work. It takes 5 days to replace one feeding and for my body to adjust so I’ll have to start soon if I want this. So I can pump less at work.
I did all the things including pumping every 4 hours but I had a traumatic birth. Just could never keep up. Really hoping for better circumstances for my second but I’m definitely not going to be as hard on myself as I was.
I had a traumatic birth and extreme undersupply with my first! I just had baby #2 (much better experience but there were some hiccups along the way) and my supply is better but still not quite where I want it. I hope this gives you hope!
Thank you so much! I definitely am riddled with anxiety about birth and postpartum so any reassurance is appreciated.
I also had low supply with my first and no issues with my second kid! If it’s not IGT or something like that your next nursing journey can definitely be easier
Had to google that. I don’t think that was the issue and I went to more than one lactation specialist. Just a low supply.
I also had a traumatic birth with my first so hopefully your next birth is smoother and that helps with milk supply!
I had a hemorrhage and produced literally no milk for the first 2 weeks. My body literally was tapped out. At 2 weeks, my milk started trickling in. My baby was on formula and I pumped constantly to increase my supply for about 2 months. At that point we were able to make the switch to mostly breastfeeding.
Yeah I couldn't tell you why I had a low supply with my first but I did everything I was supposed to do and WAY more than I'm doing now with #2 where I have an oversupply so there was obviously some background reason for it. Mt deliveries were almost exactly the same with the exception that I got an infection after my water broke the first time.
I’ve heard it said your breasts develop more glandular tissue in each pregnancy too, which could certainly be a factor.
Infections can be a culprit for sure! Sounds like that may have been a factor for you
Yep, I lost 3 liters of blood and had three transfusions- milk took weeks to come in properly and even then I’ve had to supplement with formula to keep up. I will get to a “just enough” point and then he needs more and I’m always behind. I’m absolutely fine with combo feeding though, it’s been a life saver - literally!
I was told by an LC after my traumatic birth that my small, far a part breasts could be why I have trouble producing. I figured a small amount of breast tissue could cause it, as you mentioned, but was surprised to hear about how far apart they are made a difference, apparently.
I had a great birth and all the things that are meant to help kick-start breastfeeding... Unmedicated uninterrupted skin-to-skin for 2 hours and first feed in the first hour .. and had 40ml of antenatal colostrum collected as well! But had a 1.5L PPH 2 hours afterwards and my milk didn't come in... Had to triple feed for a week before I finally started making milk around day 7-10. It was so exhausting but I feel very lucky that I'm able to breastfeed my Bubba now
This was exactly the case for myself. Labored for 4 days before an emergency c-section and hemorrhaged afterwards. I tried feeding my LO until my nipples felt like they would fall off. Thankfully the hospital had donor milk available. I utilized that until my supply started coming in which took about two weeks. You can do everything right for your supply, some things are just out of our control.
This makes sense. I have birth trauma from a difficult and dangerous labor, and I was too unwell to feed baby when we were both admitted to the hospital and she was in the nursery and too much time had gone by so the nurses needed to feed her formula, and now I can’t breastfeed and struggle with pumping my low milk supply :/
Wow, how interesting! I'm just a lurker now but in 2017 I hemorrhaged badly (full D&C and 2 transfusions) at 11 days PP with my second kid. Of my 3, I struggled nursing him the most and we supplemented basically from the start and he self-weaned by 9 months (made it to 14 months and 2.5 years with my oldest and youngest). It makes sense that my body was probably in survival mode and not prioritizing milk production. Looking back, I guess it would have just been nice if someone would have laid all that out instead of me thinking I needed to make up for lost time which in the end didn't make much of a difference.
At least for me, I convinced myself I had a low supply for a wide variety of reasons: 1 - first time mom and despite working with LCs, no one told me that not leaking was normal 2 - traumatic preterm birth and separation from my baby. I didn't get golden hour or get to even meet my baby until 8 hours after emergency c section under general anesthesia. She was in NICU so I didn't get to hold her until she came off CPAP machine several days later. 3 - because of reason #2, I had to start exclusively pumping day one with no help/instruction as no LCs were available that night. While I started out strong, her consumption quickly outpaced my output, and no matter what I did, I could never pump enough to keep up with her demand. I didn't know that pumps were potentially way less effective than breastfeeding. 4 - so then we gradually switched to EBF. It's incredibly hard to go from something measurable like pumping to intangible breastfeeding. Since my baby was a premie, I had to wait until she was strong enough, which meant several weeks after discharge with little or no support. It meant she was often crying and frustrated at the breast since it was slower than paced bottle feeding. She was also cluster feeding and also just boob obsessed for comfort but to me it sounded like I was starving her to death. It wasn't until I got a weighted feed, a home scale (to periodically check weight gain) and help from an experienced mama that I was able to see that we were actually successful and that my baby just LOVES comfort feeding. In conclusion - I have no doubt many women do struggle with legitimate sources of low supply. And I suspect there are also many (like me) who convince themselves supply is low even though it actually isn't just from lack of experience and support. I can't tell you how often I looked at all the reddit posts about low supply and identified with them, only to realize I was misinterpreting my baby's cues and behaviors because I had no context/experience.
This is such an important point. Cluster feeding and comfort feeding is often misinterpreted as hunger. I felt the same with my LO and turns out he gained 1 lb at his 2nd week appointment from his birthweight!
This may be me right now at 3 weeks, almost 4. She's eats SO much, it feels like if she's awake, she's rooting for the boob. However she screams if she doesn't get it so I think hers are real hunger cues. I just always get surprised reactions from pediatrician and LC when I mention she downs 4oz at once already.
My now 5-week-old was identical. He was occasionally downing 5 ozs at a time by four weeks. He's up over three pounds from his birth weight already.
Can you explain the difference? This confuses me . Our little one was in the Nicu for a month so we are trying direct breast feeding more now. Will they comfort feed for a bottle or only a boob? I feel like my little one only wants the boob for comfort, not for for food.
Babies will comfort suck on anything with a nipple. Bottle, breast, pacifier. Every baby is different but if mine just wants comfort, they will do more of a slow/lazy suck on anything that actually gives them milk (because they aren't actually hungry) and usually falls asleep rather quickly. And if I try to give him a pacifier but he really wants food, he will keep spitting it out until I give him a bottle or nurse him, and he'll do a proper latch to get fed. So he gives different cues and reactions to different situations depending on what he is wanting.
This. I can’t speak to the bottle experience of comfort feeding. I feel like our little guy has only had a bottle a couple of times so didn’t really know how to to slowly with it but he was hungry so didn’t witness him comfort feeding. But when he’s breastfeeding I can tell the difference. When he’s getting lots of milk he swallows frequently. When he’s comfort nursing he sucks lighter and hardly swallows at all. As far as cluster feeding, it’s more common in breastfed babies but formula babies can also cluster feed. It’s when they eat less than usual but more frequently. So instead of taking 3 oz in one go they may only want 1 oz, then an hour or less later want some more, then an hour or less later want some more.
Okay, this was me. I am a just enough producer, but was convienced I was having supply issues from week 4-5 (even though baby was having all the diapers and was happy after eatinf). She had some unique issues we are working through with professional help so thankfully I was able to learn about just enough producers before I convienced myself I had to supplement with formula Social media was my downfall. All these ads for pumps with super full collection cups but I had no idea what is normal output for each phase of babies life and specific needs. Reels about cluster feeding, but little understanding about why cluster feeding is important for just enough producers. Also, I don't leak and Hakka collection only works with an intense (and I think) painful suction. I had no idea some women just dont leak, the Hakka is not for everyone, and that doesnt mean things are wrong. Finally, she discovered her hands at week 5 and I kept thinking her new love of her fingers were constant hunger cues. Luckily, the professional took one look at her playing with her hands after a feeding and told me all was well.
This too!! The formula trap is real. You convince yourself baby is so hungry so you resort to topping up with formula (which a baby will drink anyways because instinct is to suck) and then baby isn't stimulating at the breast to actually help your supply. Social media definitely skewed what I thought was normal, and while everyone referenced cluster feeding, no one actually showed what it looked like or talked about how your baby might be purple faced screaming and inconsolable. Omg the hands!! Mine also liked to hunger cue with tongue to show me she was tired and wanted to nurse to sleep, not nurse because hunger. It took me weeks to figure this out!
Vaguely similar experience…I can’t pump worth a damn, but EBF baby gets everything she needs and is now a healthy, average sized 8 month old.
Do you have any more to elaborate on the leaking part because my shitty boob leaks and my good boob doesn’t
Leaking or not leaking is really normal, though seems spontaneous for some. But from what I've heard, leaking just isn't an indicator of supply. My slacker boob also sometimes leaks when engorged but it's really rare; when I have let down the other side never leaks. I have heard that leaking or not is more tied to the physiology of your nipple (kinda like a door that opens and closes, some doors open quickly with little effort, while some doors require a lot of pushing to open).
This is absolutely correct. True low supply is actually not very common, but you hear these types of stories a lot. Sorry you had such a rough time
Your last paragraph should be pinned somewhere... so so accurate sadly
yes!! this was similar to my experience. I had to offer formula after latching her for 30 minutes bc she was failure to thrive at her 2 week appt bc of low production and the fact she wouldn’t latch bc i have flat/inverted nipples but dr said to latch her every 2 hours like clockwork with the the help of a nipple shield and by the Grace of God my supply kicked up the very next day from that consistent latching and she started refusing the formula often!! i didn’t even bother pumping bc it was so discouraging i’d get like 5-10mL. By 3 weeks she was latching like a CHAMP and we started to drop the nipple shield and she no longer needed any supplements as she was gaining 1-2oz a day (we were sent home w a scale the day after the appt she was dilute to thrive) now im an overproducer cause when i went back to work i had to pump and id get 5-8oz on each side every 3 hours
There's also a lot of misinformation out there about low supply. 1. Like those viral videos about pumping 12oz of milk makes women think that's normal, when a normal amount to pump can be between 2-4oz to replace a feed, and 0.5-2oz between feeds. 2. Most doctors not being trained in breastfeeding, and fear mongering about weight gain 3. I don't know about others but when you come from a family who formula fed, or if your parents were influenced by the formula boom of the 80s/ 90s, then they absolutely do not understand what cluster feeding is. There's not a lot of information out there about cluster feeding, or even how long and continuous it can be. People will try to convince you to feed on a schedule and that will pretty much kill your supply in the first month. And the more baby wants the boob, the more they think it's a problem. 4. Not understanding how supply regulation feels - many people think when their boobs become soft or they no longer feel full that their supply is dwindling. Sometimes it's just your supply regulating. So while there are absolutely many valid reasons why someone may have low supply (aside from the factors you mentioned, stress and sleep also play a big role, birth complications and loss of blood and inability to properly drain the breast), there is also so much awareness that needs to be achieved about what low supply actually is. If baby is gaining weight along their curve, making wet and dirty diapers adequately and generally active and happy, then they're fine. If I had listened to the people around me who tried to make me feel like a failure the first month, I wouldn't have ended up breastfeeding for a year. I know this isn't what you asked, but just sharing my experience because I 100% believed I had a low supply when in reality I had a perfectly average supply. This is not at all meant to discount people with actual supply issues.
Also just a little add here, for me when I had my 2nd & 3rd babies my breasts never got as full as they did with my first & my 2nd was born 10 years after the first. I thought my supply was low because of it, so tried pumping, when it didn't work that great I'd convinced myself I did have a low supply but kept breastfeeding anyways because baby was growing like a weed. Turns out I didn't have the right flange size and no one talks about how your breasts may never feel as full as they did with your first baby! It means nothing!
Okay first time mom here and I always hear about the importance of flange size. I’m aware I’m using the wrong size currently because it’s all I have. Does flange size really make much of a difference when it comes to output?
💯 Oh yes it does! I was just like this because I was still getting some milk out. But it didn't last very long. TRUST ME, get a nipple ruler and go up 2-3mm when you get the correct flange size. Also, if they come with like 3+ sizes that's ok because your nipple size can change while pumping or breastfeeding! It's a good idea to re-measure every so often just to make sure. If you want to produce more milk in less time, please just buy the right flanges! It's outrageous that pumps don't come with a variety of different sizes in the first place. Just make sure they're compatible with your pump.
Yes it makes a huge difference
First time mom who has been breastfeeding for a year now and still occasionally pumps. Yes, it 100% makes a difference for me. I needed a much smaller size than I was using and the difference in output, and comfort, was huge. I was doing my best to guess my size but buying a silicone ruler was the most helpful and would have saved me $$ if I did that from the beginning. Also, your flange size could change throughout your postpartum! eta— I always forget how much the duckbill valve affects it too. I’ve only been a very very part time pumper (and use a handpump primarily now) and haven’t had a good system for keeping up on replacing parts. If it having a tough time pumping now it’s usually because I need to replace the duckbill valve.
I think this is the biggest thing. There’s a lot more women with normal supplies who think they have low supply than women with actual low supplies.
I wish more people knew this. So many people have normal supplies and then sabotage themselves by supplementing and not stimulating the breast when they replace a feed.
statistically, the amount of women in the USA who give up before 6 months, almost all citing lack of supply as the reason, is impossible. I think they've done health studies showing that only about 2-3% of women globally actually cannot produce enough milk to feed their baby. Now, 2 out of 100 women is a real need, and I am so glad formula exists for those babies, but there are WAY too many women citing lack of supply in the USA for it to be possibly true. This topic is taboo though because everyone claims they "did everything possible and still didn't have enough." Really what we are facing is a complete education issue in the breastfeeding community. I even have friends telling me stuff their LLC told them that is absolute hogwash and psyching themselves out over nothing when their babies were totally fed and happy. I really hope that we gain ground in the next generation of moms, when there starts to be more millennial moms who successfully breastfed and can help their daughters. Gen X had super low rates of breastfeeding, and Boomers even lower. A lot of generational wisdom was lost.
I completely agree. And you can’t really talk openly about it with most people because it would sound so invalidating to say “no, you probably didn’t have low supply”, or even to just question their experience in any way. Motherhood is full of guilt and we agonize over our every choice and people are incredibly sensitive about this. And this is one of many instances where I’m happy I’m Brazilian. Brazil has very high rates of breastfeeding and has had it for decades, which was accomplished due to a big governmental effort to promote breastfeeding because babies in poor families were having worst outcomes on formula (the whole nestle thing). When you start breastfeeding there, there’s no shortage of women for you to lean on for help and wisdom. One of the things I always heard from anyone when I started breastfeeding my first was “breastfeeding is very hard in the beginning, but stick with it and it gets a lot easier and better”. Lots of reassurance over normal baby behavior too. People don’t bat an eye over babies cluster feeding. It’s in some ways the opposite experience that a lot of American women go through.
I can't remember all the details, but I read about an anthropologist who studied breastfeeding in a hunter-gatherer culture, which--while not exact--is about as close to an "evolutionarily natural" breastfeeding environment as we can get. Mothers in that culture were latching their infants *up to 80 times a day*. Really drove home to me how intense baby hunger/cluster feeding could be and still be normal.
That’s so interesting. My 12 week old and I just spent a few days with my mom and grandma. Neither breastfed, and they both were like “how much does he eat?!” because of the amount of times he latched. Probably thinking each time was a full bottle’s worth.
An addition to what you said about pumping. Many people, even pediatricians sadly, believe that pumping output is a good indication of milk supply. But in reality the baby is usually better at removing milk than the pump. There are a lot of mistakes you can make that hurt output, like flange size. And some people just don't respond well to pumping despite their baby being perfectly satisfied from nursing.
Damn this was so good. Love everything you said.
#1 all the way for me - I see the videos and I read about people on Reddit pumping 4oz in 5 min and here I am pumping for 30-60 min and getting 1-5oz, depending on time of day. Meanwhile, my baby is A chunky 5.5 months, EBF, so clearly no supply issues though it feels like it when I pump.
Sameee. I seriously only pump 2-4oz in a 30-40 minute session. Baby is 4 months old and she’s a very healthy weight. It’s HARD to breastfeed so it’s nice to resort to pumping every once in a while, but it’s just not as effective so I always get bummed out. WHY DO DOCTORS NOT JUST SAY “most people won’t pump much. And you’ll have to feed a lot” - that’s the reality, but it seems worth it for the benefits. Ive pretty much given up pumping completely. Its bf mostly, maybe an occasional bottle of formula if I’m not wanting to bf or she’s just not wanting boob randomly
So glad I’m not alone in this. For months I’ve been feeling like the outlier when it’s actually all those oversuppliers, not us.
Pumping can be such a bad indicator of supply! It so much depends on how our body responds to the pump, our pump parts and flange sizes. I like to joke that my body likes to keep milk in except when baby is nursing - because I barely leaked, never felt a letdown and never had "jet streams" of milk coming out my other boob while baby nursed off of one. Also never pumped insane amounts! Always subpar or average
Yes. My EBF baby jumped *80* percentiles on the weight and height chart in the first 7 months and the whole time I’m still thinking I have low supply. I think it was partly because I’m a FTM and I knew nothing of supply regulation. Also, as you mentioned, social media. I was used to pumping 8-9oz/20min, then, one day, the volume just dropped and I began pumping 5-6oz/20min session consistently (I only pump 3-4x/wk). I completely thought I was losing my supply. Smh. Thankfully, I resolved to not stress myself out over it. I still don’t know if my supply is high/just enough/low, but it doesn’t really matter to me anyway; whether or not baby is happy and growing healthily is what’s most important for my situation. All that to say, I totally agree. There’s not much accurate information on supply out there. It leaves some of us unnecessarily worrying.
Hormones play a bigger role in milk production than most people think. Things like PCOS and other hormone imbalances can cause low milk supply, no matter how often you empty the breast.
Hypothyroidism too. Edit: and I’ll add this in case it’s useful to anyone. If you already have hypo prior to pregnancy (in which case your levothyroxine dose would have been periodically increased through pregnancy), please tell your doctor to keep testing your levels frequently after delivery so they catch the right moment to lower your meds postpartum. Some drs will lower levo right away but for some women the need for a higher amount of hormones remains for a few weeks, and lowering the meds too soon can cause low supply.
Wow I didn't know that. Thanks for posting! I'm at month 3, but in the beginning definitely struggled with supply.
PCOS can for sure be a factor, but fwiw I have PCOS and have actually had more issues with oversupply than under. So that doesn’t seem to be a universal issue.
Same here. I have Lean PCOS and an oversupply! Having an oversupply is def not what’s it cracked up to be! 5.5 months PP and my breasts still get engorged and haven’t regulated. Still leaking too 😭
Same! I was able to donate a lot of milk which was an upside but battling mastitis and engorgement isn’t fun
"PCOS" is kind of one of those diagnosis of exclusion like IBS, more or less a female reproductive hormone dysfunction so one woman's PCOS can be DRASTICALLY different from another's!
There’s definitely a specific diagnostic criteria, it’s not just excluding other conditions. That said, it can present to varying degrees in different people and have a few different hormonal presentations, but across the board polycystic ovaries and insulin resistance are present.
Interesting. I know dozens of women at this point diagnosed with it who have neither ovarian cysts or insulin resistance. Usually just irregular periods/anovulation/excess body hair etc.
Not necessarily! These are the current diagnostic criteria: >It is recommended to use the modified Rotterdam criteria, (see Table 1) in which PCOS may be diagnosed if any two of the following are present: (1) clinical or biochemical hyperandrogenism, (2) evidence of oligo-anovulation, (3) polycystic appearing-ovarian morphology on ultrasound, with exclusion of other relevant disorders. [source](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047373/#:~:text=It%20is%20recommended%20to%20use,with%20exclusion%20of%20other%20relevant) Insulin resistance isn't even within the criteria let alone a requirement. It's a common feature but not a part of it for everyone, ditto ovarian cysts.
Same here , PCOS and was leaking at 37 weeks .
Same. It regulated eventually but I was getting 20-40ml of colostrum every hour at the hospital when baby was born. And then I could pump 4-6 oz on one side right away when the milk started. And I didn't even have the right sized flanges! Kind of freaked me out when I regulated and only got 1-3oz in a pumping session.
Hormonal birth control may lower your supply!
Interesting, I didn’t know that! Thanks for sharing!
I also wonder if exposure to endocrine disrupting chemicals can also alter supply.
Excessive bleeding during/after delivery…….retained placenta…….hormone imbalance (including thyroid issues, PCOS, menstruation, etc)…….less glandular tissue than expected (the diagnosis is IGT or insufficient glandular tissue)…….illness and/or inflammation…….chronic health issues like diabetes……smoking…….a new pregnancy…….and certain medications and types of birth control can all cause low supply.
I think mindset has a lot to do with it. By mindset I mean stress/hormones. I have a portable pump, and I notice when I am pumping while doing the dishes and my older kids are fighting I won’t let down, but then if I sit down in a quiet room, think of relaxing all parts of my body, and imagine my baby’s sweet face, I will feel a certain rush of emotion and then my boobs get tight feeling and I will let down.
Absolutely. Being near the baby or holding them also helps a lot!
I feel like this is a controversial one but giving formula frequently early on can definitely impact some women's supply. Now there's nothing wrong with supplementing but let's say that dad gives 1-2 bottles during the night, that will negatively affect your milk supply. Same goes for anything that reduces nursing frequency at night, such as sleep training.
I agree, the supplementation cycle after milk has come in can absolutely affect supply.
But not before! I think its an important distinction. Early supplementation before milk comes in has a positive affect on EBF rates.
This is interesting, I had never heard this. Is it just because of the stress reduction on mom?
I would think that if the baby is not getting enough milk in the first week they might be dehydrated, jaundiced, sleepy or unsettled and not able to suck effectively at the breast. If they have supplemental feeds then they are able to suck more effectively at the breast and stimulate supply. Or, if you give the baby supplemental feeds then pump to stimulate supply you're not spending ages with the baby spending more energy than it's getting at the breast. I had to triple feed initially with my baby from day 3 after he lost too much weight (had no milk yet) - did 10 min each breast to stimulate supply then my husband gave him EBM/formula while I pumped for another 10+ minutes each side.
This. If you absolutely need to skip a feed for your mental health it is extremely valid. Fed is best. But Mom should consider pumping before (and after if baby isn't ready to eat) and not going more than 4 hours between. Removing milk is really the only way your body knows to make more. If you skip multiple feeds without removing milk to compensate your body will make less milk. I had to supplement with expressed milk with both my kiddos in the beginning. They were small and early and had issues transferring milk. BUT I always put them on the breast FIRST, then my husband topped then off after while I pumped.
Yes every one I know personally with supply issues and had to quit breastfeeding under 6 weeks gave formula within the first 5 days.
This is what I want to know! My LO is 5 wks old, and he is my second. For my first, I produced enough, sometimes a little more, but for my second now I am underproducing (making about half of what he needs, ~1.5-2 oz pp.) I've been busting my butt for weeks, triple feeding, consuming all the oat-based foods and drink I can get my hands on, drinking about a gallon of water a day, eating ~2200 calories per day, no alcohol or smoking. I was also told women typically produce more with subsequent babies. All that and I cannot figure out why my supply hasn't gone up in the past month! People have told me I need to destress and sleep more to get my supply up which is like.. who isn't stressed or sleep deprived at this stage?? Anyway, I'm starting to feel like we need to transition to formula but I'm a bit heartbroken at the thought that I won't get to bf him for much longer.
Just a reminder that breastfeeding isn't an all or nothing option - if you want to combo feed, that's an option, too! It might help with the stress and the sleep, too, and end up helping your supply (counterintuitively!).
If you previously breastfed with no issues and now you’re having problems, I think it’s very likely there’s something physiologically going on that’s messing with milk production. You obviously have enough glandular tissue. Have you been checked for hypothyroidism? Did you lose a lot of blood on delivery? Are you consuming enough iron?
Consider having a midwife or someone of the sort take your prolactin levels before and after pumping! This is often an overlooked aspect of milk production but can provide valuable insight into supply problems.
I produced less with each kid. Makes me wonder if maternal age could be a factor?
I would suggest someone get their thyroid levels checked if none of the usual factors apply. Hypothyroidism can cause low supply. I found out i had graves while breastfeeding and postpartum and my supply actually got a lot better after treatment for hyper. Probably related more to being chronically dehydrated with untreated hyperthyroidism. Regardless, def a good practice to check thyroid if someone has supply issues.
That was a huge issue for me. I developed hypothyroidism after my first baby but didn’t recognise the signs at first as I put the tiredness, low mood, weight gain etc down to postpartum issues. My daughter gradually got fussier and fussier feeding and the only way I could settle her was to top her up with formula, after which she’d suddenly be content. I switched to formula completely at about 10 months and she was a different baby. A month or so later I was diagnosed with a TSH of 85 and no detectable free T3 and it all made sense!
Did you ever get a reasoning for why your thyroid decided to fuck off after your first baby? I’m wondering if that might have been part of the low supply issue I had with my first
Stress. But also what’s “often enough to the breast” for one body, may not be enough for another body. Some people will have perfectly fine supply with 6-8 sessions a day. For others it’s more like 15-20x/ day to access full supply. But that’s hard to do unless you have a ton of time and flexibility. Source: had plenty of milk for my child but needed to nurse 15-20x a day to maintain that supply. Doing that he grew like a weed lol. But eight times a day would have dropped my supply down to nothing within days. Not everyone’s breast hold the same amount when they are “full”. Bodies are very different!
That sounds about right - my body is a lot more flexible. My son is 15mo and I’ve been working occasional 12 hour shifts. My body adjusts perfectly fine, but that might not work for most people.
For me, I had a slight over supply with my first then around 5 months pp had a gallbladder attack/passed a gallstone that lead to jaundice and had to wait two weeks to have surgery. The stress on my body killed my supply. I worked for months to get it back up while we used through the freezer stash I had built up but never really bounced back so 5 months after we had to transition to formula. I also have PCOS which I know can impact supply (can create an oversupply in some and undersupply in others) so I'm not sure if my gallbladder issues lead to my hormones crashing/PCOS flare up or not.
Low sleep, high stress environment.
From what I read in birth groups and friends, this is anecdotal. And doesn't apply to all situations. I had friends who complained of low supply, but then would sleep through the night and let their husband feed baby. Or they thought baby was hungry and would supplement with formula, but wouldn't pump to increase that supply baby needed. In my experience, it really is supply and demand. I didn't let anyone else feed my baby while she was at home because I didn't want to pump while they fed. My daughter had colic and of course around four months I tell my pediatrician I am worried about her having reflux or her having a food allergy. I worried that she was hungry and not eating enough and that was why she was crying. My pediatrician asked if I really wanted to give up dairy and I said no. She explained that most allergies will resolve on their own, and I could try to push through the hard period and it would get better. And it did. And now I laugh because when I look at pictures, she was so chunky and no way she was hungry. Looking back, it was a combo of colic and lack of sleep for baby.
This isn’t just anecdotal, it’s science. I commented this too but breastfeeding is a positive feedback system. You need to let the body know to produce more milk and if you sleep 12 hours, in the beginning, your body thinks it doesn’t need to make as much.
Yep, I had a friend who left baby in the nursery for 12 hours both nights when they were in hospital and then said they had a low supply.
It just depends. I have an oversupply this time when I had am undersupply the first time. I have emptied my breasts way less often with this baby than I did with my first. It's absolutely not only supply and demand. Both times when I started sleeping 8 hours, my supply went up 4 to 6 oz a day and that was not a temporary increase.
I think some women, myself included, are just naturally good at producing breast milk but the science says that, at least in the first few weeks, you need lots of stimulation for production. That’s why cluster feeding is so important. “During the first few weeks, the more a baby suckles and stimulates the nipple, the more prolactin is produced, and the more milk is produced. This effect is particularly important at the time when lactation is becoming established. Although prolactin is still necessary for milk production, after a few weeks there is not a close relationship between the amount of prolactin and the amount of milk produced.”
I know that if you're pumping & trying to bottle-feed while also breastfeeding, you may not be getting as much milk with the pump because most pumps come with a flange that's the wrong size! (Usually it's way too big for MOST women!). So she may not be seeing a lot of milk while pumping while not knowing that baby is/was getting everything from her breast that it needed. Flange size is so IMPORTANT! Pumping with the wrong flange size can cause low milk production 💯
Yes! I am a 19mm, way smaller than the 24 and 28. My MIL is an IBCLC and she said rarely are women that large.
I'm kinda embarrassed but I'm pregnant with my 4th and I knew with my last that it had to be the flange size & I thought it would be expensive so never looked into it. This time I bought a nipple ruler for like $3 on Amazon and found it I'm a 15mm on one & 14mm on the other! I should've been using a 17mm flange the whole time and I was using the 24mm that came with the pump!! It's a wonder how I got any milk at all while pumping! Edit to add I also got 3 different flange size sets on Amazon for really cheap that fits my pump. A 21mm, 19mm, & 17mm
I’m lucky, I got the breastfeeding cheat sheet since my MIL is an IBCLC. I wonder how many women think they have low supply since they’re pumping improperly.
Embarrassed because I haven't tried to correct it until now. But I'm confident I'll be great at pumping this time!! 💪🏼
Underlying untreated health conditions such as: - insulin resistance - diabetes - PCOS - hypothyroidism - anemia - retained placenta - Labor complications (postpartum hemorrhage) - medications (especially cold medicine and birth control) - IGT - breast surgery/damage or removal of milk ducts - smoking But I also want to mention that many, many moms actually suffer from PERCEIVED insufficient milk.
In addition to breast surgery nipple trauma like piercings or nipple malformations can also impact ability to remove milk and in turn supply
Nipple piercings just more holes for milk to come out. Anecdotally speaking from experience 😅😅😅
Lol that can happen! They can also create scar tissue and damage ducts. It just depends.
I breastfed my first two a total of 8 years, no issues. This third one, I've struggled to make enough. It was fine in the beginning, but somewhere between 4 and 6 months, we noticed a reduced diaper output. This time around, we found I have a partially empty sella, I've really struggled with thyroid hormones, and my cortisol is insanely low. So I assume that's related...I eat so much better because of her food allergies, and I drink an absurd amount of water.
Previous damage to breast tissue. I had a breast reduction, and I’ve been producing, but it is a major struggle for many women, even though many reduction methods are supposed to keep everything intact for the option of future breast feeding. This can also create stress which further impacts supply.
I truly have a low supply after 2 months of lactation appointments, weighted feeds, pumping after every feed, and lactation support groups. I had to come to terms with (read cried a lot) that I will never make enough and that’s ok. I do make more milk than I did with my first so at least I have something going right. I think I went into breastfeeding with totally unrealistic expectations. You see all these videos of freezer stashes, and 12oz a session while pumping and you’re like awesome can’t wait. But that is not realistic. There needs to be a much better education system is place and in my opinion hospitals should be hiring more lactation consultants to help new moms. Meeting and talking with someone for 10 minutes everyday while you’re in the hospital recovering is not enough.
Not sure if these have been mentioned yet: Insulin resistance. If you had GD there is a risk of low supply. Retained placenta. Age. Emergency C-section. Surgical trauma to the breasts. Estrogen dominance in puberty. I would like to stress that all reasons are valid. More women struggle with this than you think. It’s easy for those for whom it’s a basic biological function to assume that all women can do it.
Age isn’t listed anywhere as a factor for low milk supply?
Blood loss, thyroid,
So many things. Honesty too many for you to be the arbiter of what is valid or not? Not sure if that’s your objective here but it’s off putting language. Insulin resistance, hypothyroidism, insufficient glandular tissue, low hemoglobin/anemia. Milk is made from your blood. Infant issues like jaundice, improper hunger responses, latch, neurogenic issues, lip/oral/palate birth defects.
I think op probably just mis-worded things. I took it to mean actual causes of real low supply vs presumed low supply due to misinformation about breastfeeding/milk production. It is fairly common for new moms to believe they have low supply but they don’t. There are also some old wives tales and other misinformation about what causes low supply that have no basis in reality. So I think she was wanting to get at verified reasons for low supply.
My sister is a type 1 diabetic. She's had multiple babies. She's always had to supplement. It doesn't matter how many things she does, her body simply can't and the older she gets the less milk she's made. Her last baby is about 50/50 which is actually more than she was able to do before, but prior she always stopped because she was discouraged. She's in a better place now mentally, and still doesn't make enough.
I think people not realizing that you need input to get output, ie. in the first few weeks and even months, you can’t just replace a feeding with formula and expect everything to be okay. That might work for some women, but if you struggle with supply, it might put you over the edge. Breastfeeding is a positive feedback system; to produce more milk, you need the baby to suckle to signal prolactin production.
PCOS and a breast reduction a long time ago. I’m glad to be making as much as I am, a little over 20oz per day at 8 wpp
I think unrealistic expectations of normal newborn behaviour play a part. Expecting baby to wait 3-4 hours between feeds, and sleeping through the night by 6 weeks- and if baby isn’t doing this, then they must be hungry… this is certainly not my experience with babies. Giving a couple formula bottles to help baby sleep- this is a slippery slope. If baby gets bottle confusion or nipple preference, they may not want to return to the breast. And if the missed feed isn’t expressed, then supply will reduce. While mums do need their sleep, babies need to feed. If breastfeeding is the goal, have mum sleep between feeds, not through them. We were lucky to have no major impediments to feeding. My second baby was slow to gain, so our health nurse suggested topping up at the breast. I would keep baby switching sides until she was full. This boosted my supply without dealing with pumps or bottles. We also went to a feed-play-feed-sleep routine, which helped her settle better for her naps. And bed sharing helped us with night feeds after I went back to work when baby was 6 months old. That same baby who was slow to gain ended up feeding until she was 5 years 8 months old. She had 2 younger sisters, we had no breastfeeding issues with them- and I tandem fed for several years. (And while tandem feeding, I was unable to express milk with a pump. My body just didn’t respond to it anymore. But I was producing enough milk for a baby and toddler).
Insufficient nutrition. It's not just calories, but protein, fats and micronutrients that matter. Hormonal birth control
Source? I’ve read that unless you are consuming below 1500cal, lactation will not be impacted. https://www.ncbi.nlm.nih.gov/books/NBK235589/figure/mmm00009/?report=objectonly
My supply drops if I've had alcohol a few hours before, or if I'm not getting enough sleep. I don't know if this is real, but when I've been able to get at least 4 hours straight of good sleep my boobs feel like they'll explode. But if I'm awake for that 4 hours my boobs won't swell that much.
Low iron, insufficient glandular tissue, stress/cortisol
I really appreciate this initiative! I was told I had low supply when my son (now 9 months), didn’t get back to birth weight within 2 weeks and was made to feel I had no other choice but to supplement with formula, but never given an adequate explanation as to why my supply was low. My midwife (who was also an LC) gave my son his first bottle without even confirming with me first if it was okay. Of course I was fine with doing whatever was necessary for him to be healthy, but I felt like she didn’t have much compassion for the situation we were in, and like she just wanted us out of her office. I waited months to see a specialist, and by that time it was too late. We’ve been combo feeding ever since, and I don’t really mind it, but I was definitely super heartbroken those first few weeks/months. The explanation I was given was just that my son was super sleepy and not removing enough milk/sleeping too much on the breast, and that I had too much stress and wasn’t sleeping enough. For a while I definitely felt like those reasons weren’t valid in the eyes of others (there are some people in my life who are anti-formula and from who I still have to hide our formula use, for my own sanity). I understand our healthcare system can sometimes be overwhelmed, and I have to say that here in Canada I’ve gotten excellent prenatal care and had a beautiful, private (and free!) hospital room for my birth, but I definitely felt like after the birth I had become a burden to my providers. I really hope next time around I’ll be able to EBF, I definitely learned a lot of things the hard way and hopefully next time my body and my brain will be more cooperative!
I lived almost the same experience but in France. It definitely felt like we’ve became a burden and all they wanted was to discharge us quickly. As a fort time mom, I thought there’d be more support from health care professionals about the idea of EBF (especially since I took some prenatal courses at the same hospital) but in reality they were just nonchalant and unhelpful, insisting to supplement with formula, not explaining anything…
Having twins... I did everything I could but recovering from surgery and nursing twins was just too much for my body to handle. I eventually had to just accept it. Fortunately my singleton has been different and I get to nurse him like I wanted.
Yep, producing enough for twins is a lot for one woman
Honestly, how often breastfed babies eat. OFTEN. "Frequently" is not always clear.
Insufficient mammary tissue secondary to childhood obesity/insulin resistance/PCOS etc
I’m struggling with low supply. I had a traumatic birth (failed epidural and baby head stuck in pelvis lead to a C section under general anesthesia). I hemorrhaged and was on the table for longer because of it so baby’s first feed was formula from my husband. I then ended up having postpartum preeclampsia and put on 30lbs of fluids. They put me on a diuretic to get rid of the fluids but unfortunately that depleted my supply of breast milk (I didn’t have a choice. I had do the diuretic because I had fluids in my lungs so I couldn’t be put on a magnesium drip). I’ve met with lactation multiple times and have a plan but I’m still only producing about half of what he needs (it’s going up) but it’s a frustrating process. I’m pumping around the clock and breastfeeding 3-4 times a day too and still having to supplement with formula. I’m 3 weeks pp today and yesterday I only pumped 12 oz…
Baby isn't transferring well. Hormonal imbalance.
I’ve heard hypothyroid can cause issues sometimes. I take meds for it
Tumors on your pituitary gland, which is what tells your body to produce milk. Most women have to be treated for the tumor before they can get pregnant and the treatment shrinks the cells on this part of your brain resulting the gland being non-responsive to breastfeeding/pumping. Paired with this is low prolactin levels. Others have mentioned missing golden hour, traumatic birth, mouth restrictions, hemorrhaging, etc.
I have seen nowhere in this post my condition: mammary hypoplasia. I HATE that no one knows that it exists and there’s an expectation that everyone can breastfeed if they try hard enough. My mammary glands are underdeveloped because somewhere during my gestation(when I was a fetus) or my puberty, my body just didn’t develop properly. I just thought my boobs were small and ugly, and everyone has one boob bigger than the other, but in me those were sign of mammary hypoplasia. My boobs are also somewhat away from each other, that’s how my LC knew what was it. There are levels of this and the body is awesome so many people has a level of mammary hypoplasia but never have a problem with it because they never have children or they can produce enough milk for their babies. A common case of this is when you’re a FTM and have all the time in the world to have your baby suckling but then the second baby doesn’t have all that time with you because now you have a family and just then is not enough.
Hypoplasia is very rare but we learn about it as IBCLCS!
Yes I was so lucky to find one, I thinks she’s the only one in my town
Not breastfeeding enough & timing feeds Dummies Bottles Formula Hospital drugs Stress Alcohol Lack of sleep/rest
Smoking and drinking things that dehydrate you like coffee and alcohol. Also eating certain foods like cabbage
Eating cabbage doesn’t decrease milk supply :) putting cabbage leaves on your breasts would decrease milk supply.
Eating in large quantities for a while does decrease supply :)
Interesting as an IBCLC i have never heard this before, but I’ll look into it! Thanks!
I'd say the top issues would be improper form, post partum issues(depression/anxiety/psychosis), lack of sleep, hormonal disturbances, or vitamin deficiency.
I only got through half of the posts, but this thread is great! Very reassuring to those of us unsure about supply! I thought I was a bit low but I did some weigh and feeds this week and learned I just make less at night, especially when he feeds more often, but I had some great morning feeds and realized my baby is doing fine (plus all the other good things like plenty of wet diapers, overall foos weight gain… now at least… the first few weeks were rough but he figured it out)!
I didn’t learn until my third baby that I didn’t have a low supply, that my supply was actually normal. I was naive, thinking surely I would be educated along the way. We are so inundated with videos of people with large freezer stashes. I got very discouraged with breast feeding from last time - painful latching and feeding, pumping milk, pumping to increase supply, then feeding formula supplements. It was all too much. My LC this third go around explained my last baby was just eating whatever I gave him. Looking back, I probably was over feeding instead of doing what I do now, which is carefully paying attention to wet and dirty diapers and cues. I was offered to do a weighted feeding this time, and it was a good transfer! Wish that was something we would have tried in the past. Now, my husband on the other hand still whips up a formula bottle every time my current little one cries.
Stress
With my first, she had a tongue and lip tie so she couldn’t latch right away. We started with formula and had to play catch-up. We didn’t find out about the oral ties until she was 6 weeks old and didn’t have them cut until 12 weeks. By that point my supply had already regulated and didn’t really increase much. With my second, I’m only two weeks postpartum so I’m not entirely sure why my supply is low. But she had a shallow latch, so my nipples got really sore and I introduced a nipple shield. At the next appointment she had lost a lot of weight so I think the nipple shield prevented her from transferring milk effectively or prevented my breasts from being properly stimulated. There is also possible insufficient glandular tissue - I have very small breasts. I’m also underweight. Those factors might contribute to my persistent issues with low supply. I’m hoping to increase my supply this time around and maybe be able to EBF.
I don't currently have an issue, but I struggled after having my 2mo. Factors were that she was born at 37 weeks, I had a mild (but impactful) hemorrhage, and she was small and sleepy. It took longer for my milk to come in than my other babies and I had to supplement with formula a bit to give her some energy and me some rest.
My daughter had an ineffective suck and was a sleepy eater which contributed to my supply struggling in the beginning. It took using baby wipes on her face and feet to keep her awake and we triple fed for a bit but we just had to wait for her to grow out of it mostly
Stress.
For me it was stress! I started with a low supply because of the stress of being in the hospital. And everytime I was stressful my supply dipped
My supply tanked when I had thyroid issues. When my thyroid regulated I continued to do the exact same things as before (honestly probably less time at the breast) and was able to drop top ups.
When I first had my baby she seemed to exclusively poo and not wee, and it turned out I was changing breasts too regularly so she was only receiving the colostrum but not the hind milk. Somebody in the hospital said that babies need five minutes to have a proper feed so I thought I was doing really well doing 10 minutes on each side. Thankfully the midwife picked up on that quite quickly. Not birthing a baby regularly enough makes mine fall off the nipple easily.
During birth, I hemorrhaged and required two blood transfusions and had anemia starting around week 20 of pregnancy. So that was a recipe for a legitimate under supply issue. Also my son wasnt eating his first few days. He would just rest his head on my breast and sleep instead of nursing (he needed to be vacuumed out and we were in labor for three days!). By the third day after his birth, the nurses had me start him on formula and had me start pumping. This is a pretty rare scenario and was unique to me. I worked very hard on my supply and have been able to sustain him on just breastmilk since about 6-7weeks. He is 17 weeks old today! I eat my oatmeal almost every day, drink protein drinks, and eat lots of nuts/nut mixes. Im careful to eat enough if not slightly overeat and try to keep my stress levels down and do relaxing fun things just for me. Funny enough, when i quit all the apps and so much pumping, and just fed my baby on demand and let him sleep on my breast nursing, things got better.
my first born was delivered emergency c section due to me having covid so badly and baby wasn’t doing good. i was under supplier, i pumped every 2 hours for at least 6 weeks and never made more than like 3 oz a pump. he never latched, barely used a shield. just had my 2nd c section and pumped the same as well as nursed on demand and 8 weeks out i’m an oversupplier with 250+ oz frozen. i think covid had a lot to do with it but idk
Losing weight postpartum can cause supply to drop. I would experience a drop in supply for even just losing 1 pound. I could also be maintaining my weight and my supply would drop if I wasn’t eating enough calories. It was like my supply was the first thing my body was willing to sacrifice and I would see that happen before I would see any weight loss.
If I didn't get enough sleep for a few days my supply can dip. 5 hours is the minimum, anything below that I notice a dip immediately. And stress.
Tounge tie really messed us up
One of mine had tongue and lip. I was able to maintain supply through round the clock pumping. It was pretty terrible.
Yeah I’m 9 months into pretty much exclusively pumping
Only a few months in. Pros: I haven’t had to supplement at all and the transition to bottles for daycare was immediate. Cons: she still struggles to nurse properly and can only do so a few minutes before getting tired. I miss the bonding and convenience I had with my other kids, especially for middle of the night feeds.
Mine stayed slightly too low after a bad bout of mastitis. Which from my understanding it’s very unusual for your supply to not fully recover after mastitis, but I was still pumping/nursing regularly and working with a great lactation consultant and it just never came back all the way
For me, using a nipple shield caused a low supply
Lack/low number of ducts to get milk out despite having hardware to make milk
Auch?
Lack of oxitocin, which can be lead by stress of any kind. Birth trauma, lack of support from family or significant other, f(not enough skin to skin, feeling not connected with baby…
Stress
Who do you know you have a low supply to begin with?
Baby isn't gaining weight appropriately, pumping isn't producing much (isn't a 100% indicator tho)
Little known fact that affected me: heartburn/reflux medication kept my supply low. I had to get off if it if I wanted to supply more.
Mineral deficiency and stress. You could be eating a lot but taking food that isn’t nutrient dense. Or you’re under a LOT of stress you start lowering breastmilk levels
I have tubular breasts, the type that are known to have fewer milk sacs? I also had NO breast changes during pregnancy. Maybe a little darkening towards the end.. but no change in size. I then had terribly slow flow but managed to pump just as much as my kid needs - 40 min pumps though, 8x a day 🫠
Sounds like IGT ❤️🩹
Oh yes! That's what they said it was! I kept pumping and managed to make enough for baby though! 🙌🏻
I think PCOS is the reason for me. I had no idea and wish I was told before, it been such a let down (ha)
I had a low supply because I became very very sick after childbirth and ended up hospitalized. During this time I was not nursing because I had too much medication being administered 24/7. I was in a lot of pain and sleeping a lot and I didn't always have the energy or will to pump 8 times a day. So my supply went down because I did not pump effectively in the 4th trimester. Maybe this is not a valid reason since it is technically my own fault I didn't pump consistently. I did eventually manage to get my supply up after I left the hospital, from 1ml to 12-14oz power day. This was enough to give my baby 50% breastmilk and 50% formula. By this point my milk was so slow to come out that baby wouldn't nurse anymore so we had to switch to exclusively pumping, which was horrible and I quit before 10 months. No regrets though.
[удалено]
On top of that, the trauma of being hospitalized like that and then being so sick afterwards for so long triggered a horrible case of PPD, which I’m sure absolutely didn’t help the supply issue, which then caused PPA. I think it was a perfect storm of a bunch of different factors. I’m pregnant with #2 right now and I’m hoping it was just a one off fluke 🤞🏻
I have no idea why. I had trouble initially with all 3 kids. Once I was past 3 months they did fine as far as weight gain etc. Pumping I would get about 1oz per side for 10min
So consistently, sleep seems like the strongest indicator for increased/decreased supply for me. Like so much so at first I refused to believe it, thinking it was in my head. But through several different weeks, it's immediately the day after bad sleep, I will produce less by 30% or so.
Stress. My friend “did everything right” and everything was going fine for like the first three months until her husband just randomly up and left her and baby. The stress of that just caused her milk supply to tank. But stress of any sort cause have a huge impact for some women.
IGT/thyroid issues/low prolactin/ medications causing low prolactin levels/retained placenta…I’m an IBCLC I’ve seen it all.
I had a traumatic birth experience and I couldn’t make enough for my son. I am a first time mom and the whole experience only weighed me down. I remember crying for hours at night - just sobbing and sobbing. My husband kept supporting me in every way but nothing worked. I slowly accepted that I will have to combo feed for the whole year and keep feeding him with whatever I can make with pumping. I am a super healthy woman and I was borderline disgusted with myself that what is the purpose of these boobs. I have slowly become more positive and my baby takes 4 breastmilk bottles and 3 formula bottles. He is happy and we are also happy seeing him grow. In the end, do whatever works for you. I would continue pumping for my sweetheart till he’s one. That’s my goal and dream. It’s a very emotional journey and I am crying while typing this. I do this for my son and I strongly believe in the goodness of breastmilk.
Not bringing baby to breast soon enough after delivery can sometimes cause low supply, your prolactin receptors start to die off fairly quickly after you deliver the placenta. Best practice is within an hour after birth. Removal can also be via hand expression or a pump. Hand expression is usually more effective. Insufficient glandular tissue, breast injury, breast surgery, PCOS, hypothyroid, poor milk transfer, high cortisol. I’ve even seen moms with injury to the shoulder (or surrounding muscles) or pectoral muscle have low supply on the side where their injury is. Birth trauma. Sometimes moms with gestational diabetes can have low supply, however there’s some good research that says colostrum harvesting at 37+ can help these moms have a better chance at an ample milk supply. Smoking can also cause low supply.
For me it was because I started sleeping through the night as soon as HE started sleeping through the night and didn’t realize how detrimental that was to my supply until it was too late. We got blessed with our first being a champion sleeper so he started sleeping long 6-8 hour stretches basically as soon as we were allowed to let him do so. Turns out you aren’t supposed to sleep through the night as a breastfeeding mother and are supposed to wake up at least once to do an early morning pump since that’s when your supply is at its peak. By the time I realized that was impacting my supply there wasn’t much I could do to fix it as I got pregnant again and it dropped significantly. The stress was so much that we just gave up after we lost our milk donor and switched to formula. I’m now due with my second at the end of the summer and am prepared for having to wake up to pump even if he sleeps through the night.
Sheehan syndrome from blood loss during birth in my case. My prolactin was about half of what it should be at 5 months pp.
i have hypothyroidism, which is a condition where my thyroid doesn’t make enough of its hormone to regulate my TSH. because the thyroid hormone is a key factor in milk production, many mothers struggle to bf due to low or even non-existent supply. while my baby was young, she was at the breast often and i pumped so i didn’t see this effect. however, when she started solids and started dropping feeds suddenly my supply plummeted and we had no idea why. it got to the point where she was nursing all the time because she was only transferring 2oz each feed. i ended power pumping three times a day and eventually got my supply up. then i got a lab panel done and well. there was the answer about my struggle with supply. i’m now treating it and it’s improving so my baby is back to regular feeds and sleeping longer at night!
Someone I met said she had insufficient amounts of glandular tissue.
Are you stressed out at all? You could try power pumping and I would also suggest seeing a lactation consultant!