The Low Milk Supply ABC’s You Need to Know

If you are struggling to make enough milk to exclusively breastfeed and you are wanting to try to increase your supply, then these are the ABC’s that you need to know.

A: Advocate

First, you have advocate; you have to advocate for your health. This is not applicable to everybody with a low supply, but you want to rule this out early on. Going to a medical professional, such as your doctor or even a lactation consultant (who can help you start this process), is really important.

You want to communicate with them that you are struggling, you’ve tried a variety of best practices, and you’re still not making enough milk. Then ask them if they can actually help you. Unfortunately, most medical professionals have not received any lactation training in their schooling and won’t be well versed on how to proceed.

That can be really frustrating when they don’t really have the knowledge to help you. This is where a lactation consultant or somebody in the lactation industry who knows low milk supply can help you. Keep in mind that not all lactation consultants are familiar with low milk supply either.

This is why you must advocate for yourself and should keep going to different professionals until you get the support you need. You need to be the one to tell them, “Something’s not right. I need help,” and continue to do so until you find somebody who is able to work with you. Ideally, your doctor will say, “You know what, this is not my expertise or specialty, but let me refer you to somebody who might be able to help you.”

B: Bloodwork

The goal is you’ll find somebody who can order comprehensive bloodwork. Bloodwork is key because there’s a lot of different things that can go into a causing a low milk supply. These include nutrient deficiencies and hormone imbalances. Bloodwork allows you to really rule things out such as PCOS, insulin resistance/diabetes, and thyroid disorders, for example.

These conditions are just some of the most common things that can lead to a low milk supply. However, they are also not an exhaustive list of root causes which is why you’ll want multiple tests ordered. It’s important to note that any type of hormone imbalance can have an effect on lactation because milk production is purely driven by our hormones. So if your hormones are off, it can cause a chain reaction and in turn affect how your body is making milk.

Bloodwork – A word of caution with “normal” results

Bloodwork results can be complicated to read because your results will be compared to “normal ranges.” Normal is good but not great because normal tests to see if you are in a diseased state. This means it’s looking to see if you are headed in that direction and if things are beginning to fail proper functionality.

So what you want to look for are “optimal ranges.” Optimal is really important, but not everybody knows how to interpret results for optimal numbers. This is relatively new science so you will likely need to look at working with an integrative or functional medicine professional who has the training and education to look for optimal bloodwork ranges. Unfortunately, not all doctors who have a traditional, western medicine education are able to do this or need specialized continuing education in order to do so.

Bloodwork Hurdles and Challenges

I also want to mention that not all doctors are always on board to run all recommended labs. This in part is because not all doctors are familiar with low milk supply (or even lactation for that matter). You may find that they are hesitant to order these labs because they don’t think they are all necessary.

It’s also possible they don’t think it’s justified. This is really important if you want to make sure it gets covered by your insurance. However, if you explain how conditions such as PCOS, thyroid disorders, diabetes, and insulin resistance are all conditions linked to low milk supply you may convince them to help you further investigate these.

Another approach could be stressing the fact that you are postpartum and a lot of hormones shift after delivering a baby. So if you tell them “I’m postpartum and I know my body is going through a lot of changes. Even if I’ve never had a history of these conditions before, something may have changed. Can we just double check?”

There’s always the option of paying out-of-pocket. Another strategy is to see what you can get covered by your doctor and insurance. Then, if you are still wanting to get the rest tested, that might be something that you look into paying the difference.

Bloodwork Recommendations

Here’s the list of all the labs I recommend you request to have ordered:

Zinc

Calcium

Vitamin B12 (especially if you are vegetarian or vegan)

Vitamin D

Iodine (especially with any history of thyroid issues)

Prolactin

Ferritin

Progesterone

Testosterone (both free and total)

DHEA-S

Blood lipid profile

A1C

Fasting 3 hour glucose tolerance test with hourly draws (or Quest Diagnostic’s Cardio IQ® Insulin Resistance test)

TSH

Free T3

Free T4

TPO Antibodies

Thyroglobulin

C: Cause – The root cause

It’s important to acknowledge any time the body has a biological function and it’s not operating like it’s supposed to there’s always a reason behind it. This is where your bloodwork comes into play. After you get your optimal results interpreted, you may find a problem or issue at hand. Whether you can fix the issue(s) or not varies.

The root cause behind your low supply is what needs to be addressed if you want to improve your odds of increasing your milk supply. There are two main categories that your root cause(s) can fall under. There categories include primary causes and secondary causes.

Primary vs. Secondary Root Causes

Primary issues are things that are happening within your body. Primary causes can include hormone imbalances and nutrient deficiencies, as previously mentioned. It can also include some type of structural issue with your breasts and/or some type of history of trauma inflicted upon your glandular tissue.

Secondary is a little bit more broad; it’s anything outside of your body that could be affecting your supply. Some of these includes tension in your baby, if they have an oral tie, and more. It could also be something to do with their palette or their jaw. other things include complications or medical issues with your pregnancy or while in labor. There’s also certain foods that could have a negative effect on lactation. These can all affect your ability to produce enough milk.

You can get my free guide here that outlines various primary and secondary issues to help you explore your unique root cause(s).

There’s a large range of things that can be at hand here. There could even be more than one contributing factor which means these problems can begin to stack. This is why you definitely want to rule things out as soon as possible in order to figure out what the problem is, and then from there, tackle those specific issues. When you spend time trying to tackle all the things, it can be a big waste of time, effort, and money if they don’t even apply to you.

Keep in mind you only have so much time to try and increase your supply before your milk will “regulate,” and that happens between 6-12 weeks. This is when your supply becomes driven less by your hormones and more by the concept of “supply and demand.” It isn’t impossible to increase your supply after it regulates but it gets harder to do so. Because of that, you want to use your time wisely.

D: Do something!

Do something about it! Now that you have this information, don’t let this get away from you. This isn’t going to resolve on its own; it won’t get better. If you have been doing all the right milk management techniques (that would include removing milk often enough, ensuring you have a good latch, etc.) but there’s no change, then there’s always a reason why you are struggling with your supply.

I really encourage you to seek out help using the steps outlined above. Because when a bodily function isn’t performing as expected it can actually be a red flag. This is your body’s warning sign to you that there is something else going on. It may be with you or with your baby, and this is something that neither one of you should be struggling with. Which is why I really encourage you to push forward and get the help that you need. The help that you deserve.