Milk production is a demand and supply process. As milk is removed from your breasts, your body is signalled to make more milk. The more frequently and thoroughly the breasts are emptied (though breasts are never truly ‘emptied’), the faster they try to refill.
There are two important hormones involved with breastfeeding and making milk:
Prolactin – which promotes milk production
Oxytocin – which promotes milk ‘let-down’ or the flow of the milk to the baby. The ‘let-down’ may feel like a tingly, prickly feeling in the breast, but you may not notice this until your baby is around one month of age. Some mothers don’t feel a ‘let-down’ but you may notice that your baby starts to suck more slowly and deeply at the breast or you may feel thirsty. During a let-down some mothers leak milk from the other breast when they are breastfeeding.
Why your milk supply may be low
- Supplementing feeds – this interferes with the demand and supply process. As your baby removes milk from the breast, your body works to replace it. If formula, juice or water is given your body does not get the signal to make more milk.
- Using a pacifier/ dummy – baby may spend less time breastfeeding, which can reduce milk production.
- Nipple shields – a nipple shield that is not being applied correctly may reduce the amount of milk your baby is able to drink.
- Timing or scheduling feeds – offer a breastfeed whenever your baby is hungry. Sometimes when babies are premature, small or jaundice they may need to be woken for a feed.
- Health issues such as:
- Hormonal disorders – such as thyroid or pituitary imbalances
- Insufficient glandular (milk producing) tissue
- Previous breast surgery
- Medical conditions – High blood pressure, Anaemia; Retained placental fragments
- Some medications such as cold and flu preparations and hormonal birth-control
- Hormonal birth-control should not be started before your baby is six to eight weeks old
- Smoking or high caffeine intake
Tips for increasing milk production
- Breastfeed your baby frequently – 8 or more times each day.
- Once your baby has drained your breast on one side, offer your baby your other breast. If your milk production is very low, you can switch breasts several times, especially if your baby is sucking but not drinking (this is known as ‘Switch Feeding’).
- If your baby is sucking and not drinking, massage your breast, or compress your breast by positioning your hand on the back of your breast and gently squeeze.
- Express extra milk after breastfeeding. If you express beside your baby and after cuddles, it often results in more milk being expressed. If your baby is gaining weight slowly, you can feed this extra breastmilk to your baby.
- Hand express, or use a breast pump, for about 10 minutes on each breast.
- Try to relax, your milk production responds to stress– listening to relaxation music may help.
- Rest and good nutrition are important. Three healthy meals per day, with snacks. Drink at least two litres of water per day.
- Warm compresses and massaging the breasts before and during expressing will help your milk ‘let-down’.
- Try to reduce caffeine levels to less than three cups of instant coffee per day.
- Avoid smoking or try to reduce the number of cigarettes smoked each day. If you do smoke, smoke straight after breastfeeding or an expressing session.
- Enjoy Kangaroo care (cuddles with your baby, skin to skin). Wear a shirt you can unbutton, remove your bra and cuddle your baby close to your chest. Babies benefit from this contact, and your body responds positively to holding your baby close. Skin to skin cuddles are a great way to encourage milk ‘let-down’.
When building milk production, remember, plans you set in motion today may not show results for a few more days down the track.
If you have any concerns, talk to your lactation consultant, child health nurse or doctor. In some instances, medication can be used safely to help to increase milk production. The most commonly used medication to increase milk production is Domperidone, available by a prescription from your doctor.
For more information
Children’s Health Queensland fact sheet: Is my baby getting enough breast milk?
Queensland Health | qld.gov.au/health/children/babies/breastfeeding
Australian Breastfeeding Association | breastfeeding.asn.au