To learn about the causes and reasons for a low supply of breast milk, read the entry Low Breast Production Milk Causes due to the Mother and Breastfeeding Practices.
Updated article on January 2024.
Below are practical things you can do to avoid low breast milk production.
- Skin-to-skin with mom or dad is important day and night. With Mom, her smell will help the baby as it roots to get to the breast. For situations like this, it’s a good habit to develop during the first weeks.
- Eating a good diet and hydrating yourself well will certainly help maintain production.
- Natural products* can increase milk production, such as fenugreek, which seems to have a good effect after birth, but less so in the long term use. The dosage is 1500 to 1800 mg orally 3 times a day (source Médecins du Québec, April 2023). As for blessed thistle, it seems to optimize the effect of fenugreek, and the usual recommended dosage (source Médecins du Québec, April 2023) is 900 to 1100 mg orally, 3 times a day. When using natural products, always read the relative warnings and contraindications before use.
- We can also suggest breast compressions. When the baby is feeding, compress the breast at the same time to help empty the surface ducts and help the milk flow faster into the baby’s mouth.
- Stimulate production using a double electric breast pump, because it produces better stimulation in the brain and therefore, better production. It is a great alternative if the baby cannot suck or if the mother cannot breastfeed.
- Avoid overwork and get good rest on a regular basis.
- Get help in the home for household tasks. This will help new moms concentrate on breastfeeding, rest, eating well and lower stress. For some hints about this, watch Adaptation to the Return Home with a New Baby*.
When you have tried all these non-pharmacological measures and it didn’t improve the situation, it’s important to see your doctor or professional for a follow-up exam to explore other alternatives. The best option is non-pharmacological solutions, but if necessary, the doctor can prescribe domperidone. Always follow the indications (not for women with known heart conditions for example). The usual starting dose is 10 mg orally 3 times a day, but the dosage may change for some women, depending on their personal situation or if it is to be used over a longer period.
With increased production comes increased flow into the baby’s mouth. Their feeding will be more satisfying as they keep up with the flow. However, a mother who breastfeeds their baby AND becomes pregnant again should never take domperidone.
Your doctor may order an EKG as a precaution before prescribing domperidone. There is few reported side effects from its use in breastfeeding settings, but they can include: dry mouth, headache and abdominal cramps. This product works best in women with breast hypoplasia (few mammary glands), breast asymmetry, breast reduction or implants and when the baby is born very prematurely. Metformin may be added to domperidone. This medicine has a different action which, when combined with domperidone, can significantly increase milk production in new mothers who are known to have polycystic ovaries, diabetes or obesity for example.
That covers information about low milk production during breastfeeding. I hope that is can help you understand the phenomenon and encourage you to see your doctor.
And don’t stop your breastfeeding before having asked for help. To learn more, watch Breastfeeding and Specific Situations*.
Talk soon,
Marie
The Baby Expert
*Both videos are in french.
