You’ve read the books and blogs. You’re doing “all the things”. You may have even talked to your health provider about your concerns. But what if you are still experiencing low milk supply? What if you're not getting the answers you're looking for? What's next? Let’s discuss why you might still be experiencing low milk supply and how to take the next steps to get things moving in the right direction...
How common is low supply?
According to the Low Milk Supply Foundation, up to 15% of lactating parents experience chronic low milk supply. In fact, low milk supply is a common reason for weaning earlier than desired. If you are experiencing low milk supply and not ready to wean, you are not alone and there is help available!
Why does it happen?
Low milk supply can happen for a variety of reasons. Some things you have control over, some things you do not. Practices that promote optimum supply include allowing breastfeeding whenever your baby desires at least 8 times in 24 hours, breastfeeding at night, skin to skin and snuggle time, delaying pacifier use until lactation is well established and not limiting time at the breast or going too long between feeds. But what if you are doing “everything right” and you still aren’t making enough to meet your baby’s needs?
I think I have low supply. What should I do first?
First and foremost, I highly recommend a breast evaluation, oral assessment and feeding assessment by an IBCLC. Often, a lactation professional can help you identify and manage the secondary causes of low milk supply. These are the issues like shallow latch, management issues such as limiting time at the breast and infrequent milk removal. Secondary issues, if present, should generally addressed first to optimize lactation. When corrected, can make a huge difference in milk transfer and thus improve supply! If you're pumping, I also highly recommend a professional flange fitting session. In my experience most of my clients are pumping with the wrong size...usually too big. When corrected, milk supply often takes a turn for the positive because the breasts will be much more efficiently drained. But what if it's still not better after optimizing everything you can? It can be so frustrating to not have the answers and you may be experience a primary cause for low supply.
I've seen an IBCLC and still don't know why my supply is low. What next?
Primary causes for low milk supply are caused by medical conditions or anatomical issues in the mother. Primary causes will generally not improve on their own with time but, if identified, can often be managed! These health conditions (whether you know you have them or not) can affect the hormone balance that is so key to optimal milk supply. These include thyroid imbalance, polycystic ovarian syndrome (PCOS), gestational diabetes or insulin resistance, insufficient glandular tissue (IGT), micronutrient deficiencies, anemia and others! Medications that impact prolactin levels or tobacco use could also be the culprit. Unfortunately, getting a diagnosis can be a challenge.
Who should I call for investigation of primary low milk supply?
Your provider may be excellent at many things but most, unless they have sought out additional training, are not experts in the field of lactation. Your best bet is to find a Breastfeeding or Lactation Medicine Provider that can walk through the steps of finding the root cause of your low supply. Some MDs or DOs have additional training and expertise in this field. There are also Nurse Practitioners (like me!) that specialize in Breastfeeding Medicine! If you don't know of a local or telehealth provider that can help, ask your IBCLC! She is a wealth of resources and often has connections to specialists. You can also search the LactMap for Breastfeeding Medicine providers your area.
What happens during a visit focused on low milk supply investigation?
First, your provider will take a detailed history about you and your baby's health, pregnancy/birth details, breastfeeding experience and more! Labwork will be recommended based on your unique history and likely factors that are impacting supply. There is not a "one size fits all approach" and everyone's lab plan looks a little different! After labs are resulted, you'll discuss and get a targeted plan for moving things in the right direction!
If you live in select States, I can help you!
I have full Nurse Practitioner licensure in a variety of States...currently Florida, Idaho, Iowa, Nebraska, New Mexico, Vermont and West Virginia with more to come! My specialty is Lactation Medicine and I love helping families work through low milk supply! I can offer personalized help as you search for solutions:
✓ Hassle-free Telehealth appointments with a Nurse Practitioner/IBCLC
✓ Comprehensive health history review and discussion of your lactation goals
✓ Individualized recommendations for lab work
✓ Lab order to draw at center of your choice (or insurance preference)
✓ Self-pay labs also available at wholesale pricing to save you $$$
✓ Visits often qualify for insurance coverage through the Lactation Network (TLN). You can start the pre-approval process here.
✓ For many conditions, I can to support you with continue management and lab monitoring
In conclusion, if you are experiencing low milk supply, you are not alone! Please reach out for help from your IBCLC and move on to next steps if needed! If you are having trouble locating a suitable Breastfeeding Medicine Provider, please reach out to me and I will do my best to connect you with someone that serves your area. You can get in touch here.
Information presented is educational only and not to be taken as medical advice. If you have specific questions about low milk supply in the context of your unique health profile, let’s do a video visit and talk about it!
Additional Resources:
Low Milk Supply Foundation – a wealth of information!
Facebook: IGT and Low Milk Supply Support Group and Instagram: Low Supply Mom
Photo credit: Markus Winkler via Unsplash