Breastfeeding: how do I know if I have a low milk supply?


Lactation consultant Emma Pickett answers our latest question on breastfeeding

Although a minority of new mums do genuinely struggle with milk supply, many others panic or are made to worry unnecessarily and often turn to formula when it isn’t needed. This, in turn, can lead to a real reduction in milk supply.

The only things that tell us about milk supply are a baby’s weight gain and nappies. Some say that ‘babies should be settled after a feed’ but this isn’t necessarily true – some babies get wind, have reflux or simply wake up and want second helpings.

It’s normal for a newborn to lose weight in the first few days, however, ideally your baby shouldn’t lose more than 10% of their birth weight or lose weight a second time.

In the first four weeks, after mum’s milk has come in (around day two to five), expect six wet nappies in 24 hours and three poos the size of a £2 coin or bigger. Later, poos can slow down for exclusively breastmilk-fed babies. In the early days, parents are encouraged to look out for baby not producing lots of wet nappies and poos, as this is the main way of knowing if they are getting enough milk.

10 myths of low milk supply
You do not necessarily have a low milk supply because:

1. Your baby requires frequent feeds. This can be normal for lots of reasons.

2. Your breasts are no longer leaking breast milk. It is normal for leaking to reduce as your baby becomes more efficient at feeding.

3. Your breasts feel softer than they used to.

4. Feeds have got shorter. Your baby could be stronger and more efficient at draining your breast, and your milk supply is in sync.

5. You have small breasts.

6. Your baby wakes up a lot.

7. Your baby won’t ‘go down’ after a feed.

8. Your baby will take a bottle after a feed.

9. You cannot feel your let-down reflex anymore. It is common for the feeling of a strong let-down reflex to fade.

10. You don’t pump very much milk. Pumping and breastfeeding are unrelated.

If you have low supply…
If you have a baby struggling with weight gain, it is likely you’ll need a breastfeeding assessment. This will monitor a variety of things, including:

• Latching. Just a small adjustment to your baby’s latch can mean they drain your breast efficiently (this also stimulates your breasts to produce more milk during and after the feed).

• Assessing if your baby has problems with their tongue, such as tongue-tie.

• Assessing the length and timing of feeds. Maybe your baby doesn’t show strong hunger cues and you need to offer feeds more often.

• Finishing a feed with breast compressions to get an extra dose of fatty milk into baby.

• ‘Switch nursing’. Try going back to the first side – there will be milk there.

• Expressing. Express on an emptier breast to send more signals to your milk supply.

• Rarer problems, such as thyroid problems or polycystic ovary syndrome.

Be sure to focus on getting the help you need and then giving yourself time to feed and build up your supply. You’ve Got It In You: A Positive Guide to Breastfeeding (£6.99, aims to make you feel as well-prepared as possible. For more help and advice, contact the National Breastfeeding Helpline on 0300 100 0212.

Emma Pickett is an International Board certified lactation consultant