Make sure you read the first part of this entry, Insufficient or Low Levels of Breast Milk.

Many low breast milk causes are due to the mother and breastfeeding practices exist.

  • Pacifier: Parents use a pacifier instead of breastfeeding the baby. Breastfeeding stimulates production. The pacifier interferes with milk production.
  • Latching: there are mothers with flat or very large nipples. Based on the baby’s mouth and morphology, it’s difficult to fully latch on to the nipple and this incorrectly stimulates the neurotransmitters at the base of the nipple.
  • Photo - maman qui allaite son bébéBaby positioning: it’s important to position the baby properly for breastfeeding. This provides better stimulation, and sometimes you just have to shift the baby’s alignment towards the breast to improve latching.
  • You have to stimulate both breasts when breastfeeding. This promotes milk production and milk flow for the baby. Avoid feeding from one breast at a time because it can diminish milk production over time.
  • Medication: if the mother is taking medication, it can indirectly affect their production (for example certain decongestants containing pseudoephedrine). Hormones are sensitive, even when using medications that are theoretically compatible with breastfeeding. It will be different for each woman, so remain watchful.
  • Hypothyroidism: if the mother has hypothyroidism (a lowering of the thyroid gland function which influences other organs in the body), it can impact production.
  • Hypoplasia: a mother might have hypoplasia (fewer mammary glands in her breasts) unilaterally (one breast) or bilaterally (both breasts). Your caregiver can examine your breasts for this. If you note that your breasts didn’t really change during pregnancy, this can be an indicator.
  • Breast reduction surgery: if a mother had breast reduction surgery to remove mammary glands for back pain or other issues, their nipple might have been moved. If so, the nerve endings to the nipple were cut along with milk production signals to the brain.
  • Breast implant surgery: we see many more mothers with breast implants. If the nipple wasn’t moved and the implant was inserted under the breast, milk production should be fine. But any surgery should be considered, as the targeted structures go through trauma. But generally, there should be no problem breastfeeding a baby after breast implant surgery.
  • Polycystic ovaries: if the mother has been diagnosed with polycystic ovaries, this can influence their milk production.
  • Fatigue, stress, and pain felt elsewhere in the body can negatively impact milk production.
  • Caffeine and tobacco use can also influence production.

The caregiver will advise you when the potential causes have been identified. They will know your pregnancy and childbirth history and observe your breastfeeding. They will weigh the baby and ensure they gain between 25 g and 30 g a day. A first step could be the use of non-pharmacological measures to improve the situation.

  • Examine breastfeeding positions;
  • Examine your medication (ex.: contraception, Synthroid for hypothyroidism, iron for anemia);
  • Carefully use material to help breastfeeding, depending on the situation, such as a nipple shield (ex.: flat nipples) or an electric breast pump (increase stimulation);
  • Will they provide supplemental milk to the baby for weight gain? If yes, how, to avoid confusing the baby and harming your breastfeeding? With a cup? Lact-Aid (little tube)? Spoon?

I can’t say what’s the best option, because each situation is different. One thing is certain. Every effort will be taken to meet the baby’s needs as quickly as possible without compromising breastfeeding. Everyone wants to give the mother the best chance for success continuing to breastfeed her baby.

To continue reading, go to Practical Advice to Avoid Low Breast Milk Production.