Baby's Best Beginning Blog

“Other” Reasons for Low Milk Supply



“Other” Reasons for Low Milk Supply

By: Stacy Notestine RN, IBCLC



Milk 💦Supply can be impacted by many “OTHER” things! So what are these 🚩red flags that might give the indication for low milk supply? 


 🚩 Insufficient Glandular Tissue (IGT). This is where there is not enough milk making tissue on the inside of the breasts. It is not the actual size of the breasts but what is on the inside that may impact milk making ability. Breast size is generally related to how much fat is in the breasts, not the actual glandular tissue. What actually causes IGT is a current hot topic of research.


💦 Significant difference (2 or more cup sizes) between the two breasts or very widely spaced breasts. Breasts are never exactly the same size, but when there is dramatic difference in cup size or there is a space larger than the size of ones fist that can fit between the breasts, this may impact milk supply.


🚩Anatomical breast or nipple anomalies. Often breasts that look underdeveloped with a small amount of breast tissue or underdeveloped nipples and areolas that are bulbous or tubular in appearance may also be an indication that milk supply may not be adequate.  


💦 Breast surgery or injury to the breast. Any time there is damage or cutting into the breast tissue, milk ducts or nerve supply to the breasts (breast augmentation, biopsies, breast reduction surgery, chest tubes, blunt force to the breast) might impact the ability for the breasts to make a full milk supply.


🚩No changes in breast size/fullness during pregnancy. During pregnancy the breasts should get bigger and fuller in preparation for breastmilk production. If there are no changes this may be a red flag that milk supply may be impaired.


💦 Infertility issues/PCOS-Polycystic ovary syndrome (especially related to hormonal imbalances). Certain hormones are needed to achieve pregnancy. If those hormones are not at the appropriate levels then getting pregnant is difficult. No different than the body’s ability to make milk. Those hormones must be in place to produce milk.


🚩 Hypothyroid disease, diabetes, severe obesity or other endocrine disorders. Our endocrine system plays a powerful role in making milk, especially the thyroid gland. If you have a known endocrine disorder it is best to have your levels monitored by your health care provider. Often prescribed medicine is needed to maintain those necessary levels to make milk.


💦 Smoking. Research proves that mothers who smoke make less milk and wean sooner. Nicotine impacts the hormones that are involved in the milk making process.


🚩Hormonal Birth Control. Milk making is largely influenced by our hormones. Any birth control that contains estrogen, progesterone, or testosterone can potentially impact milk supply. Some moms are unaffected by progesterone only birth control (such as the mini pill), but it is always best to use with caution.


💦Newly pregnant. Although it is not dangerous to continue nursing during pregnancy, some moms may see a decrease in supply due to the shift in pregnancy hormones. The taste of the milk may change as well and that may cause natural weaning.


🚩Certain medications. Especially this time of year with cold meds, anything that can dry up mucus can potentially decrease milk supply. Peppermint essential oil or tea is also known to decrease supply.


💦Baby issues- A baby who isn’t able to effectively drain the milk from the breasts for all different kinds of reasons (prematurity, suck problems, birth trauma, tongue tie, etc.). Breastfeeding is 50/50 with mom and baby and often we need to address baby issues to increase milk supply.


There may be other issues as well so it’s always a good idea to consult with your health care provider or an experienced IBCLC to get further guidance!


Marasco, L. and West, D. Making More Milk, 2020



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