Low milk supply is one of the top reasons that parents stop chest/breastfeeding, not to mention a major stressor in the already trying days of early parenthood. There’s so much uncertainty and it can be hard to figure out what’s causing the low milk supply and—perhaps more importantly—how to get it up. But we’re here to help.
Why is my milk supply low?
There are many factors that can play a role in how much milk you produce:
- Insufficient chest/breast tissue. This can be caused by previous breast surgeries, especially breast reductions and cyst or tumor removal.
- Hormone issues. The hormone prolactin is responsible for milk production and can be affected by retained placenta, severe postpartum bleeding, thyroid diseases, high levels of stress or anxiety, diabetes, obesity, PCOS (polycystic ovarian syndrome), smoking and alcohol use.
- Infrequent/ineffective emptying. Milk production is all about supply and demand. When the body produces milk, that milk has to then be removed to signal for more to be made. The more milk that’s removed, the greater the milk-producing capacity.
- Obstacles to feeding. Sometimes, there are logistical challenges that can make it hard to produce and maintain a solid milk supply. This is often the case with preterm babies. Prolonged hospital stays, having a baby in the NICU (neonatal intensive care unit) and the inability for an infant to suck at the breast directly can all affect this process.
What medications help with low milk supply?
Galactagogues are substances that enhance milk production. These can be foods, herbs or drugs. Domperidone is the most widely used medication for milk supply, though there are some concerns about adverse effects on the lactating parent’s heart health and rhythm.
An Australian study had mothers report their perceived effectiveness when using different galactagogues. Domperidone use had the highest perceived effectiveness rating, 3.25 out of 5, but it also came with the highest number of reported side effects (40 percent versus 20 percent in those who used herbal galactagogues). This study found that lactation cookies (often oat-based), fenugreek and blessed thistle (more on those below!) were slightly to moderately effective with ratings of 2.5 to 2.75 out of 5. That lower chance of side effects is why many people who struggle with milk supply turn to herbal galactagogues before trying medications.
What are the best supplements to increase milk supply?
Herbal galactagogues have been traditionally used in many cultures to help the function of milk-secreting cells in the breast. Some can have estrogen-like effects to stimulate breast tissue and/or prolactin levels. Others might work by helping increase oxytocin to allow a stronger milk release and therefore more efficient milk removal.
Like the study mentioned above, much of the research we have on herbal galactagogues is anecdotal because it’s really hard to conduct properly controlled trials for breast milk volume. There’s a ton of variation in technique and feeding amongst parents and infants and it’s even harder to account for volume consumed by baby directly from the chest/breast. Sometimes we can use baby’s weight pre- and post-feeding, but it’s not practical to have parents properly weight their babies on the regular with feedings happening around the clock.
Fenugreek for milk supply
Fenugreek is a Greek hayseed that smells like maple syrup (because of this, having maple syrup-smelling urine is its most common side effect). The seed itself contains compounds such as mucilaginous fiber and steroidal sapogenins which are responsible for Fenugreek’s benefits. It’s been used around the world to help with chest/breastfeeding and may work by improving prolactin activity. It also has anti-anxiety properties and may enhance oxytocin to help with milk ejection.
One anecdotal study of 1,200 breastfeeding women found that almost all of those who used Fenugreek along with an electric breast pump reported increased milk production within one to three days. Another survey-based study in the U.S. found that of those who used Fenugreek, 54 percent felt that it helped improve their milk supply.
In a study of ten exclusively pumping women, they reported that milk production increased on average from 207 to 464 milliliters a day within one week of taking Fenugreek.
Blessed Thistle for milk supply
Blessed Thistle is a Mediterranean herb that’s often used in combination with Fenugreek. It helps stimulate blood flow to the mammary glands. Using Blessed Thistle with Fenugreek may lead to overall better results as reported by breastfeeding parents. Positive effects have been reported within six hours to five days of taking these herbal helpers.
Moringa for milk supply
Malunggay, also known as Moringa, is a plant rich in Vitamin C, Vitamin E and other antioxidants. Plus, it offers anti-inflammatory and other protective properties. Small studies out of the Philippines suggest that it can help increase prolactin levels and milk supply. In one of these studies, the average increase in milk volume of 124 milliliters was seen after seven days of taking Moringa.
The South Asian plant brings other perks during the fourth trimester (the first three to four months postpartum), which can be a challenging time for a lot of birthing parents. Fatigue, brain fog, poor memory and changes in mood are all common. Moringa can help during the postpartum period as it supports the function of the nervous system and may even enhance memory. Preliminary studies also show it may be useful in cases of depression.
Looking to get these herbal galactagogues with your daily supplement? Add the Lactation Boost to The Postpartum to support milk supply with these three research-backed botanicals, along with 24 other essential nutrients to support you and your babe.
What other tips can help with milk supply?
Aside from taking galactagogues, certain lifestyle habits can support you in chest/breastfeeding:
- Hydration levels. Breastmilk contains a lot of healthy fats and nutrients, but is also water-based, which means you need to be well hydrated to make milk. Aim to drink at least 2 litres of water per day.
- Breast and nipple stimulation. Stimulation and infant sucking triggers the release of prolactin. You can use your hands, a breast pump, or both! Stimulate each breast for about 10 to 20 minutes several times a day/night.
- Warm compress. A little heat helps relax the vessels in the chest/breasts, while cold constricts them. Apply a warm, moist compress directly to the upper portion of the breast (from armpit level to the top of the areola) for 10 to 15 minutes before feeding to get the flow going.
- Naps! Sleep can increase prolactin. If you’re especially exhausted or fatigued, getting extras shut-eye can help make more milk.
- Relaxation techniques. Try breathing exercises where you emphasize long slow exhales to decrease the “fight or flight” response. Relaxing music or a guided meditation can help, too. After all, mealtime is all about “rest and digest”—and that goes for both you and baby.
- Oats and oatmeal, especially steel cut! No one has really figured out the science on this one, but oats have been reported to have galactagogue actions. They’re also a nice warm comfort food full of fiber and nutrients.
- Skin-to-skin and cuddle time. Remember, skin-to-skin contact releases oxytocin, the milk-ejection hormone. This can help with breast emptying so your body can start refilling them.
- Nighttime emptying. Natural prolactin levels will always be highest in the middle of the night (around 2 a.m.), so this is prime time for emptying your supply! If you’re pumping, this is also when you should notice the highest volume produced, compared to day-time hours.
- Helpful resources. Reach out to a qualified lactation consultant and/or connect with breastfeeding groups such as La Leche League (lllusa.org or lllc.ca) and MOBI (mobimotherhood.org).
How do I know if my milk supply is improving?
If you’re doing a combination of chest/breastfeeding and pumping, it’ll be hard to know how much you’re making and how much baby is getting, but these are the most common signs to look for:
- Chest/breast fullness and engorgement
- Infant feeding behaviour (gulping) and satisfaction
- Total daily pumping amounts, if pumping
We know how stressful taking care of a newborn can be—and the added anxiety that comes with low milk supply. We hope these tips are helpful and that you can be gentle with yourself no matter which feeding path you take.
