Low Supply

Breastfeeding is a supply and demand system. Whatever your baby needs, your body will produce. Your milk is made fresh each feed in response to the suckling stimulus. The more your baby breastfeeds, the more milk you will produce. If your baby acts hungry, feed more frequently for a few days. Your supply will increase and your baby will settle into a new feeding pattern.

Generally, there is no need while breastfeeding to supplement your baby’s feedings with formula or water. If you are concerned your baby is not getting enough milk, see ‘How do I know my baby is getting enough milk?

If you notice there are signs that your baby is not getting enough milk, the following suggestions should help your supply meet your baby’s needs..

Increase the frequency of breastfeeds

Breastfeed your baby at least every two hours during the day. If your baby has been sleeping for more than two hours, wake it up for an extra feed. Consider waking your baby for at least one extra night feed, especially if you have a baby who sleeps for more than a four or five hour stretch at night.

Don’t wait for your breasts to “fill up” to tell you when it’s time for another breastfeed

There is always milk in your breasts for your baby, and more milk is made while you breastfeed. Studies have shown that fat levels in milk are higher when the time between feedings is shorter. This means when you offer the breast again minutes after the last feeding when your breasts may still feel “empty”, your baby is getting the high-fat milk that makes those cute chubby babies.

Offer the breast more often

The first golden rule of breastfeeding ‘Supply=Demand’ implies that babies will demand the milk they need. Like every rule, there is always the exception. Some babies, especially sleepy babies and those that are naturally undemanding, may not breastfeed as frequently as they need to without Mum forcing the issue a little. If this sounds like your baby, you need to take the lead and give your baby more frequent opportunities to breastfeed. Lots of skin-to-skin contact, night breastfeeds, breastfeeding in a sling or having a bath together will help to stimulate longer, more frequent feedings. If your baby has really long sleeps and doesn’t appear to be getting enough milk you will need to wake your baby up for extra breast feeds. What? Wake a sleeping baby, are you crazy? Afraid so. If you need to give extra feeds and your baby doesn’t care, you will need to wake your baby up.
Waking a sleeping baby

These are based on Dr. Sears recommendations for waking a Sleeping baby found at askdrsears.com. They are fabulous, gentle and natural techniques.

  • Try to wake your baby during REM sleep. You can recognise this by fluttering eyelids, little smiles, clenched fists, and limbs that are not limp. A baby in deep sleep is harder to wake up.
  • Prod and poke your baby a bit. Undress your baby down to the nappy, get yourself top less and place your baby skin-to-skin against your tummy and breast, while you drape a towel or lightweight blanket over baby’s exposed back and head. Your own body heat should keep him toasty warm (a mother’s skin temperature automatically goes up a bit while breastfeeding) but not so toasty that your baby falls asleep.
  • If that doesn’t work, hold your baby upright and talk encouraging him to open the eyes.
  • Instead of the usual bonding positions (which relaxes babies), straighten out your baby’s body and extend the arms – these postures perk up the brain- Nifty!
  • Stroke the palms of the hands and soles of the feet to help your baby wake up.
  • Rub your baby’s face with a cool washcloth- O.K this ones not so gentle, but it generally works.
  • Hand express a few drops of colostrum or milk. Using your tantalising leaking nipple, tickle the lower lip to stimulate your baby to open the mouth. Talk to your baby while you are breastfeeding to keep him stimulated. If he nods off, stroke the legs or pat the back.
  • Get in the habit of changing sides as soon as your baby begins to nod off.
  • If your baby drifts off after only a few minutes of breastfeeding, take baby off the breast and help him wake up again before changing sides. Wake your baby several times if you have to, until there has been at least ten or fifteen minutes of good sucking.

Have long breastfeeds

Don’t limit the length of your baby’s breastfeeds to a predetermined number of minutes on each side. Allow your baby to finish the first breast before changing sides. This will give your baby an opportunity to fill up on the high-fat milk brought down by the later let-downs. If you change your baby to the second breast too soon, you won’t completely empty the first breast which means that next time the breast won’t make as much milk.

Change side often

The advice in the previous point about finishing the first breast first may not work well for babies who suck at a leisurely pace or who fall asleep a few minutes into a breastfeed. Changing sides often will encourage a baby to suck more vigorously for a longer period of time allowing more nutritive sucking time. You can try to let the baby feed on the first breast until the intensity of the suck and swallow diminishes. Before baby drifts off into comfort sucking, swap over to the other breast. This will encourage another letdown and baby will have to drink vigorously again.. When the sucking action slows again go back to the fist breast, and keep doing this until your baby has had enough milk and you feel that your breasts are empty.

Give top up feeds

Some mothers find this a good adjunct or alternative to changing sides often. After you finish the feed and baby seems content, hold or carry baby upright and awake for 10 to 20 minutes, allowing any burping that needs to take place. This makes room for more milk. Feed your baby again from both breasts. This will stimulate more let-downs which will increase the volume and energy content of your milk.

Undress your baby during breastfeeds

Skin-to-skin contact helps to wake up a sleepy baby and stimulates less enthusiastic feeders. Undress your baby down to the nappy. To maximize skin contact, take off your bra and wear a shirt that you can unbutton all the way down the front, better still take off your shirt all together. To prevent your baby from getting chilled you can place a blanket around the two of you. Remember also, that warm fuzzy feelings make milk and skin to skin contact makes warm fuzzy feelings. This is the effect of the bonding hormone oxytocin.

Sleep with your baby

One of the most powerful ways to stimulate increased milk production is to take your baby to bed and breastfeed at will. This relaxes both you and your baby and stimulates longer and more frequent breastfeeds. It also increases your levels of prolactin and oxytocin, the hormones that make milk and that make breastfeeding an enjoyable experience.

Sling feed, topless

Naturally, keeping baby nice and close to your breasts will entice him to eat more. Wear your baby in a baby sling between breastfeeds, even while your baby is sleeping. In fact, some babies feed better and more often when on the move. Again, this is skin to skin contact, the easiest hormone producing, milk making method there is.

Focus on breastfeeding

Expect nothing of your self except to breastfeed your baby. What activities and worries are draining away energy that could be better spent looking after yourself and your baby? Are you trying to do too much, are you taking enough time to sit down to feed and enjoy your baby? To make more milk for your baby, you have to make breastfeeding and taking care of yourself a priority. Let go of other responsibilities for a while. Have your partner share in non-feeding baby care, so that you can rest, take a walk, or take a shower.

Get household help

Get help with laundry, dishes, cooking, and cleaning. If you have a demanding toddler, get someone to come to your house after school to entertain your older child and give you a few hours of relief so you can sit and relax and breastfeed your baby. If possible you could ask your partner to take time off work for a few days so that you can concentrate only on breastfeeding and making milk.

No bottles, No dummies (or pacifiers)

When there are concerns about weight gain, all of your baby’s sucking needs to be done at the breast. Bottles of formula will interfere with the delicate balance between your milk supply and your baby’s need, as will satisfying your baby’s need to comfort suck with a dummy or pacifier. If it is medically necessary to give your baby supplementary formula feeds, speak to a lactation consultant about a supplemental nursing system. Also ask the lactation consultant to show you how to use it. I’ve spoken to a few mothers who have managed to tangle themselves and their babies up in the tube.

Enjoy your baby

While you are feeding, stroke and calm your baby using a lot of skin-to-skin contact. Enjoy looking at and feeling your baby. This will help your let down reflex. Between breastfeeds and immediately before a feeding, imagine your baby breastfeeding and your breasts pouring out milk to satisfy your baby.

Get professional help

Contact your local breastfeeding counsellor and/or a professional lactation consultant for help increasing your milk supply. A lactation consultant can help you evaluate your baby’s attachment and suck so you can be certain that baby is breastfeeding effectively. Support from a breastfeeding counsellor will help you feel more confident about your ability to breastfeed your baby.

Trust your body

If you’re breastfeeding often enough, and you baby is sucking effectively, you will make enough milk. It’s rare that a mother is unable to produce enough milk for her baby. And while it may seem that your life is stressful, mothers throughout history have breastfed their babies through war and famine. There’s no reason to think that you won’t succeed at breastfeeding.

Massage and heat

These can encourage your let down reflex. If you are having trouble getting a let down try this before you feed your baby.

Apply a warm compress to your breast, such as a warm towel or cloth nappy soaked in warm water. Then, with your fingertips, stroke from the top of the breast down and over the nipple, using a light touch. This helps you to relax and helps to stimulate the milk making hormones. Massage the glands and ducts by pressing the breast firmly with the flat of the fingers into the chest wall, beginning at the top and working in a spiral down toward the areola. Massage in a circular motion a few strokes at a time before moving to another spot. While leaning forward, gently shake your breasts, allowing gravity to encourage the stimulation to release milk.