Not Enough Breast Milk? What You Need to Know

One of the most common concerns our lactation consultants (IBCLCs) help people with is low milk supply. Most often though, the actual problem is not physical, but in perception. It’s most often true that a person thinks they don’t have enough, but they actually do.

Why This Happens

There are normal low milk supply issues, and normal “drops” in milk supply. When people are not taught to expect these natural occurrences, they might be led to believe that they don’t have enough milk. There are a lot of reasons you might start to suspect that you are not making enough milk. The most common include:

1. The baby wants to eat too often.
2. The baby seems fussy unless at the breast.
3. The baby doesn’t seem to be taking big swallows.
4. Your breasts don’t feel full of milk.
5. You are not leaking or spraying milk.
6. You can’t get much out with the pump.
7. Other people seem to be doing better/different.

The Reality

All of the reasons listed above could be indications of a low milk supply, but can more often be explained by something other than low milk supply.

1. Especially in the first 3-5 days, babies need to eat often. It could even be every hour! This is because their bellies are very tiny at first and can’t hold much. Also, early breast milk digests very quickly.
2. A baby who is fussy unless at the breast might be cluster feeding. This is a normal developmental imperative that ensures that your baby eats enough and that your milk supply keeps up with their increased needs. It happens every once in a while during normal growth spurts.
3. If your baby is not taking obvious swallows or gulps AT FIRST, this is normal. In the first few days of life, there is very little milk. It’s called colostrum, and there isn’t supposed to be very much. It’s just enough to fill their very tiny bellies.
4. In the first 3-5 days, it’s very normal that your breasts don’t feel full. You only have that very small amount of colostrum. It is a very dense substance, and your baby can’t hold much and doesn’t need much. It digests very quickly and acts as a laxative to help your baby clear bilirubin and avoid jaundice. If your breasts don’t feel full even later, that might also be ok. Some people just don’t get engorged or full. It might mean that you’re making just enough to satisfy your baby and no extra.
5. If you don’t have any leaking or spraying in the first few days, that’s very common. Again, you only have a very small amount of milk at that point, and it’s extra thick and dense so a lot less likely to leak out or spray. If you are still not leaking later, you might just be lucky! Everyone’s body is different, and some people just don’t leak.
6. If you can’t get much milk out with the pump, it does not necessarily mean you aren’t making enough milk. Every pump is different, and every body is different. You might need a different flange size. Some people get better results with a manual pump or a different brand or style. Pumping is very different from direct breastfeeding, and your success or failure with pumping isn’t a good indicator of the health of your milk supply.
7. It’s important not to let social media images or other people’s stories make you doubt your ability to make enough milk. Some people can pump out freezers full of milk while others can barely squeeze out a few drops. But both can probably feed a baby very well from the breast.

How to Know your Baby is Getting Enough

You can reassure yourself that your baby is getting enough milk if you see the following signs:

• Plenty of wet diapers. In the first week, you’re looking for at least 1 wet diaper per day of life.
  • Day 1=1 wet diaper
  • Day 2=2 wet diapers
  • Day 3=3 wet diapers
  • Day 4=4 wet diapers
  • Day 5=5 wet diapers
  • Day 6=6 wet diapers

After the first week, you can look for 6+ wet diapers per day.

• Plenty of dirty diapers. Babies might not have as many dirty diapers, and there is a lot of variation here, especially for breast fed babies after about six weeks of age. A breast fed baby might only have one dirty diaper PER WEEK and still be very healthy. My daughter did this until she started eating solid food. After being assured by the pediatrician that it was normal, I was very happy to have fewer dirty diapers to change! It can be normal for a breast fed baby not to poop much, but at first, you might look for this:
  • Day 1=1+ dirty diapers
  • Day 2=1+ dirty diapers
  • Day 3 ON=3+ dirty diapers
• Weight gain. This is an important marker. If your baby regains their birth weight by two weeks, and then continues to gain weight at an average of 1 ounce per day, they are likely getting enough milk.
• Happy content baby. If your baby is generally happy and content and alert when awake, they likely have a normal energy level and are getting enough calories.

If your baby is not reaching these markers, you might visit with a lactation consultant (IBCLC). They can do a weighted feed to see how much milk your baby gets from breastfeeding, and can assess your positioning and the baby’s latch. Most of the time, just some minor modifications can improve your situation and give you the confidence and peace of mind to continue breastfeeding.