“Not enough milk” is one of the most common causes for stopping breastfeeding or choosing to supplement with formula. Unfortunately often it is a perceived notion of not having enough milk which is loosely based on one or several of the following:

• feeling as if the breasts are not as full as they used to be
• baby feeding more frequently
• low maternal confidence
• misunderstanding/mismanagement of growth spurts
• lack of support from partner/family/society
• baby pulling away from the breast/restless at the breast/fussing between feeds
• limited amounts of breastmilk when pumping to assess the amount (never a good idea)

More often than not, the milk supply is adequate but is perceived as being low by the mother. With limited support available and a lot of misleading advice on available on the internet, a perceived low supply can easily become an actual low supply due to incorrect management.

Low milk supply in breastfeeding, whether perceived or actual, is an issue that needs to addressed and managed if prolonged breastfeeding is to occur.

Helpful List to Assess Whether the Low Milk Supply in Breastfeeding is Perceived or Real

Note that there is a vast difference depending on the age of your baby as their needs are constantly changing.

For newborn babies:

• Fewer than 3 wet nappies/24 hours by day 3 (2-3 is normal for first 2 days while baby only receiving colostrum)
• Fewer than 5-6 heavy wet nappies/24 hours after day 5
• Concentrated urine
• No change to normal breast milk stools by day 3-4 and scant stools thereafter
• Dry mucous membranes
• Weight loss greater than 10% birth weight
• Further weight loss after day 3-4
• Less than 20 gm weight gain/day after day 3-4
• Failure to regain birth weight by 2 weeks of age

Week 1- 3:

• Fewer than 5-6 heavy wet nappies/24 hours
• Concentrated urine
• Scant stools (expect 2-3 breast milk stools in 24 hrs often while feeding)
• Dry mucous membranes
• Excessive crying, weak cry
• Baby appears unwell

Growth Spurts:

Growth spurts occur at around week 2, 3 and 6 are a very real cause for concern and perceived low milk supply in breastfeeding because during a growth spurt, breastfed babies nurse more often than usual (sometimes as often as every hour) and often act fussier than usual.

The increase in baby’s milk intake during growth spurts is temporary. Physical growth is not the only reason that babies may have a temporary need for increased nursing. Babies often exhibit the same type of behavior (increased nursing with or without increased fussiness) when they are working on developmental advances such as rolling over, crawling, walking or talking. Mum’s milk is for growing the brain as well as the body!

They occur again at month 3, 4, 6 and 9 so take note and do not despair. Go back to the list, meet up with other mum’s with babies of similar age and find support to reassure yourself.

I cannot stress enough the value of rest and diet when there is a perceived or actual low milk supply. Breastfeeding takes time and energy. Slow down. Watch your baby.

If none of these help then seek advice from lactation consultant who will take a full history, watch your feeding and give you a plan to work with going forward with regular follow up.

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About the Author

Karen Wilmot is a Midwife, Yoga Instructor, Birth and Lactation Consultant. In August 2009, she started a community based service offering birth preparation classes, home and hospital visits and support throughout pregnancy, birth and beyond.

Learn more: www.pregnantinoman.com | Contact: karenwilmot@gmail.com