Breastfeeding: What causes insufficient milk supply?

When I had my first baby, I didn't have much milk. She didn't gain enough weight and my milk supply didn't increase, no matter what I did. Are there some women who cannot breastfeed? If a woman has trouble with her milk supply the first time, will the same be truw with my second baby?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Though it is rare for a mother not to be able to produce enough milk, an insufficient milk supply (real or perceived) needs to be taken seriously!

Most difficulties with insufficient milk supply result from unresolved problems with breastfeeding during the first six weeks, as a mother's milk supply is being established.

Reduced milk supply may result from an insufficient number of feeds, from limiting length of feedings, and from improper positioning at the breast.

There are also maternal factors that have been associated with insufficient milk supply. Some medications, such as birth control pills,antihistamines and sedatives may decrease the milk supply. Smoking, excessive caffeine (over five cups a day), hormonal problems and fatigue have also been associated with poor milk ejection reflex.

Rarely, a mother may be born with insufficient glandular tissue. Breast surgery, particularly breast reduction, may have a similar effect. Any breast surgery where milk ducts have been severed may have an impact on breastfeeding.

Babies can also play a part in insufficient milk supply. Underlying health problems in the infant need to be ruled out by a physician. A baby with a tight or short frenulum (a piece of tissue anchoring the tongue to the floor of the mouth) may not be able to nurse properly until the frenulum is clipped, or in some cases stretches on its own over time. There may be other problems with the baby's suck.

Insufficient milk supply should not be ignored! If you suspect that there is a problem, it is very important to schedule a visit immediately with your Pediatrician, working in conjunction with a Board Certified Lactation Consultant. Together they can help you to continue breastfeeding (while increasing your milk supply)without compromising the health of your baby.

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