Breast milk - Milk
Author: TLN

When to Call an IBCLC: Common Milk Supply Issues

Worried about your milk supply? Here’s what to look for and how to get help when you’re a breastfeeding mom

If you have concerns about your milk supply, you’re not alone. While many moms worry about whether they’re producing enough and try different tricks to make more milk, their supply is often totally fine. Here’s some reassurance: If your baby is gaining weight well, your supply is great. Pumping output, how full your breasts feel, whether you feel let-downs or leaking and other factors aren’t accurate indications of milk supply issues.

So, what should you pay attention to, and what issues might come up? We’re breaking down five common issues that contribute to decreased milk supply and how to get help.

#1 Infrequent nursing or pumping

Milk production is based on supply and demand. Your baby (or your breast pump) must remove milk often to tell your body to produce more. This is especially important when establishing your milk supply.

What to look for:

If you’re scheduling feedings, cutting them short or skipping pumping sessions, you may be signaling your body to slow production. In the initial days when your baby is extra sleepy, you might be tempted to stretch feedings further apart. 

What to do:

To establish a strong milk supply or boost what you currently produce, nurse or pump frequently (or more frequently!). Follow your little one’s cues—unless he or she is super sleepy, in which case you may have to wake the baby to feed. If you’re supplementing with formula or having your partner feed a bottle of pumped milk, add a pumping session to make up for that missed feeding.

#2 Latching or transfer issues

If your baby isn’t able to effectively remove milk from your breasts, due to issues with latching or transferring milk, he or she won’t signal your body to continue making it.

What to look for:

Pain while nursing, clicking sounds or trouble getting a deep latch can all be signs that something isn’t right. Also keep an eye on the number of wet and dirty diapers your baby has, and work with your pediatrician to monitor weight gain. If diaper output or weight gain is not as expected, this could be a sign of an issue.

What to do:

If you’re concerned about how much milk your baby is getting during a nursing session, set up a one-on-one consultation with an Internationally Board-Certified Lactation Consultant. An IBCLC will do a weighted feed, weighing your baby before and after a feeding to measure how much milk they are drinking. If milk removal isn’t happening effectively due to your baby’s latch, positioning, or a physical issue like a tongue tie, or your supply truly is low, an IBCLC can help identify the problem. In the meantime, adding in some pumping sessions will help boost your supply and provide supplemental milk for your baby.

#3 Pumping problems

The amount of milk you pump isn’t always an accurate indication of your milk supply. Unless your baby has trouble with latching or transferring milk, he or she will usually be more effective and efficient at milk removal. That being said, if you have trouble producing milk while pumping, or you’ve been pumping regularly and notice a dip in your output, some troubleshooting may be in order.

What to look for:

Feeling pain while pumping or not being able to fully “empty” your breasts can be signs that your pump isn’t doing its job right. 

What to do: 

If you’ve never responded well to the pump, start with flange fit (yes, they come in different sizes!) and suction strength. An IBCLC can help you find the best fit and settings to maximize your milk output. If you’ve been pumping previously and notice a decrease, swap out your pump parts (membranes and rubber backflow pieces wear out over time). Then use some hands-on massage while pumping or hand express afterward. Because of that supply-and-demand cycle, adding a little extra time, “power pumping” or scheduling an additional pump session can help boost your supply.

#4 Clogged milk ducts

Clogged ducts—those painful lumps or engorged areas that sometimes pop up in your breasts—block your milk flow. This is a temporary issue but the decreased output can be one of the first signs.

What to look for:

A lump or engorged area on one breast, tenderness or soreness and a feeling of not draining completely are all symptoms of a clogged milk duct.

What to do:

There are lots of ways to clear a clog, but some go-to tricks include applying heat, massage and vibration. Clogged ducts won’t go away on their own, so it’s important to get rid of them before infection sets in. If you get recurrent clogs, check with an IBCLC to find the cause and correct the issue.

#5 Your menstrual cycle

While breastfeeding can delay the return of your period, some moms do have a period while breastfeeding, especially in later months when their babies may not be taking in as much milk. The hormones associated with your cycle could cause a temporary decrease in your supply.

What to look for:

If you notice a decrease in your pumping output or your baby starts to demand more nursing sessions, and you expect your period shortly, those cyclical changes could be to blame.

What to do:

This type of dip in supply is temporary and will bounce back as you cycle through the month. Some moms turn to calcium-magnesium supplements to help prevent the decrease, so check in with your doctor about this option.

One more note: The belief that stress, fatigue or dehydration tank your supply is actually a breastfeeding myth. Yes, you may see a short-term dip when life gets hectic, but your supply will usually recover just fine. While reducing stress, getting more sleep and drinking water are great goals, mom life doesn’t always make things easy. To increase your milk production, focus on milk removal. It’s all about supply and demand!

In rare cases, moms truly cannot produce enough milk, even when all other aspects are working well. Insufficient glandular tissue, surgeries, hormonal issues and other physical issues can cause low milk supply. Your doctor or an IBCLC can help you determine if one of these factors is affecting your production.

If you’re dealing with a milk supply issue, or you’re just feeling uncertain, connect with a breastfeeding expert who can work with you to figure out what’s going on. The Lactation Network is here to provide support and expert advice with the goal of helping moms and babies have a successful breastfeeding relationship. Get in touch with our team to set up a personalized consultation!