4 Signs Your Milk Supply Is Decreasing and What You Can Do
Experts explain what you need to know about breast milk production, including signs your milk supply is decreasing and how to replenish your breast milk.Medically reviewed by Katie Drakeford, MA, RD, CSP, LD, CLCMedically reviewed by Katie Drakeford, MA, RD, CSP, LD, CLCOne of the most common worries a new breastfeeding parent has is that they are not producing enough breast milk for their baby—or that their milk supply is decreasing instead of regulating. In fact, one study of Australian parents found that nine weeks after birth only 49% are still breastfeeding exclusively due to a perception of insufficient milk supply (PIMS). Meanwhile, an older study of US parents found 35% of all breastfeeding parents that end up weaning early do so because of PIMS. “One of the biggest concerns of nursing [parents] is whether their baby is getting enough to eat and is their milk supply sufficient,” says Corrie Moran, RN, BSN, IBCLC, a certified lactation consultant with Children’s Hospital New Orleans. “There are many factors that can affect a milk supply from the beginning and throughout your breastfeeding journey. It is important to establish a full milk supply from birth.”If you’re concerned your milk supply is drying up, here’s what you need to know about milk production, including signs your milk supply is decreasing and what you can do to remedy the situation so that you can continue breastfeeding without issue.
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How Breast Milk Is ProducedBreast milk goes through a number of different transitions once your baby is born until it reaches a state of regulation or consistency. In the beginning, your body produces colostrum, or pre-milk, as soon as your baby is born. This liquid gold is chock full of nutrients and antibodies and sets the stage for your breastfeeding journey.By day two to four after delivery, your breasts will start to produce milk in larger quantities. During this time, they will feel fuller—people often describe this process as your milk coming in. From day seven to day 14, the breast milk is considered transitional milk and after two weeks it is referred to as mature milk. It is usually around this point that many breastfeeding parents start to worry that their milk supply is decreasing—though it can happen at any point.
How Does Decreasing Milk Supply Differ From Regulation? Often, milk regulation can feel like your milk supply is decreasing, but it is just your body adjusting to the needs of your baby and usually occurs around four weeks, says Moran. “Usually, your body produces more than is needed in the beginning [until] your baby regulates what they need.” As your baby gets older, they may nurse less frequently and more efficiently spending less time at the breast although the breast milk supply remains constant, she adds. “This can sometimes cause [parents] to question if there was a change in their supply.”
Signs Your Milk Supply Is DecreasingWhile many of the signs of milk regulation—like softer breasts or shorter feeds—are often interpreted as signs your milk supply is decreasing, they are actually just indicators that your body and your baby are adjusting to breastfeeding.“Remember, too, that it’s normal for infants to have periods of growth spurts and cluster feeding to increase maternal milk supply,” says Jenelle Ferry, MD, board-certified neonatologist and director of feeding, nutrition, and infant development at Pediatrix Medical Group. “These brief [usually two day] periods of cluster feeding are usually not a sign of decreased or inadequate milk supply.”Your body is also becoming more efficient at milk production and not needing to store as much milk in between feedings, says Dr. Ferry. “[This] usually means less engorgement as milk production coincides more with infant feeding. [Your milk] supply often balances with your infant's demand.”That said, a decrease in milk supply can occur, especially if you’re stressed or had a challenging birth experience. Here are some potential signs your milk supply is decreasing.Your baby stops gaining or loses weightAlthough it’s normal for a breastfed baby to lose weight after birth, says Moran, they should return to their birth weight by about 10 to 14 days. And, they should continue to gain weight thereafter, she says.“Weight gain naturally slows a bit around 4 to 6 months,” adds Dr. Ferry. “But infants should continue growing along their curve on the growth chart—usually gaining at least a pound per month. Not growing can be an indicator that they are not taking in enough calories, or not getting enough milk.”Your baby has low or decreased energyA more subtle sign of decreasing milk supply may be decreased energy, says Dr. Ferry. “If your baby is very fussy, getting tired more easily, or having trouble staying awake to feed, this can also be a sign of not getting enough to eat.” Decreasing milk supply can sometimes occur naturally as your baby's demand decreases, she adds. “There are also a variety of other reasons your body may start to produce less milk, even when your infant is still requiring a larger amount of milk.”Your baby’s number of dirty diapers changesNot having enough wet and dirty diapers is usually a telltale sign that your baby is not getting enough breast milk and could indicate that your milk supply is decreasing, says Moran. “A breastfed baby should have one wet diaper and one stool on day one of life,” she says. “Day two they should have two wet and two stools. Day three, three wet and three stools; day four, four wet and four stools; and day five six to eight wet and three to four yellow, seedy stools. These stools may taper off as your baby gets older, though.”Your baby appears dehydratedWhen a baby does not get enough breast milk, they may start to experience dehydration. You will notice a decrease of urine in their diapers, no tears when crying, and a fontanelle (or soft spot) on top of their head may appear sunken or flat.“If your baby is having fewer wet diapers, crying without tears, or having darker urine than previous, this could indicate dehydration due to not getting enough fluid,” says Dr. Ferry.What Causes a Decreasing Milk Supply?A decreasing milk supply can occur at any time in your breastfeeding journey, especially if you’re stressed or not breastfeeding as often, says Dr. Ferry. Lack of sleep, not pumping enough when you’re away from your baby, dieting, changes in hormones, clogged ducts, and health issues also can play a role.“[Parents] who may have a low milk supply are those who may have had a postpartum hemorrhage, retained placental fragments, a history of PCOS, thyroid problems, diabetes, and obesity,” says Moran.A history of breast surgery or those who have insufficient glandular tissue may also have a low milk supply, she says. Likewise, if your baby is nearing the end of their first year of life or older, a decrease in supply can occur naturally as the weaning process starts. Moran says other possible causes include:Having an improper latch causing the breast not to be stimulatedExperiencing feeding issuesMissing pumping sessions when away or not pumping properly Struggling to establish your supply after birthHaving an oversupply that has decreased to meet baby’s needsExperiencing a change like an illness or different lifestyle habitsReturning to work or spending time away from your babyTaking antihistamines, some decongestants, or birth control pillsGetting pregnant while still breastfeedingIntroducing solids or a change in your baby’s nursing patternsStrategies and Techniques To Increase Your Milk SupplyAccording to Dr. Ferry there are two keys to increasing your milk supply—making sure you’re getting the nutrients you need and removing milk from the breasts frequently and effectively. “Most important is for [the breastfeeding parent] to make sure [their] own body is getting what it needs. Remember that if [your] body isn't adequately supported, it won't be able to do more to support another little human.” Here are some strategies experts recommend that will help to increase your milk supply:Maintain healthy habits. Make sure you're also getting enough sleep, check your diet, and drink plenty of water, she says. “If you're feeling stressed or anxious, reach out to friends or family to help with infant care. Don't hesitate to seek out mental health help with therapy and medication as indicated.”Remove more breast milk. You also should increase the number of times milk is being removed from your breasts and make sure that milk is being removed effectively. For instance, you may want to pump or hand express milk after nursing sessions to make sure your breasts are fully emptied after each nursing session.Nurse as much as possible. Also, consider nursing your baby on demand as much as possible, says Moran. “Have a ‘nurse-in’ with your baby. Spend the weekend having skin to skin contact and nurse as often as you can.”Try power pumping. You also can try power pumping, says Moran. This is where you pump for 20 minutes, take a break for 10 minutes, pump for another 10 minutes, then take another 10-minute break, and then one more 10 minute session of pumping. She advises doing this one to two times a day for a few days.Consider foods that support lactation. “Some foods can act as galactogogues and may help support lactation, including oats, brewer's yeast, nuts, fennel, and fenugreek,” says Dr. Ferry. Galactogogues are substances that can increase your milk supply. They are often plant-derived, but they also can be synthetic, and may be used to treat low milk supply or a decreasing milk supply.
Working Parents Can Still PumpIf you're working and having trouble keeping supply up, Dr. Ferry suggests advocating for yourself. There are both federal and state laws designed to protect milk production. The Fair Labor Standards Act mandates a private space that is not a bathroom and sufficient break time to pump for the first year of your baby's life, she says. “Make sure you’re pumping at work as frequently as your baby is eating. When you're home, spend some extra skin to skin time.”
When To Get Outside HelpIf your milk supply isn’t enough for your baby to grow and thrive, you should get help right away from your baby’s pediatrician, a lactation consultant, or a feeding specialist. They can determine if your baby is showing signs of dehydration, or ascertain if they are not producing enough wet or poopy diapers. They also can help make sure your baby’s latch is correct and offer tips on how to boost your milk supply. “If your baby isn't growing and/or is showing signs of dehydration, it's important to troubleshoot milk supply issues early to get back on track,” says Dr. Ferry. For more Parents news, make sure to sign up for our newsletter! Read the original article on Parents.
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