Low Milk Supply

One of the biggest fears of mothers is having a low milk supply. Many moms worry their baby won’t get enough milk and either be hungry or won’t grow adequately. This in turn leads to anxiety, stress, and even shame.

When I meet with moms who ask how to increase their supply, I first like to ask WHY they are worried about their supply. Have they gone back to work and are pumping during the day? Is there a new stress in the house? Is the baby more fussy? Many times moms fear a low supply when in reality the baby is signaling to increase feeds because of a growth spurt rather than a problem with supply.

Below are a few tips for increasing milk supply. Remember that any one of these might make a difference with you, but usually a combination will be the most effective. And I cannot stress enough that increasing breast stimulation and keeping well hydrated are the most important for having an adequate milk supply. Water, water, water!!!!

  • Ensure an optimal latch. If the latch isn’t great, milk is not being removed efficiently and thus ineffectively signaling the body to make more.
  • Increasing frequency of feeds. Frequency is more important than overall time spent expressing.
  • Double pumping after a feed. Do as many times as you can throughout the day, start small and work up.
  • Use a combination of the electric pump + hand expression. This combination has been proven to be the most effective. Using a hands-free nursing/pumping bra can be really helpful with this.
  • Consider trying “power pumping.” This is when you pump for ten minutes, rest for ten minutes, and so on, for a total of 60 minutes making up the ‘power hour.’ (This can be done a few times a day.)
  • Watch what you eat! Getting enough protein is key. Plus water, water, water, water. Oats, mother’s milk tea, and herbs such as Fenugreek are known to increase supply. In my own breastfeeding journey, I noticed having a bowl of oatmeal for breakfast everyday really helped keep my supply up. Watch out for peppermint, sage and parsley. These herbs are known to decrease supply. Peppermint candies, desserts, and teas can drastically reduce supply. Follow the link for more information on foods to eat and avoid or attend one of my classes.

And if you want to know more about how to produce more milk or how to keep your milk supply up (if, for example, you’re returning to work or planning mother-baby separation time) see the links for consultations and more information! Or attend one of my classes.

Cabbage for engorgment

Cabbage is not just for Cole slaw. Did you know that cabbage leaves have been used for decades to help reduce breast engorgement? A handful of studies have shown that placing a chilled green cabbage leaf against the breast has been effective to reduce breast swelling and pain. It is suspected that the compounds found in the plant leaves have strong anti-inflammatory properties that help improve blood flow, decrease swelling, and allow milk to flow more freely.


Using Cabbage Leaves for Engorgement:

✏️Chill the cabbage, green cabbages are best

✏️Wash off one or two inner leaves, be mindful to remove any dirt, pesticides or residue

✏️Gently pat dry with a towel

✏️Crush the center stem for maximum potency

✏️Wrap a leaf around the affected area of the breast, exposing the nipple when possible.

✏️Use a bra or lose wrap to hold the leaves in place

✏️Leave for 20 minutes

✏️Discard the leaves

✏️Cautions:20 minutes seems to be for most the right amount of time

✏️Repeat no more than 1-2 times a day for engorgement, as cabbage leaves used more often can actually decrease milk supply!

✏️This process is also used for weaning breast milk, such as when quick weaning is needed or when mothers are done breastfeeding.

Depression with weaning

Weaning blues. If postpartum depression weren’t enough, it’s also possible to have depression and mood shifts from weaning from breastfeeding. During breastfeeding, oxytocin, the cuddle or love hormone, is released every time milk lets down. This feel good hormone helps reduce the risk of post partum depression and aids in bonding with baby. Prolactin, the hormone that actually makes the milk, also brings a feeling of well-being, calmness and relaxation. There is very little research on the subject, but it’s hypothesized that when you wean, the decrease in prolactin and oxytocin can make some feel moodiness, sadness or even anger. The faster the weaning process the more abrupt the shift in hormone levels, and the more likely that you will experience feelings such as being tearful, sad or mildly depressed. Some also experience irritability, anxiety, or mood swings. These feelings are usually short-term and often go away in a few weeks. Dropping no more than one feeding per week is a gentle way to wean and adjust to shifting hormones. People who are forced to wean before they are ready (or for reasons beyond their control) and those with a history of depression are also more likely to experience depression after weaning. Even for those who are ready to wean and doing so gradually, there may still be a sense of loss and sadness. Your breastfeeding relationship has been a major part of your parenting journey and it is understandable that you’ll feel a wide range of emotions.

Can I empty my breast?

Did you know that you will ALWAYS be able to make milk? You’ve had the milk making glands in your breasts since puberty. They’re like little empty clusters of balloons at the back of the breast. Pregnancy activates your milk making hormones, allowing the glands to expand and start filling with milk between 16-20 weeks gestation. In the early days after birth, the more stimulation the breast has (from feeding or pumping), the more the milk making glands and their corresponding hormone receptors multiply. The milk balloons fill and empty milk multiple times per feeding.

After at least 40 days of not expressing any milk, once you completely wean, your milk making balloons deflate and become dormant, like before pregnancy. But they aren’t dead. Pregnancy and breastfeeding hormones caused a permanent change in your body. Your milk making glands will FOREVER remember how to make milk. They can ALWAYS make milk again, no matter how long it has been. They just need enough of the right stimulation to turn on and start filling again. Some times years after breastfeeding a mother may feel the tingle of let down if she hears a baby cry. Or she may leak if her partner does enough nipple stimulation. There are grandmothers in other cultures who bring back milk to breastfeed their grandchildren! Our bodies are AMAZING!! Now you know!

Caffeine and breast milk

An average cup of coffee can contain 95mg of caffeine, but some can contain as much as 500! Which is important to know when breastfeeding as generally considered safe to drink up to 300 mg per day— about 2–3 cups of coffee or 3–4 cups of tea.

The caffeine content of coffee depends on many factors, such as:

• Type of coffee beans: different varieties of coffee beans naturally contain different amounts of caffeine.

• Roasting: Lighter roasts have more caffeine than darker roasts.

• Type of coffee: caffeine content can vary significantly between regularly brewed coffee, espresso, instant coffee and decaf coffee.

• Serving size: “One cup of coffee” can range anywhere from 30–700 ml (1–24 oz), greatly affecting the total caffeine content.

• One cup of brewed coffee (8 oz) contains about 70–140 mg of caffeine, or about 95 mg on average

• One shot of espresso is generally about 30–50 ml (1–1.75 oz), and contains about 63 mg of caffeine

• Instant coffee usually contains less caffeine than regular coffee, with one cup containing roughly 30–90 mg

• Decaf has about 0–7 mg per cup, with the average cup containing 3 mg

Want to enjoy a coffee alternative that gives all the feels while still being breastfeeding supportive? My two breastfeeding friendly favorites are @wearerasa and @milkstabrew.

Sunflower lethicin and plugged ducts

Lecithin is used in food to provide a smooth, moist texture and to keep ingredients from separating. Lecithin can naturally be found in green vegetables, red meat, and eggs. Commercial preparations are often made from soybeans, egg yolks, or animal products. It is also commonly used in eye drops, skin moisturizers, and food emulsifiers (agents that keep ingredients from separating).

Sunflower lethicin, a specific kind of lethicin, is often taken during breastfeeding to reduce plugged ducts or to help increase milk flow. Sunflower lethicin is thought to reduce the “stickiness” of breast milk by thinning out the fats in the milk and keeping them from clumping together. There are no known contraindications for breast-feeding, and lecithin is “generally recognized as safe” by the FDA. However, people with a preexisting tendency to depression may become depressed if taking high doses of lecithin. While very rare, if you begin to have a fish-like odor while taking high doses of lethicin, stop taking it immediately and notify your physician, as this is a serious sign of liver damage. As there is no recommended daily allowance for lecithin, there is no established dosing for lecithin supplements. Different brands might have different amounts of lecithin in each pill or capsule, so be sure to read labels very carefully before taking lecithin or any other dietary supplement. Per Kellymom.com, the maximum dosage recommended for recurrent plugged ducts is 4,800mg/day. As always, consult with your doctor before trying any dietary supplements while pregnant or breast-feeding.

Why should I see an IBCLC or lactation consultant

If you broke your foot you wouldn’t go to your local nail salon to have your pedicurist look at it. Yes, they work with feet. I just wouldn’t trust their expert opinion on whether I need a cast or some physical therapy. If my car engine was making smoke and my gauges were outside the appropriate ranges, you wouldn’t go to the car wash to have it looked at. Yes, they work with cars. I just wouldn’t trust their expert opinion on whether my engine block is cracked or not. So why when we’re having lactation problems do we turn to mom groups or even pediatricians? Yes, moms have babies. Yes, pediatricians work with babies. But neither are the experts in lactation (ok, occasionally a pediatrician will seek additional training, but honestly it’s rare). To become a board certified lactation consultant, you need to take advanced college level coursework specifically in human lactation. You need to spend hundreds to thousands of hours being directly mentored by someone who already is board certified. And you have to pass a FOUR HOUR board exam. To be board certified. IBCLCs spend thousands of dollars and years of their lives training to become experts in breasts, babies, and feeding. If you’re struggling, please find the correct help. There’s a lot of bad information out there that may inadvertently sabotage your breastfeeding journey without you even being aware.

Coffee while breastfeeding

An average cup of coffee contains 95mg of caffeine, but some types contain over 500mg. That’s important to be aware of when breastfeeding as it’s generally considered safe to drink up to 300 mg per day— about 2–3 cups of coffee or 3–4 cups of tea.

The caffeine content of coffee depends on many factors, such as:

• Type of coffee beans: different varieties of coffee beans naturally contain different amounts of caffeine.

• Roasting: Lighter roasts have more caffeine than darker roasts.

• Type of coffee: caffeine content can vary significantly between regularly brewed coffee, espresso, instant coffee and decaf coffee.

• Serving size: “One cup of coffee” can range anywhere from 30–700 ml (1–24 oz), greatly affecting the total caffeine content.

• One cup of brewed coffee (8 oz) contains about 70–140 mg of caffeine, or about 95 mg on average

• One shot of espresso is generally about 30–50 ml (1–1.75 oz), and contains about 63 mg of caffeine

• Instant coffee usually contains less caffeine than regular coffee, with one cup containing roughly 30–90 mg

• Decaf has about 0–7 mg per cup, with the average cup containing 3 mg

Want to enjoy a coffee alternative that gives all the feels while still being breastfeeding supportive? My two breastfeeding friendly favorites are @wearerasa and @milkstabrew.

Comparison will steal your peace

Too often we look around to see what everyone else is doing and it makes us feel incomplete, incompetent, like we’re doing something wrong or not doing enough. We see the success of others in parenting, sleep training, their milk supply, pumping, whatever, and it makes us feel like we’ve failed. Comparison is the number one way to have your joy and peace stolen. Stop looking at Becky over there with her oversupply and thinking your normal supply is inadequate for your content and growing baby. Stop looking at Gina over there whose baby has slept through the night since two months and thinking there’s something wrong with your happy child. Stop comparing your tiny but mighty that looks like the rest of your flock to my giant giraffe babies that look like the rest of my herd. You’re not getting a grade. Breastfeeding is not a pass/fail activity. Trust your baby. Trust your body. You’ve got this.

Do I need to wean when baby has teeth?

When a baby is latched correctly, their tongue comes over the gums (and teeth) to cup the nipple and breast. If a baby is latched deeply, they physically cannot bite the breast. They may bite while unlatching or if they slide down the breast because of distraction or behavior. Never fear, you can safely continue to nurse once baby starts teething. I can’t guarantee you won’t get bit, but that’s another post.