What to do if my breast milk is low

"I feel like I'm running low on breast milk": a complete guide and practical advice from 23 mai Paris

Bonjour, chères mamans de la tribu 23 mai Paris ! Aujourd'hui, nous allons aborder l'une des préoccupations les plus courantes et les plus angoissantes dans le monde de l'allaitement : le sentiment d'avoir « peu de lait maternel ». Avant toute chose, sachez que vous n'êtes pas seul et que cette interrogation est tout à fait légitime.

Chez 23 Mai Paris, nous accompagnons les mamans dans leur quotidien d’allaitement avec des essentiels pensés pour le confort et la praticité, comme notre collection de t-shirts d’allaitement.

First of all: do you really have a low milk production?

Before you panic or assume that you're not producing enough milk, it's important to understand that the perception of "low milk" often doesn't correspond to reality. There are several signs that can mislead us:

Baby who wants to suckle "all the time":

Newborns have small stomachs, and breast milk is easy to digest. It's NORMAL for them to want to feed frequently (every 1.5, 2 or 3 hours, even more often during growth spurts!). This doesn't mean you don't have milk, but that your baby is doing his job to establish and increase your production.
Pouvoir donner le sein facilement, surtout lors des tétées fréquentes, est essentiel — notamment avec des vêtements pratiques comme les pulls d’allaitement.

Soft breasts :

After the first few weeks, it's common for your breasts not to feel as "full" or congested as they did at first. This is a good sign! It means that your body has adjusted its production to your baby's demands. It doesn't mean you've run out of milk.

Baby cries after feeding:

Crying can have many causes: colic, gas, the need for contact, a dirty diaper, sleep or simply the desire to continue suckling for comfort (non-nutritive feedings).

Shorter feeds:

As babies grow, they become more efficient at suckling and can empty the breast more quickly.

Do not feel the "milk rush" or ejection reflex:

Some women feel it intensely, others more subtly and others almost not at all, and all of them can produce enough milk!

Pumping little milk:

The amount you pump is NOT a reliable indicator of your total production. A baby is much more efficient at extracting milk than any machine.

So what are the RELIABLE signs that your baby is getting enough milk?

Focus on these objective signs:

Wet diapers: A well-hydrated baby will wet at least 5 to 6 disposable diapers (or 6 to 8 cloth diapers) in 24 hours (after the first 5 to 6 days of life). Urine should be clear and odorless.

Soiled diapers :

• First month: at least 3 to 4 yellow, lumpy and abundant stools per day.

• After the first month (for exclusively breastfed babies): this can vary considerably. Some go several times a day, others every few days, or even once a week! If the stools are soft and the baby is doing well, this is generally not a problem.

Adequate weight gain: This is the most important indicator. Your pediatrician will assess this during follow-up visits. Consistent weight gain (according to WHO growth charts for breast-fed babies) is the best evidence.

Active, awake baby: A baby who gets enough food is usually active, awake when awake and has good muscle tone.

Swallowing noise: During feedings, you may hear your baby swallowing milk rhythmically, especially after the initial "swallow".

If these signs are present, take a deep breath! It's very likely that you're producing enough, even if you feel otherwise. When in doubt, always consult your paediatrician or a certified lactation consultant.

Possible real causes of low milk production (and what to do about it)

If, after assessing the reliable signs and consulting a professional, it turns out that your production is low, it's time to look for the causes. The good news is that, in most cases, it's possible to improve the situation.

1. Grip and position problems :

• Cause: a poor latch prevents the baby from expressing milk efficiently. This can not only injure your nipples, but also send a signal to your body that "not so much milk is needed", which in turn reduces production.

• Solution: get help! A lactation consultant is an expert in this field. Make sure your baby's mouth is wide open (as if yawning), that it covers a large part of the areola, and that his lips are turned up (outwards). Try different nursing positions until you find the one that suits you best.

2. Insufficient frequency and duration of feedings :

• Cause: Breastfeeding works on the principle of "supply and demand". The more the baby feeds and the more the breast is emptied, the more milk is produced. Limiting the duration of feeds or offering the breast too infrequently (for example, by following strict schedules rather than on demand) can reduce production.

• Solution:

• Breastfeeding on demand: Offer the breast as soon as your baby shows the first signs of hunger (reaching for the breast, sucking with his hands, little noises), without looking at the clock.

• Efficient emptying: Make sure your baby empties at least one breast per feed. You can offer him the second if he's still hungry.

• Avoid "topping up" unnecessarily with breast milk: unless there is a clear medical indication, giving formula supplements can cause the baby to feed less at the breast, reducing your production.

3. Use of teats or bottles (especially at the beginning) :

• Cause: this can lead to "nipple-nipple confusion" in some babies. What's more, if the pacifier is used to soothe the baby instead of breastfeeding, you lose out on stimulation opportunities. We've already talked about this in our blog on pacifier use.

• Solution: Ideally, wait until breastfeeding is well established (around 4 to 6 weeks) before introducing teats or bottles. If you need to supplement breastfeeding on medical advice, consider alternative methods that interfere less with breastfeeding (cup, syringe, nursing teat).

4. Maternal factors :

• Stress, fatigue, poor diet/hydration:

• Cause: extreme stress and exhaustion can affect breastfeeding hormones. A very deficient diet or dehydration can also play a role.

• Solution: ask for help, rest when your baby sleeps, eat a balanced and varied diet (you don't need a special diet, just a healthy one) and stay well hydrated (water, broths, safe herbal teas).

• Hormonal problems: uncontrolled hypothyroidism, polycystic ovary syndrome (PCOS), diabetes.

• Previous breast surgery: breast reduction or augmentation can affect the ability to produce milk, depending on the surgical technique used.

• Retention of placental remnants: although rare, this can interfere with milk production.

• Breast hypoplasia: a rare condition characterized by insufficient glandular tissue.

• Severe anemia: can have an impact on energy and production.

• Certain medications: some antihistamines, decongestants (containing pseudoephedrine) or diuretics can reduce production. Always consult your doctor before taking any medication.

• Solution for medical factors: it is essential to consult your doctor and/or lactation consultant. Most of these problems can be treated, and production can be optimized.

5. Baby factors :

• Prematurity or low birth weight: babies may have weaker suction at first.

• Ankyloglossia (short tongue frenulum): makes it difficult to latch on properly and transfer milk efficiently.

• Jaundice ("yellowish" baby): can make the baby more sleepy and less energetic when feeding.

• Solution: medical care and close monitoring. Breast milk extraction and supplementation (ideally with your own milk) may be necessary while the underlying problem is resolved.

Effective strategies to increase your milk production :

If you really need a helping hand, here are the most effective strategies!

1. The golden rule: stimulation and frequent, effective emptying!

• Breastfeed more often: offer the breast every 1.5 to 2 hours during the day and at least every 3 hours at night (or more if your baby demands it). Don't wait for your baby to cry desperately!

• Breast compression technique: while your baby is suckling, if you notice his suckling becoming less active, gently compress your breast with your hand in a "C" shape to help the milk flow more and encourage him to continue suckling.

• Make sure you have a good plug: check the points mentioned above. A good plug is the basis of everything.

• Skin-to-skin contact: it's magic! Spending time with your baby skin-to-skin (both in diapers, covered with a blanket) stimulates your breastfeeding hormones (oxytocin and prolactin). Try it before or during feedings.
  Des pièces faciles à ouvrir, comme les nursing dresses, facilitent aussi ces moments prolongés de proximité.
  

• Des vêtements confortables et pratiques : il est essentiel que vous vous sentiez à l'aise et que vous ayez facilement accès à votre poitrine pour ces séances fréquentes. Nos vêtements d'allaitement sont conçus dans cette optique. Des t-shirts fonctionnels aux sweats pratiques, nous voulons vous faciliter la vie !

2. Milk extraction (Power Pumping) :

• What is breast pumping? It's an extraction technique that mimics the frequent feedings of a growing baby, sending a powerful signal to your body to produce more milk.

• How does it work? Extract milk for 20 minutes, rest 10 minutes, extract 10 minutes, rest 10 minutes, extract 10 minutes. Total: 1 hour. You can do this 1-2 times a day for several days.

• Important: use a good breast pump and make sure the nipples are the right size. You can give the extracted milk to your baby if you need to supplement his diet, or store it.

3. Galactagogues: natural allies?

• What are they? These are foods, herbs or medicines that are supposed to help increase milk production.

• Foods: oats, barley, fenugreek (seed or herbal tea), fennel, alfalfa, brewer's yeast, almonds, sesame. It may be beneficial to include them in your regular diet, although scientific evidence varies.

• Herbs: fenugreek and milk thistle are the most widely studied. CAUTION: Always consult a health care professional or lactation consultant BEFORE taking any herb or supplement, as some may have side effects or interactions.

• Medication: only on prescription and under strict medical supervision (e.g. domperidone, metoclopramide). They are a last resort.

• Most importantly: galactagogues alone will not work miracles if they are not accompanied by effective stimulation and emptying of the breasts.

4. Take care, Mom:

• Rest: we know it's difficult, but try to rest as much as possible. Stress and exhaustion are prolactin's enemies.

• Nutrition and hydration: eat well, with variety and in sufficient quantity. Drink water according to your thirst.

• Emotional support: talk about your feelings. Seek support from your partner, family, friends or breastfeeding groups. You're not alone in this situation!

5. ALWAYS seek professional help:

• Certified lactation consultant (IBCLC): the most qualified professional to assess your situation individually, observe a feeding, help you position your baby and develop a specific plan for you.

• Pro-breastfeeding paediatrician: to make sure your baby is developing well and rule out any medical problems.

• Doctor (gynecologist/endocrinologist): if you suspect underlying hormonal or medical causes.

What if, despite everything, production isn't enough?

Sometimes, despite our best efforts, production doesn't cover 100% of the baby's needs. AND THAT'S NORMAL!

• Allaitement mixte : vous pouvez combiner l'allaitement maternel et le lait maternisé de manière éclairée et saine. Chaque goutte de votre lait compte et est précieuse.
  Pour mieux comprendre les bienfaits de chaque tétée, vous pouvez aussi lire notre article sur l’importance de l’allaitement maternel.
  

• Relactation or induction: In some cases, it is possible to relactate or induce lactation. This requires a great deal of effort and professional support.

• Redefine success: Successful breastfeeding isn't measured in milliliters alone. It's measured in love, bonding, comfort and effort. No matter how much breast milk you give your baby, it's an incredible gift!

Be confident, get informed and seek support

Mom May 23, concerns about milk production are real, but with the right information and support, they can usually be overcome or managed in the best possible way.

1. Assess objectively: are the signs of low production real?

2. Identify the cause: a proper diagnosis is essential.

3. Apply effective strategies: stimulation, emptying and personal care.

4. Get professional help: contact a lactation consultant.

5. Make allowances for yourself: you're doing a great job.

Chez 23maiparis.com, nous sommes là pour vous accompagner. Discover our collections d’allaitement pensées pour accompagner chaque maman, à chaque étape de son allaitement. Et parcourez notre Blog si cela vous intéresse.

Have you experienced this? What helped you? Share your experience in the comments! Your story may help another mom.

We send you a hug full of milk and love!

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