Overcoming the mirage of low supply: unveiling the truth

As new mothers, we want nothing more than to know we’re doing the best that we can for our babies. We want to ensure we can give them everything they need, and nourish them in every way, and low supply is a very big concern. As a breastfeeding mother, it can often feel hard to know exactly how much milk our little ones are taking in.

We also rely on reassurance from health professionals, which is why it’s essential for midwives, lactation consultants, maternal child health workers, doctors, paediatricians, or anyone else working with families to be extremely careful with the terminology used when discussing her baby’s weight with a mother. It’s very easy to make her doubt herself and her supply and damage the breastfeeding relationship. The words low supply gets thrown around easily and can really impact a mother’s perception of how well she’s breastfeeding.

Supply can be confusing to mothers, whether they’re having their first or fifth baby! After several weeks of feeling full her breasts may start to feel softer and she may worry her supply has dropped. Many people believe breastfeeding cannot be measured however, we can measure how many times we are feeding day and night, the baby’s output, baby’s behaviour, development, and growth. There are two factors mothers can fall into if they’re concerned about their supply, which are ‘perceived’ low supply and actual low supply.

But how do we know the difference?

Perceived Low Supply

When mothers contact me concerned that their supply is low, it’s vital to look at the big picture. In many cases, their supply is just fine. If their babies are showing all the signs they’re getting enough milk, mums can be reassured the reasons below are normal newborn behaviour, and the physical signs for mum are typical and physiological.

Some of the common reasons mums feel they have low supply:

Their baby becomes fussy and less settled
Their baby may cluster feed at certain times of the day or night
Breasts don’t feel full anymore
They are unable to express good amounts of milk
Milk is delayed ‘coming in’
They don’t get engorged like other mums
Their baby only feeds for a short time when they used to feed for longer
Their baby only put on a small amount of weight at the last weigh in

Actual Low Supply

When a mother is concerned about these symptoms or behaviours and their babies are not meeting the criteria outlined below, it’s more concerning, and this is where we would be questioning Mum’s milk supply. It’s essential to establish why the supply is low, and it could be one or more of the following reasons:

Poor positioning and attachment
Not enough feeding or pumping
Scheduling and timing feeds
Premature or jaundice baby with a lack of energy
Retained placental products

So how can you tell if your baby is getting enough breast milk?

They’re having at least 5 pale, heavy wet nappies (or 6 if you use cloth) after the first week of life
In the first week of life, they pass meconium (the lovely black tar-like stools!) by around day three, then transition to dark green stools before it turns a lovely yellow mustard colour as the milk changes from colostrum to mature milk
Regular yellow stools at least once daily for the first 6 weeks then 1-10 days beyond
Your baby is generally well-looking, with clear skin, eyes, and nice moist mucous membranes.
Their fontanelle (soft spot on the head) is nice and plump and not sunken in
Your baby is waking for regular feeds (8-12 times is the average a breastfed baby may eat daily), having some settled times
In most cases, they usually return to birth weight by around 2 weeks of age
Your baby is following their own upward curve on the World Health Organisation growth chart

In any case, where a mother is questioning her supply, it’s vital to get the support of a qualified International Board Certified Lactation Consultant to get a good look at the whole picture and work out a detailed plan to overcome any challenges she may be facing. Sometimes it’s just a matter of reassurance that everything is going well.

Read more about how to boost breastmilk supply here. To find a qualified IBCLC in your area, search on LCANZ website or if you’re in Melbourne please reach out to me for a consult.