What causes low milk production?

Sometimes a delay in the time when your milk comes in turns into an ongoing problem with low milk production. You may have been producing enough milk. But then milk production slowly, or quite suddenly, decreases. It's normal to worry about your milk production. But know that there are a few normal things that happen when breastfeeding. First, about a few weeks to a month after birth, a nursing mother's breasts will feel softer and seem smaller than before. This is normal and does not mean your milk supply is too low for your baby's needs. Also, your baby may sometimes increase how often he or she nurses in order to increase your milk supply. This is called cluster feeding. It is also normal. It does not mean there is a problem with your supply. True milk supply problems can often cause a baby to show signs of hunger, fussiness, or poor weight gain. 

Some of the conditions linked to a delay in milk coming in may also have an ongoing effect on milk production. These include:

• Conditions from a baby's delivery, such as Caesarean delivery, premature birth, stress during birth, and certain medicines

• Excessive bleeding (severe postpartum hemorrhage)

• Some pieces of the placenta stay in the mother's body (retained placental fragments)

• Thyroid conditions, polycystic ovarian syndrome, diabetes, or obesity

• Past breast surgery that cut some of the nerves, milk-making tissue, or milk ducts

• Not enough glandular breast tissue

Other things can also lead to low milk production. Maternal smoking and alcohol consumption has been shown to result in less milk. Some medicines and herbs can also decrease milk production. Hormonal forms of birth control have been found to have a big impact on milk production. This is especially true for birth control that has estrogen. But some mothers have a drop in milk production even after taking progestin-only birth control during the first 4 to 8 weeks after delivery. Milk production may also decrease if you nurse or pump less often than you did before, get sick, are stressed, or get pregnant again.

If low milk production seems to be a problem, but your baby seems to be sucking effectively talk with your healthcare provider or certified lactation consultant (IBCLC). They may advise you to:

• Increase the number of times you breastfeed or pump to 10 to 12 times in 24 hours.

• Increase the amount of skin-to-skin contact you have with your baby. Take off your shirt and baby's shirt and place your baby on your chest with a sheet or shirt over both of you.

• Review your health history with your provider or lactation consultant. This may help to find out if a health condition, treatment, or medicine is interfering with milk production.

You also may want to:

• Pump your breasts for a few minutes after breastfeeding.

• Think about renting a hospital-grade pump if you think you'll need to pump for a long time. 

• Ask your healthcare provider or a certified lactation consultant about taking a galactagogue. This is a medicine or herb that increases breastmilk production.

Think positive. Low milk production often can be reversed. But any amount of milk you produce is valuable for your baby.