When women who are breastfeeding decide to wean before they planned to, the number one reason they give is low milk supply. However, true low milk supply is exceedingly rare, given that humanity had to survive for thousands of years before formula supplementation was around. So why does this seem so common nowadays, and how can you avoid falling into this trap?

Perceived low milk supply is just that: when there is the belief that a woman is unable to make enough milk for her baby when in reality she is producing exactly the right amount. There are a number of reasons a mother might think she’s not producing adequate milk. The misperception often revolves around breastfeeding mismanagement (such as scheduling feeds) or inappropriate information (such as being told your baby should sleep through the night by six weeks or something is wrong).

Here are some of the most common reasons women think they might have a low milk supply, when in fact they are probably doing just fine:

Thinking that colostrum is too small in amount to satisfy a newborn baby.

The thought that her baby is feeding too frequently and therefore isn’t satisfied at the breast.

Thinking the reason a baby is not sleeping long enough at night is related to breastfeeding and not to normal newborn sleeping patterns.

Limiting feeding to a schedule or a certain length of time (which leaves the baby hungry because he or she wants to feed longer and would be satisfied if allowed to feed uninterrupted).

Worrying that normal newborn fussiness is solely attributed to not getting enough milk at the breast.

Formula marketing that makes women think they need to supplement in order to be successful at breastfeeding.

Inappropriate recommendations to supplement given by medical providers who do not follow evidence-based guidelines.

While the reasons above are not indications of true low milk supply, it is important to note that legitimate medical conditions do exist that can cause a real absence or decrease in milk production. These can include:

Retained placental fragments in the uterus after delivery.

Endocrine disorders such as Sheehan’s syndrome or untreated thyroid disease.

Certain medications, such as estrogen containing birth control.

Insufficient glandular tissue in the breast (this has nothing to do with breast size but rather is a true medical diagnosis).

A history of breast surgery.

Decreased milk removal, such as when a newborn has a weak suck or improper latch.

Therefore, if you are worrying whether you are producing enough milk to satisfy your baby, it is imperative that you first be evaluated by your medical provider or lactation consultant before you assume that you need to supplement with formula or abandon breastfeeding. A detailed history and exam can be done to see if your baby is gaining weight appropriately, to assess how your baby is feeding (and how often), to identify if there are any red flags that could signal a true milk supply issue, and to see if any medical tests need to be performed.

The good news is that most of the time, some simple troubleshooting can get breastfeeding back on track. So be sure to speak up if you are worried about the amount of milk you are producing, and seek help early on.

Sources:

• The Academy of Breastfeeding Medicine
• Protocol #9: Use of galactagogues in initiating or augmenting the rate of maternal milk secretion.
  J
• Riordan and K
• Wambach
• Breastfeeding and Human Lactation, 4th edition.
  RA Lawrence and RM Lawrence
• Breastfeeding: A Guide for the Medical Profession
• 7th edition.

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