Concerned about low supply?

What's the deal with making enough milk?

By Emma Biggar, IBCLC

Last updated 5th October 2019

There can be so many mixed messages out there about what is normal and what isn’t. We might hear stories of others who “didn’t have enough milk” or whose milk “dried up suddenly” which can leave us feeling unsure about our own ability to make enough milk. If these are the only stories we are hearing it’s understandable that this may have a negative impact on how we view the likelihood of successful breastfeeding. Our understanding of breastfeeding tends to be shaped by cultural beliefs and the stories we hear from the people around us. We tend to accept what society tells us is true but sometimes these cultural beliefs and understandings are not always accurate. Even if you do find yourself experiencing low supply, this doesn’t have to be the end of your breastfeeding journey. Breastfeeding doesn't have to be an all or nothing thing and there are certainly ways to boost and maximise milk production but it can be helpful learning to distinguish between breastfeeding myths and truths to understand more clearly what is happening in order to find the best solution moving forward. Knowledge is power.

Humans are mammals with breastfeeding being the biological normal way to feed an infant. In fact, the word “mammal” is the English version of Modern Latin “Mammalia” meaning “of the breast” which was first introduced in 1758 as a way to distinguish the class of animals that have a mammary gland to feed their offspring. The word “mammal” is literally referring to breastfeeding. We would not have survived as a species if lactation was so easily compromised. While it is true that some women find they can’t produce enough breast milk, primary causes of low milk supply are rare. So what is happening? Why does it seem like so many women are having difficulty making enough milk?

It’s important to distinguish between primary and secondary causes of low milk production. Primary causes originate within the mothers own body but is not common.The majority of the time, perceived low supply is actually a secondary cause where a mother will start out with a full supply or has all the working mechanics to establish a full supply but then something happens along the way that interferes with the milk making process.

So what happened? Firstly, it’s important to understand what is needed to establish and maintain an adequate milk supply. The initial part of the milk supply equation is having all the working mechanics. This actually began before you were even born with the development of mammary glands around the sixth week of gestation. During puberty, further breast development occurs but it’s not until pregnancy that these glands become fully mature, ready for the production of mature milk. Following birth and the removal of the placenta, there is a huge shift in hormones signalling to the body to begin making copious amounts of breast milk. Prior to this, the breasts had been busy making colostrum which began during pregnancy. Sufficient glandular tissue is but one component of the working mechanics required. You also need to have intact nerves and ducts as well as the correct level of hormones and hormone receptors. Surgeries such as breast augmentation and biopsies can disrupt the nerves and ducts. Hormonal imbalances can also jeopardise our bodies ability to make milk. This can be caused by retained placenta or because of a new or pre-existing conditions.

The second part of the milk making equation is stimulation and frequent, effective removal of milk. Breast milk production works on a supply and demand basis. It’s the removal of the milk that tells your body to make more and how much to make. Without this our bodies get the message that the milk is not needed and so shut down production. Notice how I said “frequent” AND “effective”. If breastfeeding is not effective then there is a good chance this can impact on supply, even if you have all the working mechanics. It is almost always something from this part of the equation that originates the low milk supply.

Some mothers might feel they are stuck with the equipment they got and that there is nothing that can be done or that they simply just “can’t breastfeed” so it’s not worth bothering. Sometimes women think it runs in families; that their mother had trouble breastfeeding so it’s inevitable they will too. Genetics can play a role but more often than not the perceived low supply can be traced back to misinformation. The truth is, there is almost always things you can do to improve milk production that are certainly worth trying.

If you are concerned about low supply the first step is to determine whether your baby is getting enough milk. Click here to read about the signs that your baby is getting enough breast milk. If you have gone through the checklist and still feel like you might have low supply the next step is to work out why. This will guide you on what to do and plan of attack in moving forward. Click here to read more about ways to increase supply.

Click here to return to blog homepage

Emma Biggar is an International Board Certified Lactation Consultant (IBCLC), Registered Nurse and mother of three. Emma provides in-home breastfeeding and early parenting support to families in the Eastern and South Eastern suburbs of Melbourne. Click here to read more about the types of services available or here to visit the online booking page. Contact Emma by email here or visit her website or Facebook page.