Low Milk Supply

I am worried that I don’t have enough milk. How can I check?

Clare Byam-Cook says

If a baby is getting plenty of milk and has no physical problems (such as wind, colic or reflux) he will gain the right amount of weight and be happy and contented. Although breastfed babies are not expected to gain as much weight as a formula fed baby (new charts are coming out soon to reflect this difference) but he should still gain weight steadily. If your baby unsettled but is still gaining the right amount of weight, you should not worry about your milk supply but you should try to find out why he is unsettled – wind, colic or reflux being the most common causes.

If your baby is unsettled and is not gaining the right amount of weight, he is not getting enough milk and you need to find out whether this is because your supply is low or because he is not sucking well enough to get all the milk out. You can establish which it is by offering a top-up immediately after he has finished feeding on the breast; if he drinks some milk this shows that he wanted more than he got from the breast. You could use a breast pump to see how much milk was left in the breast compared with how much he took from the bottle. If you can easily express the same amount your supply is fine and it is his feeding that is the problem. In this case, you need to check whether he is latched on correctly and staying awake for long enough to take a full feed.  If you can’t express any milk, then your supply is almost certainly low.

If you are still struggling then a simple way of checking is to substitute several breast feeds with a bottle and then use the pump to see how much milk you can express at each feed compared with the amount he took from the bottle.

Note: A very small number of mothers can never express any milk with a pump, even before a feed when they know their breasts are full. If you are one of these mothers, using a pump after a feed to see how much milk is left in the breasts is not an option as it will not give the right information and may even lead the mother to believe that she doesn’t have enough milk, when in fact she does.

See Myths and Facts about expressing.