Low Milk Supply? Perception and Reality
Perception and Realty
Low milk supply is among the top concern of people breastfeeding and lactating throughout the globe. Despite it being a “natural” way to feed, there is often pressures from family and the medical contrary to what is needed to establish a good supply or even understand supply at all. These pressures can lead to unnecessary supplementation or even stopping breastfeeding altogether. People’s perception of their supply doesn't always equal reality though and it can be hard to tell the difference. Let’s review some reasons that AREN”T indicators of low milk supply and when to get help if you do feel this way.
Normal Expectations
Expect your baby to lose 7-10% of their weight within the first few days and to regain their birth weight within the first 2 weeks. This is normal and without other medical concerns, isn’t a reason to supplement feeds or suspect low milk supply.
Expect milk to “come in” or increase in volume around days 3-5 or longer after birth. Small amounts of colostrum is all your baby needs during this time!
Expect to feed or pump 8-12 times per day OR MORE, very often more than that is normal.
Expect to go without long stretches of sleep especially during the first several months, or often through the first 6 months-1 year. Get support and connect with others in this time, it’s hard but you are not alone!
Expect baby to gain 0.75-1 oz a day (5-7oz a week) for the first several months
Expect baby to have frequent wet and dirty diapers (stool slows after the first month but wet diapers will stay frequent)
Expect 0.5-1oz if pumping right after a feed at the breast or 2-5oz if not feeding at the breast. Large freezer stashes aren’t normal or needed!
Expect baby to have periods of normal cluster feeding, gas and fussiness especially during the first few months. A baby fussing doesn’t mean anything is wrong with breastfeeding, don’t let your MIL tell you otherwise.
Cluster Feeding
What’s the difference between normal cluster feeding and not getting enough? Normal cluster feeding looks and feels different for everyone but happens due to: lower milk supply at night due to normal hormone fluctuations, growth spurt or developmental changes, or your baby needs some kind of soothing.
Growth Spurts: 2 Weeks, 6 Weeks, 8 Weeks, 3 Months, 6 Months (+/- some amount of time for individual baby differences). Cluster feeding due to growth spurts often occur within the time that other big development or skills happen. These changes can lead to disruptions in sleep patterns or finding a new “normal” of sleep pattern. Your baby is growing and telling your supply to kick it up when needed. This is a good thing and in the meantime get comfy on the couch to do nothing else.
Responding to every hunger cue and feeding on demand (even if very frequent) is key to establishing a good milk supply. And be assured that your body will likely respond to what your baby needs!
Capacity and Storage
Everyone’s milk making tissue and anatomy is different but larger breasts do not equal larger milk storage capacity. Smaller breasts can make just as much as other sizes!
That being said, someone’s capacity and storage will likely impact how often someone will feed or need to pump in order to maintain a full supply that feeds their baby. For example: someone who only pumps 2 oz at a time but pumps 12 times a day will have the same amount as someone who can pump 4oz with only 6 times a day. Neither is right or wrong but BOTH are enough to feed their baby.
Breasts are a river, not a lake. They are never truly empty and supply varies from minute to minute.
Other factors affecting supply can include:
Baby’s age
Time of day
Time since last feed or pump
Efficacy and fit of pump
So we’ve gone over all the normal expectations for supply and differences in supply. Is there ever actually low supply for people? Unfortunately, yes. There are lots of reasons someone may have low milk supply and lots of ways to plan for the future even with a low supply.
Possible Reasons for Low Milk Supply
Poor removal or inefficient removal (either by baby or pump) especially during early weeks post partum. Get help EARLY if something isn’t going right!
Long stretches of sleep or infrequent removal (either by baby or pump) in early weeks post partum
Scheduling of feeds and not feeding on demand of baby
Supplementation without addressing/protecting milk supply
Retained placenta
Insufficient glandular tissue, not enough milk making tissue (very rare, around 2%)
Hormonal conditions or medical concerns
When to be concerned about low milk supply: Baby isn’t having enough wet or dirty Diaper. Weight gain is lower than expected over time. Baby isn’t satisfied after feeding (outside of normal cluster feeding).
Getting Help
Get help by reaching out to an IBCLC to address concerns and assess perception vs reality of your milk supply. An IBCLC can assess latch or oral function, review relevant history, discuss pumping and provide an individualized care plan to help you meet YOUR GOALS. There is no right way, only the right way for you!
