Low milk supply: Is it inherited?

I am expecting my first child and I'm concerned about breastfeeding. I really want to nurse exclusively and do what is best for my baby but my mother tried to nurse and didn't have any milk. She smoked for years. Could this be the cause, or could I have inherited her insufficient milk supply?

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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

It can be really worrisome to hear tales like this. Many women fret for years about stories they have been told regarding (their mother's) difficulties giving birth or breastfeeding. It is highly unlikely that you will have any physical problem that will make it impossible for you to nourish your baby on your milk alone!

True milk insufficiency is very rare. Most of the time problems with a milk supply develop during the early weeks of breastfeeding, as your milk supply is becoming established.

A poor milk supply can be the result of a number of things. Allow your baby frequent access to your breasts for nutritive and comfort sucking. Insufficient number of feeds, limiting length of feedings and improper positioning at the breast can all play a role in reducing your milk supply. A newborn needs to nurse at least 10 to 12 times each day. Many newborns nurse even more than this. The more often your baby nurses, and the more completely you "empty" your breasts, the more milk you make. (See my article, Breastfeeding: Back to Basics, for help with positioning.) Most babies spend at least 30 to 40 minutes breastfeeding per feed. Allow your little one to control the feed, coming off your breast relaxed and satisfied.

Some maternal factors that are associated with poor milk supply are smoking, excessive caffeine intake (equivalent to over five cups of coffee a day), use of sedatives, antihistamines or birth control pills. Severe postpartum hemorrhage, anemia and hypothyroidism (underactive thyroid), along with breast surgery can also play a part in insufficient milk supply. It is very rare for a mother to have insufficient glandular tissue.

Babies can also play a part in insufficient milk supply. Underlying health problems in the infant need to be ruled out by your baby's health care provider. There may be problems with your baby's suck. (These are often temporary.) Do you have a history of tongue-tie in your family? Your baby may be born with a tight or short frenulum (the piece of tissue anchoring the tongue to the floor of the mouth). This may make it very difficult for him to be able to nurse properly until the frenulum is clipped, or in some cases stretches on its own over time.

It is very important for you and your health care team (OB/Gyn, Pediatrician and IBCLC) to work together to help preserve the breastfeeding relationship without compromising your baby's health. My best wishes in mothering!

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