How to Increase Your Milk Supply (Realistically)
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How sad is it that the real reasons why moms aren’t making enough milk for their babies isn’t being talked about?
If you are reading this, there’s a good chance you have spent hours searching on Google, reading articles, and watching YouTube videos on how to make more milk. You’re looking for something to tell you what you need to do next, what food you need to eat, whatever it is to make more milk for your baby.
I’m going to break down a variety of things that can cause a low milk supply and what you need to know in order to figure out how to address this. I wish I had a resource like this when I was going through my low milk supply journey including not only the best practices that are standard to increasing supply but also the things that nobody ever seems to talk about.
Breastfeeding Basics: The best practices
First, let’s make sure you are doing the things that you’re supposed to be doing in order to try and increase your milk. The foundational component is “supply and demand.”
Supply & Demand (More like Demand & Supply)
I’m sure it’s a phrase you have heard at this point, and it is actually demand and supply; demand comes first. You have to have enough demand in order to signal your body to produce milk. you need to make sure you’re doing eight to 12 feeds a day. I say aim for at least 10, not eight because mom-life happens.
Maybe you slept a little longer than you were supposed to in between feeds and now you’re feeding later than you intended. Maybe you have other kids that depend on you. I say aim for 10 because you will be likely falling a little short in your average of feeds you are doing so this just cover your bases to make sure you’re getting enough milk removals in a 24-hour period.
This also means don’t skip night feeds. These night feeds are important! I know you’re tired but you need to make sure that enough milk is removed throughout the whole day to signal your body to increase production. You can’t cram eight to 10 feeds in a 12-hour window; your body doesn’t work that way and neither does your baby. Humans were designed to feed around the clock, it is just the biological design.
Now you might be like, “I have been doing a lot of demanding lately and my body is not responding.” Keep reading to make sure you have all the best practices down and then rule out the other issues I outline below.
Breast massage and compressions
Massage and compressions can help when you’re trying to get your milk flowing. The stronger it flows the more intrigued your baby likely will be and they will be encouraged to keep emptying your breast during the feed.
But I’ll be honest, there is not enough massage in the world that can increase your milk supply. So just do this as a supporting practice. This alone won’t bring up your supply.
Watch your baby, not the clock
Watching the clock can be really bad for your supply. The exception here may be if you have a sleepy baby or even jaundiced. They may fall asleep and not finish a feed so work with a lactation specialist for specific instructions. Otherwise, your baby should be alert when awake and ready to nurse.
They respond to being ready to breastfeed by giving you hunger cues and you don’t typically have to wake them to nurse. In this instance, you don’t need to watch the clock because your baby will tell you when they are done and when they’re satisfied. If you received advice to only feed 10-15 minutes each side, ignore that. That’s a guideline, not a requirement.
By watching the clock instead of watching your baby’s cues, you can hurt your supply because your baby isn’t being given the opportunity to finish emptying your breast. That’s an important process to signal your body to up production.
Unnecessary supplementation
Another thing that you can also be hurting your supply is providing unnecessary supplementation. There’s grey area here because you may have been told to supplement by a provider, like a pediatrician or a lactation consultant. In this instance it would be appropriate to supplement (although it doesn’t hurt to get a second opinion, preferably from a lactation specialist since some providers can prescribe too much of a supplement as well).
However, if you are providing the supplementation on your own accord, just be cautious and get a professional assessment because this is something that backfire. If you think your baby’s not getting enough when they really are, then you’re giving them more than they can consume which will make them overly full. This will make them go longer between feeds and that will hurt your supply because that demand isn’t happening as often.
Nix the pacifier
Pacifiers are another thing that can hurt your supply so it’s something you should minimize or completely remove altogether. This is because it can prevent your baby from giving you their hunger cues when they are ready to breastfeed if they’re occupied with pacifying.
One-sided nursing when you have two breasts
One side of nursing is not recommended when trying to increase your supply. This is not common for most moms in order to produce a full supply for their baby.
Yes, there’s twins or triplets and sometimes mom’s can go on to feed that many babies but that’s the exception, not the rule. There’s a reason you have two breasts. So use both to make sure your baby’s being fed.
Hydration is two-fold
Drinking enough water is important since it makes up over 80% of your breastmilk. But being fully hydrated is one of the things people don’t talk about enough. Hydration is two-fold: water and electrolytes.
If you are drinking a gallon a day and you still aren’t making enough, it’s not the water that’s your problem. Make sure you are drinking to thirst but no need to overdo it either. Electrolytes, on the other hand, is something you may want to consider adding or supplementing to your regimen.
You could be deficient in electrolytes, which are important for many bodily functions, and is required in general for you to maintain optimal levels of health. And that is what you are striving for because something is optimally “off” if you are not able to produce enough milk.
Quality matters though. Please don’t buy Gatorade, Powerade, or any of those “blue drinks” that you may hear about getting; those don’t help. They’re just full of sugars and garbage when you really need to get something that is a high quality product.
My favorite brand is LMNT because they have more than just sodium. They include potassium and magnesium too. They’re not filled with all kinds of extra fillers and doesn’t have any sugar in it, which is really good (which we will cover why that matters when trying to increase your supply when we talk about inulin).
(Try to) reduce your stress
Take this with a grain of salt but try to reduce your stress. Now, you just had a baby, you’re struggling with your supply, breastfeeding isn’t going how you wanted, and who knows what else is going on in your life.
I get that this is a very frustrating statement to hear sometimes, but this is something that we want to aim for. I know a lot of moms who have undergone stress through their early postpartum period and have gone to produce a full supply. So I wouldn’t say stress is the end-all-be-all to your supply.
We want to reduce stress so you can try to minimize your cortisol from spiking. It can have a negative impact on your supply.
Just try to minimize it to the best of your ability and give yourself grace because you are in a season right now where it’s very hard and you are doing your absolute best. You are killing it! And the fact that you are here trying so hard to feed your baby shows that you really, genuinely care about your little one so cut yourself some slack.
Skin to skin cuddles 🥰
Skin to skin would be another thing that is frequently recommended and there are many benefits. But if your baby is living on your bare chest 24/7 and you’re supply is still not going up, then skin to skin is not going to be the only thing to fix your problem.
Check your latch
Last but certainly not least, you want a good latch because without it your baby can’t transfer milk efficiently and appropriately. So if you have not had your baby’s latch assessed, then you would want to have a lactation consultant do that for you.
Just be wary that even if it “looks good” but it doesn’t feel good, then there’s something not right with the latch. A good latch shouldn’t be painful. There’s a variety of things that can cause this which is why it should be professionally evaluated (read more on oral ties below).
I’m doing all of this… what now?
Now we’ve been over the breastfeeding basics you should be doing in order to increase your supply. You’re at this point and saying, “Great. Now what?”
Next, I’ll go over what are known as primary and secondary low milk supply causes. You need to pinpoint the issue before you can tackle it in order to try and increase your milk supply. This is what you’ll NEED to do if you want to maximize your odds of exclusively breastfeeding. To get a free summarized PDF version of these causes click here!
Primary causes are things that are going on internally with your body. Secondary causes are external factors outside of you that are impacting your milk supply. You could also have both primary and secondary issues at hand, and all of these factors I’m about to go through, you can have multiple ones impacting your supply. In fact, it’s very possible.
There’s one book that’s really good and I recommend it to everybody who wants to learn more about these different primary and secondary factors. It’s what I call the “Low Milk Supply Bible.”
It’s called Making More Milk: The breastfeeding guide to increasing your milk production by Lisa Marasco and Diana West. This book is fantastic!
It covers a lot of the things that I’m about to go over with you but a lot more thoroughly because I cannot write out every detail in just one blog post.
Here’s the thing, I know you are in a postpartum period and you don’t have the time to read a book right now. I don’t blame you — I didn’t either.
So I’m going to go over the things that are probably the most common or most frequent occurrences you may face. This is not an exclusive list. We’re dealing with the human body and everybody has their own underlying health and biological factors involved. It’s not something I can even begin to address in entirety so double check with your doctor what may be appropriate for you.
Secondary Issues Causing Low Milk Supply
Let’s dive into secondary first. Again, these are the external things that can impact your supply. And while this is something that doesn’t mean you’ll have a low supply, it is sometimes dismissed or minimized. You may be told you can make enough milk but in reality your problem will continue unless you address the underlying issue at hand.
Let’s say your baby isn’t breastfeeding efficiently or properly, no matter what you do to increase your supply (such as pumping), once you get it up and your baby goes to breastfeed, they’re not creating the demand to sustain that supply you’ve established.
This is why it’s important to uncover secondary issues. Sure there are moms who exclusively pump and you could do the same, but if your supply is going up while pumping, there’s a good chance there’s a secondary factor involved.
While you’re trying to rule out any secondary issues, you can be incorporating pumping into your regimen (if you’re not already doing so).
Nutrition: What (not) to eat
Nutrition is really over-generalized when it comes to breastfeeding. There are some things that are actually important to acknowledge. Certain foods can hurt your supplier and other foods can help your supply. Food, teas, and herbs that can help your supply are called galactagogues.
If you are trying to increase your supply and you think that you can just magically eat your way through to the results that you want, (while possible for some) typically isn’t likely. And please, do NOT try to increase your supply with lactation cookies! We’ll cover that when I go over hormones but, just know they are full of garbage and are possibly hurting your supply.
Nutrition matters because there are important nutrients that go into producing your milk. That’s what these galactagogues come in; they fuel your body with nutrient dense foods that make up for where you may have a deficiency, and so that is why and how they are able to work. Some of these nutrients include Vitamin D, Vitamin B12, calcium, zinc, and protein.
Protein is really important. It’s a building block for your hormones and your milk is made from hormones. So if you don’t have enough protein, your body isn’t going to be able to support the milk production required.
My go-to galactagogue resources
There are two books I would also recommend on galactagogues. First, A Mother’s Garden of Galactagogues by Hilary Jacobson is great! I have gone through this one and she talks about not only the herbs and the foods, but also growing them. (If you’re not in the mood to garden, I don’t blame you.)
Nonetheless, it still has all of the points in here about the lactogenic benefits of each of these foods, so you can go in through this and skim for the parts that are actually based for lactation and not what’s best to grow them.
I also recommend Mother Food because it is also by Hilary Jacobson (although I’ve yet to read it entirely). It’s a lot bigger than her other book but it goes over the things that are good for not only promoting milk production, but it covers mother’s health, special sections for colic, allergy, post partum depression, and low milk supply (hello, right up our alley).
There are things covered in here that can hurt your supply and there are thing that are known for helping with supply but their may be special exceptions applicable to you due to underlying health conditions.
An example could be fenugreek, which is probably one of the most known galactagogues and it is used in a lot of lactation teas and products. Most people don’t know that fenugreek can actually suppress your thyroid. So if you have hypothyroidism then you might be in trouble because it can suppress that thyroid function, which is important for lactation.
So in that case it’s not going to help your supply, it’s actually going to hurt it. This book helps cover other galactagogues like that when it comes to contraindicators you need to be wary of. Please don’t take supplements blindly because otherwise you’re just shooting an arrow in the dark. It may or may not backfire.
Tight spaces, tight muscles
When it comes to secondary issues, there’s things that could be going on with your baby. Secondary issues with your baby could include things like tension, oral ties, and palate and jaw issues.
Tension can happen to your baby just like when you get a little crick in your neck from a bad night of sleep. If you think about the position and the tight space he or she is crammed in your womb, it’s not the most roomy. As they get bigger tension can occur during pregnancy, and so it makes breastfeeding harder if they have some type of muscle that’s tight when they are born. If any extraction tools were used during delivery, this can also cause tension on their head.
Now they are unable to breastfeed efficiently because that tight muscle is pulling on their jaw and they don’t have the proper traction in their jaw to be able to get that good latch going.
If your baby has tension, they may bite instead of suck at the breast. So that is something you would want evaluated by a pediatric chiropractor, an occupational therapists, or a physical therapists. They do work with babies who have tension, and you just want to get that tension released. Cranial sacral therapy is also another option for babies who have tension.
You would also want to see a lactation specialist who is well-versed in things such as tension as well as oral ties.
Oral ties: Lip, Tongue, and Buccal (Cheek)
Oral ties can affect your baby’s range of motion when it comes to getting a proper latch by limiting proper oral function. Some people say oral ties are a fad — that is not true; they are absolutely real. There are just different types of oral ties and they even range in severity which is why someone who is uneducated in ties dismisses them so easily.
Make sure that whoever’s assessing your baby for oral ties has received specialized training in order to properly diagnosis them. By all means DON’T let it be your pediatrician (they are great at many things, but oral ties is that one of them). It’s not general medical knowledge they would’ve received when getting their medical degree.
The person who is doing this evaluation has to know how to properly assess for them and needs to have that background knowledge. People who would be really great for those would be a lactation consultant who is specialized in oral ties, an ENT, or a pediatric dentist who also has that background.
Palate and Jaw Deformities
Palate and jaw issues could be things like a cleft palate or cleft lip, a high bubble palette, and more. You need to see a specialist in that instance but they are far less common than tension and oral ties. I’d go to an ENT or a pediatric dentist as well. You could find a little bit more information on these in Making More Milk.
Miscellaneous Factors
So that would be most of the secondary issues but another one to make note of is if you had anything occur during your pregnancy or labor. Did you have an epidural? That can cause a delay in your milk coming in. Did you have medications during your pregnancy? Some can impact lactation as well.
Again, there is a good chunk of scenarios that are covered in Making More Milk that I would reference if you are trying to figure out if something happened with your pregnancy or labor. They are very nuanced and very detailed, specific circumstances that I cannot break down in one post.
There are also some heart conditions babies can have that can affect your baby’s ability to breastfeed, but also, pretty rare. So just keep that in mind, there might be some investigative work you have to do.
Primary Issues Causing Low Milk Supply
Now, primary issues basically boil down to three buckets; there is trauma, hormones, and then there is anatomical/the structure of your breasts that can have an impact on your ability to make enough milk.
Trauma and Impact
First, let’s go over trauma since it’s pretty straight forward. Did you have a car accident that you were in, where the seat belt cut across your chest in any way? Have you had a surgery or a procedure such as a breast reduction or breast augmentation? That could have impacted your supply. Have you had any type of burn trauma?
I know these are really extreme situations, but these can all impact your ability produce enough milk. If nothing jumps out at you, then there’s a good chance you’re in the clear. But it’s important to note that your mammary glands stretch beyond your breasts; they kind of tuck under your arms towards your armpits and they cross across your chest, regardless of the “obvious” breast tissue.
So if anything in that region across your chest has happened to you, it might be something that you need to have a discussion about with your doctor.
Hormones May Just Be the Biggest Contributor
Other things that can cause it, and I think this is probably the most common and the biggest one that comes to mind for primary issues, is hormones. If you have any history of hormone imbalances, there’s a chance that they have played a role in your low supply.
I’d Bet My Money on Insulin
Let’s go over the main ones. Insulin is really important when it comes to milk production. Most people talk about prolactin (the milk-making hormone) and oxytocin (the hormone that lets your milk flow when babies are nursing), but not everyone talks about insulin and insulin is really important with both glandular tissue growth and mature milk production. So it has multiple roles in breastfeeding and if you have a history of insulin issues spanning from insulin resistance up to diabetes, then this could be a culprit behind your low milk supply.
Insulin related health issues are so prevalent that I honestly would say it’s the biggest root cause for many moms. Here in the US there was a study that was done by researchers at the University of Alabama at Birmingham, and it showed at least 40% of the American population is estimated to be insulin-resistant, and they found that you don’t have to be overweight to be insulin resistant (1).
And then on top of that, there was another study by the University of North Carolina that found that 88% of the American population has poor metabolic health, and that ties into your insulin as well, and they used five markers to determine what was considered for determining poor metabolic health that was blood glucose, triglycerides, HDL, cholesterol, blood pressure, and waist circumference (2).
The only way to evaluate if you fall within optimal or at least a normal range for those markers is through bloodwork. If you are in a state of poor metabolic health, you could be insulin resistant and this could be impacting your milk supply. This is something where you now need to go to your doctor and request blood work (and that is a process all on its own here in America 🙄). We do not have the best system that looks for the root cause or root problem; it treats the symptoms of our diseases.
Thyroid Hormones Can Go Both Ways
Your thyroid hormones, both hypo- and hyperthyroidism, can have an impact on milk supply. Also, if you have no history of a thyroid issue, but now you’re not having an easy time increasing your milk supply, you will want to have your thyroid checked out anyway. Because there’s something called postpartum thyroiditis which is when all was good and well with your thyroid before delivering, and then you have a thyroid condition after having a baby. (It’s much more complicated than that but that’s a simple way of summarizing it.) So get a full thyroid panel tested along with your bloodwork.
PCOS (Polycystic Ovary Syndrome)
Lastly, there is PCOS. The CDC reports that 6-12% of reproductive-aged women have PCOS here in the US (3). If you have a history of PCOS you should know that it has also been linked to insulin resistance. In fact, there are researchers and scientists that say you should also be treated (or even at least assessed) for insulin resistance in addition to you PCOS symptoms because there is such a strong connection between the two (4).
In Summary: Hormones Control Your Milk
These are the biggest hormone-related issues that can cause a low milk supply. There are other hormones so it’s possible that they could be affecting your body in some way as well. Your hormones all have a relationship with one another. They’re interconnected; when one is off, the others fall out of place as well. If one cog in the wheel is off or not working right, then they can all get muddled up.
So that also could tie into your letdown reflex. Your letdown is what allows the milk to flow and that’s done through oxytocin, like I mentioned, and again, this is just all tied into your hormones, so there’s that
Anatomical Hurdles
The last area I want to address is your breasts structurally, on an external and internal level.
External bits
So you could have a hard of time breastfeeding if you have an external issue with your nipples. If you have inverted nipples this can make it challenging to get a good latch, but usually if you work with a lactation consult they will typically have tips and tricks on how to work around various situations. I wouldn’t say most are reversible; you can’t reverse your anatomy. But there’s things that you can do to help with getting that proper latch from your baby.
There’s also receptor sites on your nipples and areolas. So if you have any history of trauma, such as a procedure or surgery where they did an incision around your nipple area, that could impact your ability for your body to receive the signaling required to increase your supply. This is the signaling that communicates the demand to your body, and therefore, increases the supply.
Internal bits
Last but not least, is the internal part of structural issues. One of these scenarios is called breast hypoplasia. This is essentially an underdevelopment of breast tissue and this is something that can happen when your hormones are imbalanced. Your hormones are what dictate breast tissue growth. Some common symptoms can include wide spacing of your breasts, asymmetrical breasts, and one breast that is significantly different in size than the other.
This could go all the way back to puberty. If you had hormone imbalances at the time, there could be an area that didn’t finish filling out as they were developing. As a result, your glandular tissue wasn’t really able to grow in that region. So you could have less glandular tissue and essentially you can produce less milk.
However, you can have breast hypoplasia and still be able to exclusively breastfeed. So it’s not something that once you have you it, you are unable to produce enough milk by any means. It all depends on how much glandular tissue you have to work with in the parts that are fully developed.
Now you may have the opposite be true where you don’t have enough glandular tissue to produce enough milk (breast hypoplasia or not). This is called insufficient glandular tissue, also known as IGT. And that boils down to, again, hormones.
So essentially, when your glandular tissue was developing (partly in puberty but mostly mostly in pregnancy), you had an imbalance in your hormones that prevented your breasts from forming the glandular tissue required to exclusively breastfeed. Most of this growth occurs during pregnancy.
Knowing that hormones drive glandular tissue growth and knowing insulin is a big driver in producing glandular tissue, I’d really recommend looking into your insulin sensitivity. This ties back to how I mentioned you can have multiple primary and secondary factors at hand and this is how each of these can stack on top of one another.
You CAN have breast hypoplasia and IGT simultaneously. But again, you could have breasts that are not hypoplastic in any way and they appear on the exterior to be fully developed breasts but still have IGT. The reverse is also true.
This has nothing to do with size. The size of your breast is developed based off of how much fatty tissue and glandular tissue yo have combined. You can have small or large breasts and be able to exclusively breastfeed.
If you did not have any breast growth happen or occur during pregnancy, they didn’t grow in size, or there was no tenderness, then that is a sign that you could have IGT.
It’s important to note that IGT is a diagnosis of exclusion, so that means you would have to literally rule out everything else on the list I just gave you to be appropriately diagnosed. It’s essentially when a medical practitioner says they’ve looked at every other option and you still can’t produce enough, therefore the only reasonable explanation is you have IGT.
Getting the right help
I say that’s not a good enough answer. We know IGT is a lack of glandular tissue and glandular tissue is grown from hormones, which means there is something off hormonally. So don’t let anybody diagnose you with IGT and not help you figure out further what the heck is going on with your body.
You deserve answers and if there’s some sort of hormonal imbalance you deserve to be treated and cared for in a way where you can deal with not just the symptoms, but the root cause so you can get rid of the underlying health issue all together.
If you want to increase your supply, at the end of the day, you cannot have these underlying causes. You cannot just treat the symptom because the underlying cause is still going to prevent you from making enough milk.
These are all treatable conditions. Every single one of them. We just have to work with the right healthcare providers that know and have the expertise to do so. And they’re out there, they’re not always easy to find, but they’re out there.
So I hope that gives more clarity surrounding how to increase your milk supply. You have to make sure none of these factors are involved or are impeding your ability to increase your your supply. And you definitely should reach out to your doctor at this point to run those labs and make sure that you are in the clear.
If you’re not, ask them what are the next steps to try and address this. That being said, if you need a starting point then I’d recommend Hormone Intelligence by Dr. Aviva Romm.
It’s all about women’s hormones, women’s cycles, and women’s health. She goes over literally everything that you would need to know to get started.
If you have any questions, please drop them in the comments. If you want someone to help you walk through this process, I do work with low milk supply moms and you can feel free to reach out to me at victoria@milmademama.com. I’d be happy to talk about your next steps!
Citations
- Vibhu Parcha, Brittain Heindl, Rajat Kalra, Peng Li, Barbara Gower, Garima Arora, Pankaj Arora, Insulin Resistance and Cardiometabolic Risk Profile Among Nondiabetic American Young Adults: Insights From NHANES, The Journal of Clinical Endocrinology & Metabolism, Volume 107, Issue 1, January 2022, Pages e25–e37, https://doi.org/10.1210/clinem/dgab645
- Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009-2016. Metab Syndr Relat Disord. 2019 Feb;17(1):46-52. doi: 10.1089/met.2018.0105. Epub 2018 Nov 27. PMID: 30484738.
- PCOS (polycystic ovary syndrome) and diabetes. Centers for Disease Control and Prevention. (2020, March 24). Retrieved June 24, 2022, from https://www.cdc.gov/diabetes/basics/pcos.html
- Marshall, John C, and Andrea Dunaif. “Should all women with PCOS be treated for insulin resistance?.” Fertility and sterility vol. 97,1 (2012): 18-22. doi:10.1016/j.fertnstert.2011.11.036