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Why Am I Not Producing Enough Breast Milk?

Reviewed by Dan Brennan, MD on February 27, 2021

Many women who want to breastfeed struggle to develop a sufficient supply. Issues with production are among the most frequently cited reasons nursing mothers don’t meet the recommended six months of breastfeeding. 

Understanding common causes of low breast milk supply can help you know if there are ways to increase yours as you work with your doctor to develop the best feeding plan for your baby.

Common Causes of Low Breast Milk Supply

Milk production problems often show up when mothers first start breastfeeding, but they can also happen after months of success. Common reasons for low milk supply include:

Infrequent nursing or pumping. Breast milk production is largely a matter of supply and demand. As infants nurse more often, production ramps up so that mothers are able to provide more milk. Likewise, supply may wane when nursing sessions are dropped. Mothers may also see dips in production when they go back to work, especially if they’re unable to pump regularly during the day.

Supplementation. Bottle-feeding your newborn with formula while you are also breastfeeding is sometimes essential for their health, but it can interfere with milk production. Nursing mothers may find that their babies aren’t draining the breast frequently enough to maintain a sufficient supply.

Scheduled feedings. Nursing on demand can be inconvenient, but excessive scheduling may limit milk production. Supply increases quickly when the breasts are emptied on a regular basis, but scheduled feedings may be too far apart for this to happen. Likewise, nursing sessions that end too quickly may interfere with supply. 

Stress. The relationship between stress and breastfeeding is complicated. The adrenaline released during times of heightened emotion can limit the release of the hormone oxytocin, which a nursing mother needs for a successful letdown.

Dehydration. It can be difficult to remember to drink enough water or find time to prepare healthy, low-sodium meals. Without proper hydration, however, milk supply can decrease rapidly. 

Weight loss. While new mothers, on average, lose more weight while breastfeeding, this varies from one person to the next. Some find it easier to maintain a desirable breast milk supply if they hang on to an extra five or ten pounds over their pre-pregnancy weight. 

Rapid weight loss is more likely to affect supply, so it’s best to stick to a slow and steady rate of one or two pounds lost per month. Once cleared for exercise, moderate physical activity can hasten weight loss without harming supply.

Obesity. Women who are obese before becoming pregnant are more likely to struggle with low milk supply. Research suggests that insulin resistance — which often accompanies obesity — could be to blame. 

Issues with glucose tolerance can negatively affect several stages of lactation, including mammary gland development during early pregnancy and the delayed onset of lactogenesis (also known as the milk “coming in”). 

Hormonal contraceptives. While most hormonal varieties of contraception are safe to use while breastfeeding, they can prompt a sudden drop in supply. The estrogen in these contraceptives may interfere with milk supply and even lead to breastfeeding ending early. 

Cold medicine. Certain medications can interfere with breast milk production. Decongestants such as pseudoephedrine, for example, may have a negative effect on supply among mothers in the later stages of breastfeeding.  

Polycystic ovary syndrome. Women with polycystic ovary syndrome (PCOS) often struggle to conceive and carry pregnancies to term. Likewise, the condition can cause problems with breastfeeding.

While PCOS can lead to limited milk production during the initial stages of breastfeeding, the problem often resolves itself with time. Research suggests that, after three months, breastfeeding rates are similar among women with and without PCOS. 

What to Do If Your Breast Milk Supply Is Low

Before taking steps to try to increase your breast milk supply, talk with your doctor. Low milk supply can be difficult to self-diagnose, and your doctor can help you know if you should take steps to increase it. Some common approaches include:

  • Relaxation techniques. Massage and meditation can help, as can skin-to-skin contact and even warm compresses. 
  • Drinking more water. Breastfeeding mothers need to increase their water intake, both due to their child’s fluid consumption and in accordance with their increased caloric intake.
  • Changing your contraception. Top contraceptive options for maintaining breast milk production include non-hormonal IUDs or barrier methods. 
  • Feeding and pumping often. With new babies, feed very frequently, as many as 8 to 12 times a day for the first few weeks. If you miss a session, pump to ensure your production keeps up.
  • Getting support. Reducing stress and easing other factors impacting milk production may mean obtaining extra help around the house from family members or therapy for mothers struggling with postpartum depression.

If your doctor agrees your production is low, supplementation may be an option. But because supplementing with formula can be both a cause of and a solution to low breast milk supply, discuss with a lactation consultant or doctor to determine what’s best for you and your baby.

Show Sources

SOURCES:

Acta Obstetricia et Gynecologica Scandinavica: “Breastfeeding in Polycystic Ovary Syndrome.”

Advances in Nutrition: “Does Insulin Explain the Relation between Maternal Obesity and Poor Lactation Outcomes? An Overview of the Literature.”

Advances in Preventive Medicine: “The Relationship Between Life Stress and Breastfeeding Outcomes among Low-Income Mothers.”

American Academy of Pediatrics: “Breastfeeding and the Use of Human Milk.”

Cochrane Database of Systematic Reviews: “Extra Fluids for Breastfeeding Mothers for Increasing Milk Production.”

Mayo Clinic: “I've heard that breast-feeding promotes weight loss. Is that true?.”

Mayo Clinic: “What causes a low milk supply during breast-feeding?”

NCBI Drugs and Lactation Database: “Pseudoephedrine.”

Stanford Children’s Health: “Low Milk Production.”

UAB Medicine News: “Pump It Up: 6 Tips for Increasing Breast Milk Production.”

UTSouthwestern Medical Center: “4 factors that can decrease breast milk supply – and how to replenish it.”

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