Examining Low Supply
Low supply is a common concern of both new and experienced breastfeeding mothers. Many women are able to produce enough breast milk if they can find proper resources and help. Some may even produce more than enough milk for their children. On the other hand, some will not be able to produce enough milk to fulfill their baby’s nutritional needs, regardless of the assistance and tools available. In these cases, breastfeeding can still continue in order to provide the many known benefits along with supplementation of donor milk or formula.
Many mothers mistakenly believe they are suffering from low supply for various reasons. The following conditions are NOT indicators of low supply:
breasts that don't leak
breasts that do not respond well to pumping
not feeling a let down
a fussy baby
a baby who cluster-feeds
a baby who feeds frequently
a baby who nurses overnight
a baby who drinks a bottle after nursing
You could experience all of these factors and have a perfectly fine supply! It is a misconception that we need to make as much milk as possible and constantly work on building our supply every day. When breastfeeding exclusively, our bodies will eventually sync with our babies and produce the exact amount of milk they need.
Some causes of genuine low supply may include certain conditions such as hypoplasia of the breasts, polycystic ovary syndrome, thyroid issues or previous breast surgeries which have cut through and caused damage to milk ducts (1). Hypoplasia is defined as incomplete development of glandular tissue and can occur regardless of breast size. Women can be properly diagnosed for hypoplasia with ultrasound imaging.
So, when mothers contact me asking for ways to increase their supply right away without me knowing their full medical history and background, it is absolutely impossible to give accurate help and support. What I can do is share my ultimate recipe for increasing milk supply in general. This recipe is a safe route to start exploring solutions to address low supply. The ingredients are:
Practicing extra skin-to-skin contact
Offering more frequent and unrestricted feedings (including overnight)
Finding comfortable positioning and a good latch
Making sure baby is actively nursing and adequate milk is being transferred
Avoiding the use of artificial nipples (including pacifiers)
Are there supplements to increase milk supply?
Both pharmaceutical and herbal galactagogues exist, which are substances that promote lactation and can increase milk supply. Pharmaceutical galactagogues are mainly prescribed to women with conditions such as polycystic ovary syndrome or for those who are trying to induce lactation or relactate.
Many mothers will not necessarily need to use galactagogues (3), but instead can start with simpler interventions such as following my above “recipe”. If the aforementioned “ingredients” are not enough to increase supply, pumping sessions can be added to the routine as well. Generally speaking, the more milk that is transferred from the breasts, the more milk the breasts will make. Frequent feedings and pumping will help to increase supply in most cases.
Herbal galactagogues, although used for hundreds of years to increase supply, have little or no studies done to confirm their effectiveness or safety (2).
A qualified herbalist may be able to provide more information on the following well known herbal galactagogues: Alfalfa, Blessed thistle, Brewer's yeast, Fennel, and Fenugreek. Many of these herbal galactagogues come in pill or tea form and are often mixed together (4).
What about lactation cookies?
I have had friends share certain lactation treats with me that they swear by and I have certainly purchased and enjoyed my fair share of lactation cookies. I was convinced they “worked”, but even if I were wrong, they still tasted delicious! If you want a safe option as well as a tasty snack, you can always prepare them at home with your own quality “galactogogue” ingredients. Some commonly used ingredients believed to help encourage lactation are oatmeal, flax seed and brewers yeast.
In conclusion, it is always best to seek individualized care and speak with a lactation counselor or qualified specialist in order to address any breastfeeding-related concerns.
In the meantime, the average breastfeeding mother can practice certain habits that will promote lactation such as: enjoying skin-to-skin contact as often as possible, offering frequent and unrestricted feedings, finding comfortable positions and a good latch, ensuring the baby is actively drinking and avoiding using artificial nipples.
Cassar-Uhl, Diana. “Hypoplasia/Insufficient Glandular Tissue • KellyMom.com.” KellyMom.com, 27 Mar. 2018, kellymom.com/bf/got-milk/supply-worries/insufficient-glandular-tissue/.
Budzynska, Katarzyna, et al. “Systematic Review of Breastfeeding and Herbs.” Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine, Mary Ann Liebert, Inc., Dec. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3523241/.
Bonyata, Kelly. “What Is a Galactagogue? Do I Need One? • KellyMom.com.” KellyMom.com, 2 Jan. 2018, kellymom.com/bf/can-i-breastfeed/herbs/herbal_galactagogue/.
Galactagogues - Boosting Milk Supply and Production. americanpregnancy.org/breastfeeding/galactagogues-boosting-your-milk-supply/.