Why Would My Milk Supply Decrease?
The dreaded decrease in milk supply can be caused by a variety of factors, ranging from infrequent removal of milk from the breasts to underlying medical conditions; essentially, your supply decreases when your body receives signals that less milk is needed. Understanding these factors is crucial for maintaining a healthy and adequate milk production.
Understanding Milk Supply Regulation
Human milk production operates on a simple principle: supply and demand. The more frequently and effectively milk is removed from the breasts, the more milk the body produces. This process is primarily governed by hormones like prolactin and oxytocin. Prolactin stimulates milk production, while oxytocin triggers the milk ejection reflex (let-down).
Factors Influencing Milk Supply
Several factors can disrupt this delicate balance and lead to a decreased milk supply.
Infrequent or Ineffective Milk Removal: This is arguably the most common reason for a drop in milk supply. If the baby isn’t latching well, isn’t feeding frequently enough, or if pumping sessions are too short or infrequent, the breasts don’t receive the necessary stimulation to produce sufficient milk.
Introducing Solids Too Early: While solids become important as babies grow, offering them too early, especially before six months, can reduce the frequency of breastfeeding, thus signaling the body to produce less milk.
Hormonal Changes: Hormonal fluctuations, particularly during menstruation, ovulation, or the introduction of hormonal birth control, can temporarily affect milk supply. Certain medical conditions, such as thyroid problems or polycystic ovary syndrome (PCOS), can also impact milk production.
Certain Medications: Some medications, including antihistamines (especially those containing pseudoephedrine) and decongestants, can decrease milk supply. Always consult with a doctor before taking any medication while breastfeeding.
Stress and Fatigue: High levels of stress and persistent fatigue can interfere with hormonal balance and negatively affect milk production.
Poor Diet and Hydration: A balanced diet and adequate hydration are essential for overall health, including milk production. Dehydration and nutritional deficiencies can impact milk supply.
Engorgement Issues: Improper management of engorgement can lead to a decrease in milk supply. When breasts are overly full for extended periods, the pressure can inhibit milk production.
Nipple Confusion: If a baby is regularly fed from both the breast and a bottle, they may develop a preference for the faster flow of the bottle, leading to poor latch and less effective milk removal from the breast.
Retained Placental Fragments: In rare cases, retained placental fragments after childbirth can interfere with hormonal balance and decrease milk supply.
Optimizing Milk Supply
Here are some strategies to optimize milk production:
- Frequent Breastfeeding/Pumping: Aim for at least 8-12 feedings or pumping sessions in a 24-hour period, especially during the early weeks.
- Proper Latch: Ensure the baby has a deep and effective latch to stimulate milk removal efficiently. Consult with a lactation consultant for assistance.
- Complete Milk Removal: Make sure the breasts are completely emptied during each feeding or pumping session.
- Power Pumping: Incorporate power pumping sessions (pumping for 20 minutes, resting for 10 minutes, pumping for 10 minutes, resting for 10 minutes, and pumping for 10 minutes) to stimulate milk production.
- Hydration and Nutrition: Drink plenty of water and eat a well-balanced diet rich in nutrients.
- Rest: Prioritize rest and relaxation to reduce stress and promote hormonal balance.
- Galactagogues: Consider using galactagogues (milk-boosting substances) under the guidance of a healthcare professional. Examples include fenugreek, blessed thistle, and lactation cookies. Always consult with your doctor before taking any supplements.
Common Mistakes to Avoid
- Spacing out Feedings: Avoid spacing out feedings too much, especially in the early weeks.
- Supplementing with Formula Without Consultation: Avoid supplementing with formula without consulting with a pediatrician or lactation consultant. Supplementation can decrease the baby’s demand for breast milk, leading to a drop in supply.
- Using Nipple Shields Long-Term Without Guidance: While nipple shields can be helpful in certain situations, prolonged use without proper guidance can interfere with milk transfer and decrease supply.
- Ignoring Early Signs of Decreased Supply: Pay attention to early signs of decreased supply, such as fewer wet diapers, less frequent feedings, and a decrease in breast fullness.
Frequently Asked Questions (FAQs)
What are the signs that my milk supply is decreasing?
Decreasing milk supply can manifest in several ways. You might notice your baby seems less satisfied after feedings, is nursing more frequently for shorter periods, is not gaining weight appropriately, or has fewer wet diapers than usual. You may also feel your breasts are not as full as they once were.
How can I tell if my baby is getting enough milk?
The best indicators of adequate milk intake are healthy weight gain and sufficient diaper output. Consult your pediatrician for guidance on expected weight gain and diaper output for your baby’s age. Generally, a baby should have at least 6-8 wet diapers and several bowel movements per day.
Can stress really affect my milk supply?
Yes, stress can definitely affect milk supply. Stress hormones can interfere with the release of oxytocin, the hormone responsible for the milk ejection reflex (let-down). Managing stress through relaxation techniques, adequate sleep, and support from family and friends can help maintain a healthy milk supply.
Will my milk supply automatically decrease when my baby starts solids?
Not necessarily. The impact of solids on milk supply depends on how gradually and thoughtfully solids are introduced. If breastfeeding continues to be offered frequently alongside solids, the supply should adjust accordingly. Offer breastmilk before solids to ensure baby is still prioritising milk and getting the most calories from it.
Is it normal for my milk supply to fluctuate during my period?
Yes, it’s common for milk supply to fluctuate during your period. Hormonal changes associated with menstruation can temporarily decrease milk production. This is usually a temporary issue that resolves itself once your period is over.
Does pumping produce as much milk as breastfeeding directly?
Pumping can be effective, but direct breastfeeding is generally more efficient at stimulating milk production. Babies are often more effective at removing milk than pumps. However, with the right pumping technique, frequency, and equipment, many mothers can maintain a sufficient milk supply through pumping.
What are galactagogues and do they really work?
Galactagogues are substances (foods, herbs, or medications) believed to increase milk supply. While some women find them helpful, the scientific evidence supporting their effectiveness is limited. Examples include fenugreek, blessed thistle, and lactation cookies. Consult with a healthcare provider or lactation consultant before using any galactagogue.
Can certain medical conditions affect my milk supply?
Yes, certain medical conditions can impact milk supply. Thyroid problems, polycystic ovary syndrome (PCOS), retained placental fragments, and postpartum hemorrhage can all interfere with hormone regulation and milk production. It’s important to discuss any medical concerns with your healthcare provider.
Is it possible to relactate (re-establish a milk supply after it has decreased or stopped)?
Yes, relactation is possible, although it requires dedication and effort. It involves frequent breast stimulation through pumping or nursing, as well as potentially using galactagogues. A lactation consultant can provide guidance and support throughout the relactation process.
How long does it take to see an increase in milk supply after making changes?
The time it takes to see an increase in milk supply varies depending on the individual and the underlying cause of the decrease. Generally, it can take several days to a week to notice a significant increase in milk production after implementing strategies such as more frequent nursing or pumping.
What kind of pump is best for increasing milk supply?
The best pump is one that is efficient, comfortable, and effective at removing milk. A hospital-grade pump is often recommended for mothers who need to increase their milk supply. Consult with a lactation consultant to determine the best pump for your individual needs.
When should I consult a lactation consultant about my milk supply?
It’s a good idea to consult a lactation consultant early and often if you have concerns about your milk supply. A lactation consultant can assess your baby’s latch, provide guidance on breastfeeding techniques, and help you develop a plan to address any issues that may be affecting your milk production.