By Dr. Kathleen F. McCue, FNP, IBCLC
It’s fair to say that I spend most of my clinical days regulating maternal milk supply. The number one complaint is “I don’t have enough milk,” Sometimes, I’m in agreement but other times, I find maternal expectations, for how much milk one is supposed to produce is pretty unrealistic. Although we don’t want to be living paycheck to paycheck (milk-wise), we also don’t want to open a Dairy Queen. I’ve discovered slow gaining babies with what we call “inadequate weight gain,” can be a result of moms who are “feeding the freezer.” They need a stash.
There are so many things that come into play when helping women regulate supply: Storage capacity of the breasts (meaning amount of glandular tissue and milk-making alveoli within the breast itself); adequate nipple stimulation to help moms produce prolactin (a hormone that promotes milk production); suckling ability of the baby (big strong baby or small jaundiced baby with a low birth weight); frequency of stimulation by either baby or breastpump (moms with less storage capacity (smaller breasts) will most likely be feeding more frequently and sometimes for longer sessions. This is not an exact science.
Trouble usually starts when moms either start on any type of hormonal contraception or return to work outside the home. Keep in mind that empty breasts make milk, so if you don’t have any significant reason for a decreased supply, you basically need to keep emptying the breasts.
Here’s the checklist that I give my consultants to work with moms with this complaint.
Keep in mind that some moms will fall outside the bell-curve and do just fine with their insurance pumps but, since this article is about low milk supply, those moms aren’t even reading this blog. Insurance pumps that you own are sometimes called “hospital grade” but in the world of lactation consultants, we mean pumps that you rent from your lactation consultant or hospital. My favorite is the Medela Symphony because it’s only seven pounds and has a soft stimulation phase that helps moms produce prolactin. Again, you will need to trial different pumps to see what works best for you.
If you’ve ticked through this entire list and are still unable to increase your milk supply, visit your local IBCLC or schedule a telehealth at Metropolitan Breastfeeding. Our website is and there’s no doubt we can help you.